Buzz
Perhaps you overhydrated before a meeting, or perhaps you were on a long road trip where no one else needed to stop, and you didn’t want to interrupt the journey. Maybe you downed a 54-ounce soda during Titanic and chose to endure the final 45 minutes.
Regardless of the situation, chances are you've found yourself tightening your pelvic muscles to hold back a flood of urine until you could finally relieve yourself. You might have even wondered: is there any harm in withholding the urge? Could your bladder rupture? Could you have an embarrassing accident? Are you putting your body at risk of lasting damage from such an experience?
"In most cases, for a rare occurrence, people with healthy urinary systems aren’t likely to suffer lasting harm," says Howard Adler, medical director of the prostate care program and clinical associate professor of urology at Stony Brook Medicine, in an interview with Mytour.
Adler emphasizes that it's the occasional instance that matters. On average, people typically urinate between four and seven times per day, depending on how much fluid they’ve consumed. If you're someone who frequently holds it in, you're risking some unpleasant consequences.
One group of people notorious for holding in their urine are nurses, who, due to their demanding eight- to twelve-hour shifts, often skip bathroom breaks. This behavior has been labeled "infrequent voiding syndrome"—or as it’s sometimes called, "nurse's bladder." A 1991 study of 72 female nurses revealed that those who frequently held it in actually increased their bladder capacity from the typical 500 milliliters to 1100 milliliters (about 16 ounces to 37 ounces, the size of a standard water bottle).
No significant negative effects were observed, but over time, stretching the bladder to unusually large sizes (metaphorically speaking—an elephant's bladder holds about 42 gallons) could eventually lead to changes in urination patterns. Holding in so much urine can weaken pelvic floor muscles, making it harder to control the urge to go. In rare cases, infrequent voiding might lead to urinary tract infections or kidney damage, and drinking less to avoid bathroom breaks might increase the risk of developing kidney stones.
But could a Big Gulp combined with a traffic jam cause a real medical crisis? According to Adler, while it's "theoretically possible" for a bladder to burst from excessive urine, this is unlikely unless the bladder has been previously compromised by outside trauma. For example, someone who drinks too much and then gets into a car accident might rupture their bladder in the collision. It's also possible to have an accident, but it's rare.
Adler clarifies that those who hold it in for long periods—typically eight hours or more—are the ones at risk. A two-hour meeting or movie won’t likely cause harm. On average, people produce 1–2.7 ounces of urine each hour. Even if you're drinking plenty of water, it will take time before your bladder reaches maximum capacity and you begin to feel discomfort. If you need to hold it, it’s fine, but don’t make it a regular habit.
