Should I Wait or Should I Go?


By Mary H. Palmer, Helen W. & Thomas L. Umphlet Distinguished Professor in Aging, UNC School of Nursing

Habits, as we all know, are the particular acts or ways of acting that we tend to do regularly. Our habits at work are often different than our habits when we are alone at home. We have habits related to many types of activities, such as working, eating, exercising, and even toileting.

Yes, we all have toileting habits, but like many of our other habits, we often don’t give them much thought. However, just as with our exercising and eating habits, our toileting habits can have health consequences over time.

What about you? Do you habitually wait so long to empty your bladder that you think you won’t make it to the bathroom in time? Do you sit on or hover over the toilet to urinate? Some women say, “It depends on where I am.” In a recent survey, most women said that they sit on the toilet to urinate when they are at home but that they’ll hover or crouch over the toilet when using a public restroom.

Which toileting habits are best for bladder health? The unfortunate answer is, we don’t know yet. However, recent studies have shown a link between waiting too long to urinate and lower urinary tract symptoms, like bladder leakage. Other factors may be involved too, like obesity, but there is growing evidence that our toileting behaviors can affect our bladder health.

When we were young children and just learning how to control our bladders, we were taught to pay attention to the urge to go. Yet as adults, many of us will ignore the urge to go because we don’t want to – or can’t stop what we’re doing – to use the toilet. When you don’t respond to your bladder’s increasing demand to urinate, several things happen. The pressure in your bladder increases and it can start to contract in response to the stretching of the bladder wall. Your bladder sphincter and pelvic floor contract more forcefully in an attempt to hold urine in the bladder, and if you avoid urination for too long, your bladder will ultimately “win” and leakage will occur.

Even if you don’t immediately leak, habitually delaying going to the bathroom can lead to over stretching which damages your bladder wall muscle. This in turn can lead to to the inability of your bladder to contract sufficiently so that you empty completely, as well as the development of kidney damage from “backed up” pressure from the bladder.

So, until we have more evidence about the effects of toileting behaviors let’s try to do the following. Go to the bathroom when you know you need to, don’t delay! Sit on the toilet seat so that you can relax and let your bladder empty completely. Paying attention to your bladder can help it and you, stay healthy!

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