Urinary Urgency: Avoid going “just in case”

This is the fourth installment in our Healthy Bladder Series! Click here to see the first installment about problems associated with “hovering” over the toilet seat to urinate, click here for the second article about how to FULLY empty your bladder, and click here for the third installment about eating for a healthy bladder.

Today’s Healthy Bladder Tip: Avoid going “just in case,” or “just one more time.”

As for the going “just one more time” question, here’s the simple answer: It’s a BAD HABIT. Going “just one more time” or “just in case” when you don’t actually have to urinate may result in the feeling that your bladder is the size of an acorn.

Basically, when you use the bathroom every time your bladder fills just a little bit, or if you constantly empty your bladder to prevent having an “issue” later, you create a hypersensitive bladder.Your bladder will begin to send signals to your brain that it is full even when it isn’t. This can cause uncomfortable feelings of urgency and will result in inordinate trips to the bathroom.

My advice is to go ONLY when you actually need to go. Use the bathroom before a long car trip, of course, but if you are just going to the grocery store and your bladder isn’t particularly full but you’re tempted to go “just in case,” don’t! Just wait! Allow your bladder to fill on its own time to prevent the trap of creating a hypersensitive bladder that will leave you unnecessarily chained to the restroom. Okay, that might be a bit dramatic, but hopefully you get my drift.

restroom sign

ride the wave

You may have noticed that the feeling of “OMG I have to pee SO BAD!” comes in a wave. It builds, then it peaks, but if you get distracted or if enough time passes you may find that the “wave” of urgency subsides. The feeling may not go away completely, but it certainly decreases.

There are two problems with running to the nearest restroom at the peak of the “wave.” First, you are reinforcing the mental suggestion that using the bathroom should happen in an emergency-like state. The mind-body (and brain-bladder) connection is HUGE and not something to be trifled with! If you are always rushing to the bathroom in a state of distress, your brain will start to associate peeing with urgency, EMERGENCY, and distress. Pretty soon, every time that “wave” of needing to urinate begins, you’ll be RUNNING. Just like Pavlov’s dogs, you will have trained yourself that needing to pee = an emergency situation.

Here is a solution to undo the classical conditioning described above: Try to “ride the wave.” Do not run to the bathroom at the height of urgency. Rather, move through that stage. When the urge to urinate subsides (it won’t altogether go away, but when you’re no longer at the height of urgency), calmly walk — DO NOT RUN — to the restroom. Decondition yourself from associating the urge to urinate with an emergency.

Here’s a tip to help make the “wave” subside. When the urge to urinate is quite strong, try doing three to five kegels. Kegels cause your pelvic floor muscles to tighten around your urethra which helps close it off (like clamping a hose). The external pressure around your urethra can actually decrease the feeling of urgency by sending a signal to your central nervous system that “now is not the time.” This allows the wave of urgency to subside. After the wave subsides, walk to the restroom in a calm, unhurried manner.

sit on it

Similar to the last tip (completing three to five kegels), you can also mechanically close off the urethra — thereby inhibiting the feeling of urgency — by strongly sitting on your perineum. The perineum is the area between your vagina and your anus. Upward pressure in this area will serve a similar purpose as a kegel. Try sitting on your hand, your foot (bend one leg so the heel is under your perineum), a rolled towel, or the edge of your chair. It might look a little funny, but if you are unable to do three to five kegels as mentioned above, sitting on your perineum might help you “ride the wave” so that you can make it to the bathroom without a feeling of extreme urgency (and without having an accident)!

chill.

Here is an unfortunate trick of nature that compounds the problem I first talked about: When you really have to go — when the situation is dire and you’re STRESSED about making it to the bathroom on time — your mind starts racing, you stop focusing on physically holding back the urine, and it’s easier for an accident to happen. Furthermore, adrenaline starts coursing through your body, which contributes to the “fight or flight” response. You know what often happens in “fight or flight” mode? Certain bodily functions take back burner, and running (or fighting, as the namesake case may be) take priority. When bodily functions take back burner, bladder control goes out the window. Have you ever heard of people who pee their pants when they’re scared? Like in a haunted house, on a roller coaster, or during/after a car accident? That’s fight or flight in action. So chill out. Even if you don’t feel relaxed, your bladder needs you to “fake it til you make it” in order to maintain control.

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walk, don’t run

I’ve already said “walk, don’t run” — but it bears repeating.

This goes hand in hand with the info just presented about “chilling.” When you’re literally running to the bathroom at the height of urgency, your brain is focused on the urgency and your body is focused on running/getting there in time. Where does that leave your bladder control? Nowhere good!

So to put it all together, when you feel the wave of urgency, try to ride it out. You may want to do 3-5 kegels or put pressure on your perineum to help the wave-like sense of urgency subside. Then take a deep breath, relax, and walk (rather than run) to the restroom.

Try this EVERY TIME you use the restroom for the next week or so. You may feel (a lot!) less urgency using these few simple tricks.


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