Doctor Amir Khan has highlighted a widespread behavior that could be counterproductive. According to Doctor Amir Khan, going for a 'just in case wee' before bed or before leaving the house might make bladder symptoms worse. He noted that people often do this to avoid urgency or waking up at night, but it might worsen symptoms.
The Daily Express also reported that a doctor has issued a warning about going to the toilet, sharing a two-hour rule. Normally, the bladder functions through a coordinated system with the brain. Doctor Amir Khan explained that the bladder is a muscle that works with nerves to tell the brain when it's full, normally when holding 300 to 500ml of urine.
If you're someone who does a just in case wee just before leaving the house, maybe before a meeting, or before bed, sometimes even twice, this is really important for you. It might actually be making your bladder symptoms worse. I see this all the time in clinic, people going again, even when they've just been, because it feels safer than risking urgency or waking up in the middle of the night to go.
However, emptying the bladder early through 'just in case wees' retrains the system between bladder and brain, causing the bladder to get used to being emptied at lower volumes. He described how this retraining occurs over time. This retraining can lead to significant consequences, including urgency and urge incontinence.
According to Doctor Amir Khan, this retraining can lead to urgency and urge incontinence, where the bladder sends 'I need to go now' signals even when barely full. He analogized it to a car alarm becoming too sensitive. Doctor Suraj Kukadia, an NHS doctor, added that peeing every hour trains the brain to misfire and could create urge incontinence.
Your bladder is a muscle and it works with your nerves to tell your brain when it's full. Now, normally that signal up to your brain shouldn't come until your bladder is holding around 300 to 500ml of urine. But if you keep emptying it early, you know, those 'just in case wees', you start to retrain that system between your bladder and your brain. And over time, your bladder gets used to being emptied at lower volumes.
The Daily Express reported that excessive trips to the bathroom can trigger lasting consequences. To avoid these issues, doctors recommend adhering to a specific frequency for urination. According to Doctor Suraj Kukadia, you should be peeing, on average, every two to four hours, even if well hydrated.
This guideline forms the basis of the two-hour rule mentioned in the warning. Several unknowns remain regarding this advice. The specific medical evidence or studies supporting the doctors' claims about bladder retraining and urge incontinence has not been detailed in the reports.
I would say to my patients, it's like a car alarm that's become too sensitive. At first it only goes off when there's a real but then it starts going off at everything - a gust of wind, someone just walking past, that's what your bladder is doing. It starts sending, 'I need to go now' signals even when it's barely full, that's how urgency and urge incontinence develop or get worse. Because instead of emptying everything, you're teaching your bladder to signal to your brain you need to go earlier and earlier.
Additionally, it is unclear how many people are affected by this issue, and what the prevalence of urge incontinence related to 'just in case wees' is. Furthermore, potential risks or side effects associated with suggested retraining methods, such as pelvic floor exercises, have not been explicitly addressed in the available information.
So you end up waking up in the middle of the night needing to go even when your bladder isn't that full. And even though you went before you went to bed, you might not needed to but you went anyway.