According to the Daily Express, a doctor has issued a warning about a common habit before bed. Doctor Amir Khan stated that going for a 'just in case wee' before bed or before leaving the house might make bladder symptoms worse. Normally, the bladder and brain communicate in a feedback loop.
Doctor Amir Khan explained that the bladder is a muscle that works with nerves to tell the brain when it is full. Typically, the signal to the brain should not come until the bladder is holding around 300 to 500ml of urine. Doctor Suraj Kukadia added that stress receptors in the bladder wall detect volume increase, and when the bladder is half full (around 150 to 200 ml), stretch receptors send a signal to the brain, causing a mild urge awareness.
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, if you keep emptying the bladder early with 'just in case wees', you retrain the system between the bladder and brain, according to Doctor Amir Khan. Over time, the bladder gets used to being emptied at lower volumes. Doctor Suraj Kukadia noted that relieving yourself too often could be sending the wrong message to your brain.
He said that if you pee every time you feel even a hint of bladder fullness at small volumes (like 50 or 100 ml), your brain starts learning the wrong pattern. This can result in the brain recalibrating to think 'bladder at 50-200 ml - time to pee'. This retraining can cause the bladder to send 'I need to go now' signals even when it is barely full, leading to urgency and urge incontinence, as stated by Doctor Amir Khan.
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.
Doctor Suraj Kukadia elaborated that the urge signal becomes stronger, more frequent, and more intense, with stress receptors becoming hypersensitive and firing at lower volumes (false alarms). To prevent this, Doctor Suraj Kukadia recommended that you should be peeing, on average, every two to four hours, even if you are well hydrated. He warned that if you are peeing every hour, you are training your brain to misfire and could be creating urge incontinence.
For those already experiencing symptoms, retraining techniques can help correct the bladder-brain loop. Doctor Suraj Kukadia advised that you can retrain the brain-bladder loop by stopping and staying still when you feel a strong urge, and tightening and relaxing your pelvic floor rapidly. The specific clinical evidence or studies supporting these doctors' claims about bladder retraining and urge incontinence remain unclear.
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.
It is unknown how many people are affected by this issue or the prevalence of urge incontinence related to 'just in case wees'. Additionally, there are no confirmed medical guidelines or official health recommendations from organizations like the NHS regarding the frequency of urination and bladder training. Long-term success rates and potential risks of the retraining methods suggested by the doctors have not been detailed.
Factors like age, gender, or pre-existing medical conditions that might influence the effectiveness of these bladder retraining techniques are not specified.
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.