Should You “Go” Before You “Leave”?

The Behavioral Side of Peeing

Your bladder is a muscle — I’m sure you’ve heard that, and it’s a little true.  There is a muscle that sits on your bladder, called the detrusor. It’s job is to assist your bladder in the filling and voiding of urine.  As your bladder fills, the detrusor remains relaxed; then once filled the detrusor contracts and assists the bladder with emptying (voiding) of the urine inside.  Like most muscles, the detrusor has another muscle that “counteracts” it; we call these other muscles “antagonists”. Much like the biceps and triceps are antagonists of one another; one bending the elbow (biceps) and one extending the elbow (triceps); the detrusor is in an antagonistic relationship with another set of muscles – the pelvic floor.

The pelvic floor muscles are responsible for communicating with the detrusor muscle whether or not it’s an appropriate time for you to urinate (void).  Once the bladder reaches a certain level of fullness, the detrusor contracts, signaling to your brain that it needs to empty. Your pelvic floor has one of two options:  Relax – and allow for the detrusor to empty the contents of the bladder, or Contract – and communicate to the detrusor (and your bladder) that it’s not a good time to void, and it needs to wait (relax).

What is responsible for the upset of this relationship?  

A lot of things can be the cause for the disruption in the relationship between the detrusor and the pelvic floor musculature, we’ll just cover one of them in this article:  Behavioral Voiding

Behavioral Voiding means urinating when your brain has not received the signal that you need to go (the urge).  This would include going to the bathroom because: you’re leaving the house, or you’re about to leave work, or you’ve just gotten to a store and don’t want to be interrupted.  If you are going to the bathroom simply because you “think you should” and not because you “feel the urge” on a physiological level – you are participating in Behavioral Voiding.

But why is it bad?  

Behavioral Voiding teaches your bladder that it needs to empty prior to it being necessary to empty, and may actually cause urinary retention.  What this may eventually do is create the “urge” to go when you’re bladder is not adequately filled, resulting in increased trips to the bathroom, confusing your pelvic floor muscles and bladder, possible leakage, and increased dependence on the toilet.

What can you do?  

Timing your trips to the bathroom can be helpful.  As a rule we should be urinating 6-8x/day; and should not be urinating any more frequently than every two hours.  

If you are urinating more frequently than that, you may want to speak with your doctor and see a physical therapist who specializes in incontinence and pelvic floor dysfunction for help.

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