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Doctors & Advice, Family Health

5 Ways You Could Pee Better

BY COLLEEN MORIARTY November 7, 2019

Common urination habits could contribute to bladder problems.

It’s one of the simplest things you do every day—relieve your bladder. Bathroom visits are so automatic, chances are you’ve not put much thought into whether or not you are urinating in the healthiest way possible. But, there are common bathroom mistakes people make that can lead to unnecessary urinary health issues.

"As urologists, we see many patients with urinary complaints, and sometimes our advice is as simple as educating the patient on healthy voiding habits,” says Yale Medicine urologist Joseph Brito, MD.

Find out if you’re making any of these common urination mistakes.

Mistake 1: Holding it

The sensation of having to “go” usually leads to a trip to the restroom. “But, sometimes life gets in the way—a long car ride, a movie, or simply doing something fun can cause a delay,” says Dr. Brito. Even though it can be inconvenient to stop what you’re doing and use the bathroom, urine-holding may lead to a variety of issues. “Ignoring an urge to urinate may lead to leakage. Or, it’s possible that chronic bladder ‘overstretching’ may lead to new bladder symptoms down the road as people age,” says Leslie Rickey, MD, a Yale Medicine urologist who specializes in women's pelvic floor problems.

Delaying bathroom breaks is problematic for kids, too. Urologists occasionally see children with recurrent urinary tract infections (UTI) or foul-smelling urine. This is commonly associated with urine-holding, Dr. Brito says. “Encourage your children to take their time in the bathroom, and remind them to take breaks from their activities for it,” he says. “The best advice is to visit the restroom when you feel like you have to go; however, if you have to urinate very frequently, like every hour, you should talk to a physician.” 

Mistake 2: Not emptying fully

When you’re in a rush, incomplete bladder emptying can cause issues far more problematic than taking the extra minute or so in the bathroom. Similar to urine-holding, incomplete bladder emptying allows a reservoir of urine to collect that can potentially cause urinary infections. It can also increase the odds of developing another painful problem—bladder stones, which are salt crystals that sometimes form when urinary concentration or ‘stasis’ develops.

Incomplete emptying isn’t something you are always aware you're doing, but it’s a good idea to make an effort to ensure you are emptying your bladder, says Dr. Brito. He says this is a particular problem for older men with prostate issues. For them, incomplete bladder emptying can lead to a smaller functional bladder capacity and subsequent urinary frequency and urgency problems. 

“Often as men get older, they will not completely empty their bladder. The problem there is, if your bladder's full and you empty it halfway and then drink fluids like you normally would, it fills up more quickly,” says Dr. Brito.

Incomplete bladder emptying becomes a problem as men age because of prostate enlargement (also called benign prostate hyperplasia or BPH), a common condition. This can bring a number of symptoms including increased urinary frequency, urgency, and nocturia (nighttime urination), as well as incomplete emptying. “BPH is usually not a dangerous condition,” Dr. Brito says, “but the symptoms can become pretty frustrating and often life-altering.” Though it is rare, these symptoms can also be a sign of something more serious like prostate cancers, and therefore should be discussed with your primary care physician or urologist.  

“Sometimes educating patients to take their time in the bathroom and ensure their bladder is as empty as possible can help,” says Dr. Brito. Other times, patients may need medications or surgery to help the bladder empty better.

Mistake 3: Going too often

One more trip to the bathroom before rushing out the door may seem like smart planning, but it can backfire. The danger is that you can end up “training” the bladder to respond to small volumes, which can lead to overactive bladder symptoms—the sensation of needing to urinate more frequently than is normal, explains Dr. Rickey.

“Going too often at night can also be a problem for men who then can’t fall back to sleep,” says Stanton Honig, MD, director of Male Urology, adding that this condition, called nocturia, can affect quality of life. “If this is bothersome to patients, there are treatment [medications] for it,” says Dr. Honig. 

Other problems can also cause increased urinary frequency, such as an infection along the urinary tract. Therefore, if you find that you need to visit the bathroom far more often than you used to, talk to your primary care physician or urologist. You may need a urinalysis (urine test) to rule out a UTI, as well as to check for blood in the urine (hematuria), which can happen to a small number of people with an overactive bladder who have a bladder tumor, Dr. Brito says. “Blood in the urine is never normal and usually requires further testing to determine its cause,” Dr. Brito says.

Diet can also be a factor for people who notice an uptick on their need to pee. “The bladder is increasingly sensitive as we age,” says Dr. Brito, “and urinary frequency can be due to certain ‘irritative’ foods and beverages such as caffeine, alcohol, carbonated beverages, chocolate, spicy foods, and acidic foods.”

Some people may also visit the bathroom frequently in an attempt to avoid leakage. Although urinary incontinence (an unintended loss of urine) is common and affects a large number of women, it is not something you should just live with,” says Dr. Rickey. “Directed pelvic floor muscle exercises [physical therapy] can resolve these symptoms.” Other treatments such as medications and minimally invasive procedures are available, too, to help with urinary frequency, urgency, and incontinence.

Mistake #4: Pushing

You shouldn’t have to use your muscles to force urine out. A healthy bladder works best if the body just relaxes so that the bladder muscles naturally contract to let the urine flow, rather than using the abdominal muscles to bear down as with a bowel movement.

In men, the need to push urine may be a sign of bladder outlet obstruction, which is commonly due to BPH. “This benign condition causes swelling in the prostate and problems starting the urine stream—or a weak flow,” says Dr. Honig.

Women are less likely to have bladder outlet obstruction, though advanced pelvic organ prolapse can lead to difficulty starting the flow of urine, says Dr. Rickey. The main symptom of prolapse is seeing or feeling a vaginal bulge; it is the result of the pelvic organs (vagina, uterus, bladder, or rectum) descending into the vaginal canal due to weakened pelvic organ muscle support. Having to work hard to push your urine out can also lead to other problems such as hemorrhoids or a worsening of hernia symptoms, explains Dr. Brito.  

If you can’t help but push urine out, see a urologist or primary care doctor to determine if you need medication, specific exercises, or other therapies to address your underlying urinary issue.    

Mistake #5: Not drinking enough water

Many urinary complaints are related to poor hydration. Generally speaking, if your urine is clear or very light, that's a sign you are drinking the right amount of water. If your urine is dark yellow or amber, that's usually a sign of dehydration.

Odor, an "off" color, and (occasionally) the sense of burning while voiding (dysuria) are other signs that might indicate you are not properly hydrated. Not drinking enough water can contribute to UTIs and kidney stones. Concentrated urine can irritate the lining of the bladder, making it more sensitive. It is also more likely to form kidney or bladder stones.

“Many patients ask if drinking alternative fluids will suffice, but many beverages contain high sugar concentrations or caffeine, which can have other health effects,” says Dr. Brito, noting these might make overactive bladder symptoms worse. “Water is the safest option to maintain hydration and keep your kidneys and bladder healthy.”

There are some conditions that can make your urine appear more concentrated even if you are well-hydrated, such as liver problems or hematuria. So, if you are drinking enough water (about 2 quarts a day) but have dark-colored urine, odor, or burning, it’s worth a trip to a urologist, who can evaluate your symptoms more closely. 

"The ability to urinate freely and without difficulty is taken for granted by most people," says Dr. Brito. So, next time you have to “go,” follow the above advice for better urinary health.

For more information about Yale Medicine Urology, click here.