But I Don't Have to Go ....
By Marja Sprock, M.D.

"I leak urine continually the entire day, but never get an urge to go." Another version is to never get an urge to go and then the bladder just starts emptying. Or "I never get an urge to go, but my lower abdomen causes me pressure discomfort."

"I sit in the chair, watching television or working on the computer, never feel an urge, till I stand up and there we go, I need an ambulatory toilet". Maybe you recognize your own problem in any of the presented ones or you may be thinking: "but they never got an urge" If I would get a dollar for every time I hear; "but I do not get an urge, I would get a nice tip every day."

As I often explain: just because you decide to drive a car without putting on your glasses and ignore another car causing an accident, does not mean the car was not there, just because your eyes did not register it. You wear glasses; the same goes for diminished hearing, your wear hearing aids. So you are still convinced a bladder always works properly and will tell you in time? You are thinking yes, because it is a bladder and not an eye or an ear: they are all organs and can fail or get diseased.

Some bladders, or more likely the nerve connection gets older or gets influenced by diseases like diabetes.

Lorraine age 74 came to the clinic.  She had been a teacher for years.  Lorraine used to be able to go hours on end without emptying or leaking. To her dismay in the middle of Home Depot-yes some women shop there too-her bladder emptied. She had not felt an urge at all. She had not emptied for 5 hours on end and had been drinking water from her water bottle. When I explained to her that after years of ignoring her bladder, it was now ignoring her and she had to start using her watch to void, I got the reply .... you guessed right ... "but I did not get an urge."

By the way Lorraine does wear glasses.

Elizabeth, age 67 would communicate with her friends and family on the computer for hours on end. When sitting your pelvic and abdominal muscles pull the urethra more closed and she could sit there dry, hours on end-without an urge to go. However as soon as she got up, there was no time to get to the bathroom. Elizabeth became very frustrated and angry, since she got no urge from her bladder and had no time to make it. When it was explained to Elizabeth, that if she had been sitting at her computer desk for 2 1/2 hours, it may have been a good idea to empty.  She replied "I do not get an urge."

The problem of leaking continually is often a little different and the bladder may not completely empty when prompted to void on the toilet and voiding by using your watch will not help much.

Besides nurses and teachers…. doctors too who tend to hold their bladder volume for a long time, there are non-profession related ways to ignore your bladder.

The recommendation to drink 8 glasses of water is interpreted by many as "the more the better." A normal bladder can usually maximally hold up to 16 oz. while not under anesthesia. A lot of us will empty at about 8-10 oz. since the entire abdomen will not feel uncomfortable. However if you drink bottles of 16 oz. every hour and do not feel like going to the bathroom-"again and again"- you will start ignoring the bladder’s signals to go empty. Once you start ignoring the bladder-eventually it will start ignoring you. A bladder ignoring you can lead to unexpected emptying in department stores, the car or in the office.

A vase is used to hold flowers - not drinking water.

If you drink 8 oz. of water , it will usually be in your bladder within 20 minutes, so maybe a good idea to plan your void, if your bladder does not warn you. Also there is no health benefit to large volumes of water. If you drink from anything larger than 12 ounces-it is called a vase and is used to put flowers in. On the 24 hour urine diary I have seen a lot of urine outputs over 3 quarts, which is excessive and can lead to all kinds of problems. Exercise every day is healthy; drinking water in excessive amounts is not. "I never heard that drinking a lot of water is not healthy for me". Well this may be the first time, it may be good to give it a try and see if it has anything to do with your leakage of urine.

By the way Kathy 54, for years had some very short black outs and nobody could figure out what was causing it. After she gave me her 24 hour urine diary and I witnessed her total output, it was clear her intake of fluid was excessive. Kathy was putting out 4 quarts a day. She thought she needed a sling for leakage; however I convinced her to cut down on her input and think. 10 oz. in, bathroom within 30 minutes.

Kathy who had been very reluctant with the recommendation came back so pleased. She had not had any more leakage and black-outs since she had cut down on her fluid intake. "Doctor I thought you were crazy, however you have made me very happy, I am dry without any surgery."

Sometimes simple adjustments in our activities and habits of daily living can make a big difference. If you are bothered by incontinence, your cure or improvement may be easily achieved or be more involved. If you drink normal amounts of fluids and go to the bathroom on a regular basis and still leak, do not hesitate and come to Central Florida UroGynecology in Rockledge. We can treat from simple to complicated; even if you…did not get an urge.

Central Florida UroGynecology in Rockledge. Call 321-806-3929 and schedule a consultation or leave a note here.