5 stupid questions about the bladder. Urologist answers

Can a bladder burst, how many times is it normal to get up to go to the toilet at night, and what happens if you endure it for a long time?

A urologist at the urological office of the Center for Medical Rehabilitation of the National Medical Research Center of the Russian Ministry of Health, explained what the bladder is and answered the most important questions about its work. 

1. Who has a smaller bladder – women or men?

Oddly enough, men have a smaller bladder volume – on average, 400 ml. For women – 500 ml. This is due to anatomical features: women have a wide pelvis and the bladder has room to expand.

The bladder is different in men and women, but the differences in shape are insignificant and do not change the functional characteristics of this organ.

Please note that these values ​​are average. There are also individual characteristics, for example, those associated with professional activity, when the patient does not have the opportunity to go to the toilet for a long time.

2. If you often run to the toilet, is this normal?

At night, for both men and women, getting up more than once is considered wrong. If we get up 2-3 times, this is considered a pathology. We should go to the toilet no more than 8 times a day. Average daily rates are from 4 to 6 times.

A change in the number of urinations per day is a reason to consult a doctor. There can be many reasons – inflammatory processes, signs of an overactive bladder, urolithiasis, in men it can be signs of prostate adenoma, inflammation in the prostate.

But not always – it also happens that frequent urination may be a consequence of taking any medications. For example, combined antihypertensive drugs.

If frequent urination predominates, you need to consult a doctor and think about what the reason might be. For example, in the morning, many people complain that when they start getting ready to go to work, the need to go to the toilet increases sharply.

It happens that patients go 3-4 times in the morning in small portions, even though they really want to. But when they leave the house, they switch to the road, work, and there is no more frequent urination. This is pathology.

Or, for example, a patient drinks coffee before work on weekdays, and this makes him go to the toilet more often. And on weekends he doesn’t drink coffee, and there’s no such problem. Such little things have serious diagnostic significance for the doctor, so the patient must observe himself.

3. Can the bladder burst?

The bladder may burst, not due to overfilling, but due to injury. But for this, certain factors must be taken into account. If we take a healthy person: let’s say he’s been driving for a long time in a car, and he’s already accumulated half a liter of urine. Under such conditions, the bubble will not burst; it will continue to stretch, maybe even up to a liter.

But if a person with a full bladder gets into an accident and the bladder area is hit, there is a small chance of the bladder rupturing—literally a few percent.

If we are talking about a patient with a chronic bladder disease, who always retains more urine, say a liter. His bladder walls are thin and flabby. Due to this injury, the pressure that is placed on the bladder can lead to rupture. Urine leaks into the abdominal cavity, peritonitis begins and mortality is quite high in these cases.

Why does this happen: a sharp increase in hydrostatic intravesical pressure when we put pressure on it, such as an impact, can lead to rupture. Moreover, if we are talking about some kind of injury or accident, the bladder does not have to be full to burst.

4. How much urine does it take for a person to want to go to the toilet?

On average, if you take a healthy person, the urge is formed with about 150 ml. But we must take into account that our nervous system is designed in such a way that we suppress these sensations.

There are patients who, as soon as they feel the urge, immediately run to the toilet. This is also wrong: the bladder is, one might say, a muscular pouch. It should stretch and contract. We urinate not because of gravity, but because the bladder can contract. Like any muscle in the body, it needs work. If we don’t fill it enough, it loses its capacitive function and will no longer be able to hold normal volumes of urine.

A good, well-formed urge occurs at 200-300 ml. In pathological conditions, these sensations change. For example, if the patient has chronic urinary retention, and the patient does not feel the urge even with a liter. And with an overactive bladder, on the contrary, the urge begins from 20–30 ml.

In general, these are approximate volumes. The exact indicators vary from person to person.

5. Can you endure it for a long time when you want to write? 

In principle, it is possible if life circumstances require it. But it is not advisable to do this. As I already said, overdistension of the bladder occurs, and perhaps you have noticed that if you wait for a long time, when you reach the toilet, the stream is not so strong.

This indicates overstretching of the bladder, its microtraumatization. Therefore, if life circumstances require it, you can be patient. But systematic stress on the bladder can lead to disruptions in its functioni