Why do you suddenly get desperate for a wee?

12 January 2016



I'll give you an example of a situation. You are driving a car and need to go to the toilet but there is nowhere to go so you can hold on for a long time, until you arrive home. As soon as you know where a toilet that you can get to is, you can no longer hold on and you have to rush to open the door to your house and run to the toilet. What is happening here?


Kat Arney put this question to Chris Smith...

Chris - I think this is a case of 'mind over matter' or maybe, more accurately, 'mind over bladder' in this case. When you are stressed about something, and I would put it to you that being stuck in a car on a motorway with an overactive bladder, thinking crikey where is the toilet, this is a stressful situation and this will initiate your 'fight or flight' reaction, which is a part of your autonomic nervous system, which is out of your control. It's under sub-conscious control and when you are under stress, then what happens is that you send very powerful supplies of nerve impulses to your guts to turn off your intestines, and to your bladder to make your bladder relax, because the last thing you want to do when you're trying to fight or run away is think, I need a wee, and this deters the bladder from activity. Now when you get home though, you now know - ahh respite is within my grasp, I am nearly home. And then what happens is those nerve impulses that were strongly inhibiting the contraction of your bladder and were making your bladder relax, and relax, those nerve impulses are now turned off. And so now the bladder begins to gain activity, and begins to compress the urine and you become much more exquisitely sensitised to the stretch in your bladder - thinking I really, really, really need to go to the loo, and so I'm going to run to the loo. And that's the reason why. I think it's because it's a psychological thing. You now know that helps at hand, you know you can make it, you now feel much more relieved before you relieve yourself and so you begin to then think - now I really do need to go to the loo.

Kat - But, of course, you should have gone before you left. That's always the thing, isn't it?

Ginny - I think there's a pavlovian element as well in that you associate seeing a toilet with going to the toilet, so seeing the toilet makes you need it more. I know that for me, if someone mentions the word 'toilet', it makes me want to go.

Kat - Like turning the taps on and things like that?

Ginny - Yes, all of that. I'm terrible.


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