Ho Chi Minh City Ms. Phuong Anh, 36 years old, is busy with work so she often holds her urine, causing her bladder to expand twice as much as normal, losing the feeling of needing to urinate.
The woman is a department head at a software company, working continuously from morning to night, drinking little water, holding her urine. Over time, she no longer feels the need to urinate, only when her stomach is full and aching does she go to the toilet but has difficulty urinating, and the urine stream is weak. Recently, she has been urinating blood, bought medicine to take herself, drank more than a liter of water but still has no need.
On October 18, Dr. Le Phuc Lien, Head of the Female Urology Unit, Center for Urology - Nephrology - Andrology, Tam Anh General Hospital, Ho Chi Minh City, suspected that the patient had an over-dilated bladder due to holding urine for a long time, leading to loss of sensation, with the risk of bladder muscle paralysis. The patient also had a urinary tract infection, causing blood in the urine.
Urodynamic measurements (bladder pressure measurements) showed that the patient's bladder capacity was twice as large as a normal person's, able to hold 700-1,000 ml of water. Doctor Phuc Lien said that the patient was lucky that his bladder muscles had not been damaged.
Doctor Phuc Lien monitors the patient's urodynamic measurement results. Photo: Anh Thu
Dr. Lien prescribed internal medicine and instructed the patient to urinate every 2-3 hours, not to hold it for more than three hours, and to practice bladder muscle exercises every day. If the patient followed the instructions well, the bladder muscles and the feeling of needing to urinate would recover, the risk of urinary tract infection would decrease, and the blood in the urine would disappear.
At Tam Anh Hospital in Ho Chi Minh City, about 50% of young people come to see a urologist because of loss of sensation in urination, urinary incontinence, urinary tract infections, and blood in the urine. What they have in common is that they drink little water, hold their urine for a long time due to busy work, forgetfulness or lack of attention to their health. This condition is also common in older people with urinary tract diseases or weakened bodies due to age.
According to doctors, if you hold your urine for a long time, your bladder will have to expand to contain all the waste water. Over time, your body will lose its natural reflex to urinate on schedule and lose the feeling of needing to urinate. The muscles that close or open the urethra to prevent urine from flowing out gradually lose control, causing urine to leak out (dribbling or frequent urination), especially when laughing loudly, sneezing, or coughing.
If the bladder muscle is overstretched for too long, it will cause paralysis. At this time, no medicine can stimulate the bladder muscle to work again. The patient cannot control the need to urinate.
Urine that stays in the bladder for too long can also cause urinary stones and urinary tract infections. The risk of these diseases is higher if the patient does not drink enough water. Women, especially pregnant women, are more susceptible to urinary tract infections because the urethra is shorter than men.
Recurrent urinary tract infections can lead to another complication called interstitial cystitis, which causes low urine output, frequent urination, and persistent bladder and pelvic pain. Interstitial cystitis cannot be cured, and can only be treated with temporary pain relief.
Nurses use urodynamics to examine bladder function. Photo: Anh Thu
Dr. Lien said that holding urine for a long time not only harms the bladder but also causes urine to flow back to the kidneys, causing infection or kidney damage, the most serious of which is kidney failure. This is the final complication of urinary diseases. Kidney failure cannot filter toxins and waste from the blood, causing the body to decline. There is currently no cure for kidney failure, only a way to slow the progression of the disease. End-stage kidney failure requires dialysis or a kidney transplant to sustain life.
Doctors recommend that people urinate every 2-3 hours, avoid having an overfull bladder, and limit holding urine. Urinating less than 8 times a day, with urine flowing easily and feeling like the bladder is empty is normal. Adults urinate 1-2 liters of water per day, depending on the amount of water taken in and the ability to lose water through sweat and breathing.
People with symptoms such as blood in urine, urinary retention, urinary incontinence, loss of the urge to urinate... should see a urologist immediately for diagnosis and early treatment.
Anh Thu
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