I have two questions for those folk out there that know a lot more about medicine than I do. They relate to that little incident about someone dying from “holding their wee for a Wii”.
I’ve seen on this board and other places that holding your urine too long can give you a bladder infection. Huh? Since if you don’t already have a bladder infection your urine is sterile, how can holding it possibly give you a bladder infection? Even if you already have a mild bladder infection, how is holding your urine going to make it worse, given that presumably you will let it go sometime in the next day or two? I can certainly see the possibility of nephritis (kidney infection) if contaminated urine backs up, but not cystitis. I also know about hydronephrosis (I’ve even had that as an indirect result of being paraplegic), but that’s not an infection.
Has anyone really ever ruptured their bladder simply by holding their urine too long without also getting hit in their lower abdomen or having something else happen that would contribute to rupturing their bladder? I would have thought the urine would just back up enough that your kidneys would temporarily shut down (back to hydronephrosis again).
I read recently that this is largely bunk. The bladder has a fail-safe mechanism to dump urine through a sphincter in case of impending failure resulting in an uncontrolled pants wetting. I have no cite but it seemed reputable.
One of the major ways that your bladder contents are kept sterile is by not letting its contents stagnate. In other words, and especially in women, there is “always” a little bit of bacterial contamination. But that’s OK so long as the bladder is emptied fairly regularly. OTOH, if it stagnates, then there is time for the bacteria to multiply and and infection can result.
A normal person will not rupture their bladder if they “hold it in” too long (or, what it more likely, if there’s an obstruction to emptying it - such as an enlarged prostate in a man). Instead, the urine backs up, putting pressure on the urine tubes (ureters) and the kidneys themselves. The result is something called hydroureter and hydronephrosis.
That being said, however, I, personally, have taken care of a woman whose bladder did rupture after she held it in too long on a turbulent trans-Pacific flight where the passengers weren’t allowed out of their seats. BUT, she had previously received X-ray therapy to her pelvis for a gynecological cancer (I can’t recall which particular organ had been the target). The radiation, which had involved her bladder, had caused it to lose its normal flexibility and distensibility. At the risk of grossing you out, after “holding it in too long”, she began to leak urine out of her belly-button. :eek: Honest to God.
The abnormal ureter (urine tube connecting the kidney with the bladder) is on the patient’s left, i.e. the right side of the X-ray from your perspective. Note the difference in its caliber near the bottom (where the bladder is - the dense area of whiteness near the bottom) compared to the other side.
Note also that is the dye which looks whitish on this X-ray.
Except in cases like that discribed byKarlGauss, bladder rupture is seen mostly in post tavern car crashes. Since ETOH can cause temporary loss of feeling, a distended bladder can be ruptured by the seat belt. When I worked as a trauma nurse, I saw three.