Medical Myths: Holding your urine in can rupture your bladder

Questionable Medical Advice:

Ok, so this isn’t bad advice per se, but it does relate to an interesting medical myth - that you can die by not urinating out of “politeness” or forcing yourself not to urinate for other reasons. You can hurt yourself and cause UTIs by holding your urine, but you can’t die from a ruptured bladder due to not going to the bathroom.

Truth:

Your urethral sphincters make it physically impossible to build up urine in your bladder to the point of rupture. The kidneys and ureters cannot produce enough pressure to burst the bladder. When there is an obstruction, the kidneys fail first. In the case of trying to hold it, the body would protect the kidneys by reacting violently, forcing urethral sphincters to fail and causing the person to wet themselves.

Historic Notable Case:

Contrary to popular belief, Tycho Brahe never died of “retaining urine at the banquet table out of politeness”. The original cause of death was assumed to be a kidney stone causing him to be unable to pass urine, but even that wouldn’t cause urine retention and bladder rupture before it caused kidney failure.

Either way, Brahe is now believed to have died from mercury poisoning, since bloody urine, extreme difficulty urinating, delirium, and high fever, are all known to be characteristic symptoms of over-exposure/consumption of high levels of mercury. The delirium without hallucination repeatedly noted by his physician in his last days of life is highly unlikely to have appeared in a case of pure kidney failure or peritonitis [which would have been the direct cause of death if retaining urine was why he died].

Recent notable case:


Jennifer Strange - in Jan 2007, Jennifer Strange was widely reported to have died of bladder failure during the “Hold Your Wee for a Wii” contest. The contestants had to drink a full glass of water every 10 minutes and not go to the bathroom to win, so it seemed like a plausible cause of death.

However, the true cause of death was acute hyponatremia [as a result of hyper-hydration], when the electrolytes [sodium specifically] in the blood are over-diluted. Since sodium is critical for muscle function, acute hyponatremia can lead to cardiac arrhythmia. Cellular swelling due to osmotic pressure changes can also cause cerebral edema and bradycardia [decreased heart rate].

Hypotonic cells caused by imbalanced fluid electrolytes

Hyper-hydration has lead to several deaths in marathon runners who consumed plain water instead of electrolyte beverages during long races. It’s also lead to the deaths of a few ravers who, in an attempt to stave off the dehydration that over-exertion after Ecstasy [MDMA] consumption can cause, drank so much water that they went way past the point of staving off dehydration. 

Before death, the brain swelling caused by hyper-hydration can cause symptoms mimicking drunkenness, which in at least one documented case, has tragically lead to those around the patient to encourage water consumption. 

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    Interesting because...(noted astronomer, mathematician
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