Urologist warns children and workers at risk from ‘holding it in’

20 July 2026

Specialists from the Urological Society of Australia and New Zealand (USANZ) fear more people are “holding it in” to delay going to the bathroom, endangering their bladder health.

With workers now back in the office, often attending back-to-back meetings, and some schools no longer allowing children to visit the bathroom during class time, there are fears people are developing unhealthy toilet habits.

USANZ Female Urology leadership team member Dr Sandra Elmer said regularly delaying or avoiding going to the toilet can, over time, affect normal bladder function. Repeatedly holding on for long periods can overstretch the bladder muscle, causing it to weaken and making it more difficult for the bladder to empty completely.

If this pattern continues, it may increase the risk of urinary tract infections and, in severe cases where poor bladder emptying is prolonged and untreated, can contribute to kidney damage.

“Extended periods without toilet use results in two main risks - Urinary Tract Infections (UTI’s) or poor bladder emptying (urinary retention),” said Dr Elmer.

"It can be very difficult to restore bladder function once the bladder muscle has been significantly damaged, which is why prevention and maintaining healthy bladder habits are so important. Unfortunately, there are currently no medications that can improve the bladder's ability to contract.”

“For some patients, a bladder stimulator known as sacral neuromodulation may help, but it is not effective for everyone and does not reliably restore bladder contractility. In more severe cases of bladder failure, patients may need to rely on intermittent self-catheterisation or an indwelling catheter to empty their bladder."

“It’s really important to set up good bladder habits in primary school. You don’t want kids to develop toilet avoidance which can happen if kids develop social anxiety about going to the toilet.”

“For adults, we usually only see them after the damage is done when they complain they can no longer empty their bladder, or have developed urinary incontinence, because their bladder has now become overstretched and dysfunctional.”

“We see this particularly in industries like truck drivers that may have to go a long time without a toilet break.”

“In regards to treatment, sometimes the bladder nerve can be stimulated, referred to as neuromodulation, but often the condition is not always treatable. People may have to learn how to catheterise themselves to empty their bladder.”

Dr Elmer recommends people go to the toilet once every four to five hours however this metric is heavily dependent on how much fluid is consumed in a given day.

“Going any less than this can increase the risk of having a UTI, however what we see more commonly is people having an underactive bladder,” she said.

You shouldn’t be allowing your bladder to fill beyond 500 - 600mls regularly. If you feel like your bladder is full and you avoid going to the toilet for more than an hour, you could be doing damage to your bladder.”

About the Urological Society of Australia and New Zealand (USANZ)

USANZ is the peak professional body for urological surgeons in Australia and New Zealand. Urologists are surgeons who treat men, women and children with problems involving the kidney, bladder, prostate and male reproductive organs. These conditions include cancer, stones, infection, incontinence, urination difficulties, sexual dysfunction and pelvic floor problems.
 

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