Have you ever felt a burning need to urinate, but had to hold it in? Perhaps you were driving along the highway, and the next rest area was still 50 miles ahead. Or maybe you were attending a seminar or class, or were at the theater or a concert, and you just didn't want to leave for the restroom simply because your bladder was full.

Our culture gives us millions of reasons for holding in urine. In fact, to be successful in society, we sometimes need to defer this personal biological need. Our training as waste retainers starts with diapers. While other creatures have the freedom to eliminate waste when the need arises, we humans living in modern, Western civilization need to carefully plan our excretions to make them convenient to our busy schedules, and appropriately performed and flushed away. In fact, we secretly pride ourselves on our ability to hold in urine. It reflect our high degree of training and civility. Being civilized means we no longer assert our animalistic need to pee without proper decorum and timing. However, there is a price to this civility!

Medicine says nothing about the common practice of holding in urine. In fact, the entire issue is ignored, as is unfortunately the case with most cultural practices that affect our health. Most doctors hold in their own urine, as well, especially surgeons during surgery. Doctors and medical researchers are trained, like the rest of society, to conform to our culture's idiosyncratic ways. This makes medicine and doctors oblivious to the obvious, since we all tend to overlook our own personal foibles. Obviously, holding in waste cannot be good for you. Once you reflect on what is in the waste, where it is stored, and what happens when the pressure of holding it in builds to unnaturally high levels, the serious cost of urine retention becomes clear.

Urine is a filtrate from the blood. The kidneys require blood pressure to force this filtration of the blood. Once the kidneys process the filtrate, it becomes urine. This then passively flows down to thin tubes, called the ureters, one ureter for each kidney. The ureters empty into the bladder, which expands to accommodate the fluid. Once the bladder expands to a certain limit, a reflex is started that causes urination. That is, if we allow the reflex to operate naturally.

Urine is predominately a salt solution, along with other waste products. When you hold it in, the pressure in the bladder builds, causing the urine to concentrate. The longer you hold in urine, the more concentrated it will become. What can happen to a salt solution when it becomes concentrated? It can precipitate, forming crystals. It's simple chemistry. These crystals are called stones.

In addition to concentrating the urine, bladder pressure will resist the flow from the ureters of new urine from the kidneys. This will lead to a back-up of all the plumbing, so to speak, as the kidneys themselves ultimately get hampered in their ability to filter the blood. This increases the toxin load of the bloodstream and can cause metabolic problems. It also inhibits water and salt elimination, and can contribute to high blood pressure and heart disease.

And there's more! When you look at the male anatomy of the pelvic region, you will see that the bladder is directly above the prostate gland. Underneath the prostate is the pelvic floor. The pelvic floor and bladder essentially make a prostate sandwich. An over-filled bladder will press on the prostate. No gland likes pressure, since pressure reduces its blood flow and general operation. If severe and frequent enough, the bladder pressure may cause the prostate to enlarge to better cushion itself form the bladder burden. It is medically known that prolonged horseback riding or bicycle riding can lead to prostate enlargement due to pressure from the bottom up. A full bladder causes pressure from the top down. A cause of prostate enlargement, which is very common in Western cultures, may thus be this cultural penchant for urine retention.

Another problem that may result from an over-stretched bladder and its storage of concentrated waste is the bladder wall and ureters may become irritated and damaged. This may increase the likelihood of succumbing to bacterial invasion. Bladder and urinary tract infections may, therefore, be another product of urine retention.

We would like to suggest the following self study for those interested in improving their urinary tract, prostate, and kidney health. Here is what you do. Whenever you feel the urge to urinate, do so. Don't wait or delay. Keep note of times you do delay. If you have a history of kidney stones, bladder infections, or prostate enlargement, reflect honestly on your tendency to hold it in. It may be an occupational problem, such as bus and truck drivers, pilots, doctors, lawyers, and others unable to stop what they are doing simply to pee. It may be a discomfort with using public restrooms. No matter what the reason, there's no excuse for storing refuse.

One further note. For fear of having to urinate at an inappropriate time, some people may avoid drinking water. This will lead to dehydration and even more concentrated urine. Interestingly, doctors tell patients with a history of kidney stones to drink more. Of course, it's hard to take it in if you are not letting it out.

According to modern medicine, the cause of most kidney stones is unknown. More than 50% of Americans will experience at least one kidney stone in his or her lifetime. Passing these stones can be one of the most painful experiences of a lifetime. Doctors recommend drugs, sonic beams, or surgery to deal with the problem.

It is never mentioned that we live in a culture that makes urination a pain, literally.