Even without alcohol, I have to pee all the time. As I’ve said before, I pee probably once an hour. Being well-hydrated isn’t a crime! Anyway, imagine my horror to hear that a 40-year-old man in Zhejiang, China, was recently hospitalized when, after drinking 10 beers and passing out for 18 hours, he ruptured his bladder from not peeing. It seems absolutely preposterous to me to go that long without peeing, especially with that much liquid in your system.
While this seems like an unusual case, I am definitely curious: How long can the average person hold their pee without it becoming a problem?
First off, having your bladder actually burst is rare. Normally, even if you’re so wasted you can’t wake up to pee, your body will manage the problem itself. People notoriously wet the bed from being too drunk — why that didn’t happen to the man in Zhejiang is unclear. More often, a person is conscious when their bladder bursts, usually from external pressure. For example, in 2015, a 24-year-old in Maine ruptured his bladder after belly-flopping into a lake following some heavy drinking. As urologist Bradley Gill told LiveScience at the time, this was “the equivalent of throwing a water balloon on the sidewalk.” Meditate on that, if you’d like.
Alcohol usually plays a part because it causes the body to produce more urine, but also because it can lower our bodily awareness. That said, bladder injuries occur among (presumably sober) children, too, who might be avoiding going to the bathroom because they’re just having too much goshdarn fun! Usually, they’ll just pee their pants, but getting hit with a ball or falling can result in a ruptured bladder, too.
Having a full bladder increases your risk of rupture because of the pressure it causes (the water balloon analogy is pretty accurate — it’s much easier to puncture a full water balloon than it is an empty one). The average adult bladder can hold around 16 to 24 ounces when full, but only fills at a rate of around 2 ounces per hour. If, hypothetically, you only drank 16 ounces of water in a day and your body didn’t use that water for anything else, it could take eight hours before you really needed to pee.
According to Healthline, if your bladder is strong enough and you really put your mind to it, you could potentially hold it in for 10 hours before causing any problems. Putting that all together, it’s possible not to pee for 18 hours without leaving long-term damage. But after 10 hours of holding it, you might develop urinary retention, wherein your bladder muscles are no longer capable of relaxing to release the urine even if you tried. From there, you’ll require medical attention to prevent your bladder from bursting.
On a normal occasion, nerves in your bladder send signals to your brain telling you that you need to pee around the quarter or half-way full point. Despite feeling the need to pee, we’re able to control when we actually release partially because of our pelvic muscles. As we get older, these muscles can weaken and cause incontinence issues. Holding in your pee for too long habitually can similarly weaken the muscles, too, making leaks more likely.
Again, though, when we’re drinking, things are a little more complicated. Not only can alcohol lower our control of our pelvic muscles, but it also suppresses the hormone that dictates the rate at which our kidneys convert liquids into urine. Exactly how this translates into needing to pee sooner will depend on what you’re drinking, what liquids you’ve consumed that day and other factors like weight and activity level. A 1997 article from Alcohol Health and Research World suggests some people may need to pee within 20 minutes of consuming their first drink.
Odds are, your bladder will hit its “maximum capacity” feeling much more quickly than it would if you weren’t drinking alcohol. Whether you’re able to hold it in will depend on your sobriety and desire not to pee — if you’re conscious, you could probably make it that 10 hours before urinary retention sets in. Or, in rare scenarios, you might end up like our old friend in Zhejiang. Either way, needing to pee for more than 10 hours and not doing it will put you in the hospital.