At a fancy dinner party in Prague sometime around 1601, the Danish astronomer Tycho Brahe reportedly drank too much wine but refused to excuse himself from the table. Leaving before the host, apparently, was a grievous breach of etiquette. By the time the party ended, Brahe found he couldn’t urinate at all. He died eleven days later.

Whether this story is medically accurate has been debated for centuries—some historians suspect mercury poisoning or kidney disease instead—but it raises a question many people wonder about: can holding your pee actually kill you?

The short answer is no, not under normal circumstances. But that doesn’t mean the habit is harmless.

How the bladder actually works

Your bladder is essentially a muscular storage bag. Urine produced by the kidneys flows down the ureters and collects in the bladder, which sits in your pelvis. The bladder wall contains a layer of smooth muscle called the detrusor, which relaxes as urine accumulates and contracts when you urinate.

Most adults produce between 800ml and 2,000ml of urine daily, depending on fluid intake. The bladder can comfortably hold about 400-500ml, though its maximum capacity in emergencies can reach 800ml or more. When your bladder contains around 150-250ml of urine, stretch receptors in the bladder wall start sending signals to your brain, creating that familiar “I could go” sensation. By the time you reach 400-500ml, the urge becomes much more insistent 1.

The act of urinating involves coordination between your brain, spinal cord, and two sphincters—rings of muscle that act like valves. The internal sphincter is under involuntary control (your body handles it automatically), while the external sphincter is under voluntary control. When you decide it’s not the right time to urinate, you’re essentially overriding the urge by keeping that external sphincter clenched.

This system works remarkably well most of the time. Your brain receives the signal that the bladder is filling, weighs up the social situation, and decides whether to grant permission. During sleep, this filtering system typically prevents accidents (though anyone who’s had dreams about finding a toilet knows it’s not perfect).

What happens when you hold it

When you ignore the urge to urinate, the detrusor muscle keeps relaxing to accommodate more urine while the sphincters remain closed. The bladder wall stretches, pressure builds, and those “please find a toilet” signals from the stretch receptors grow increasingly urgent.

If you keep holding, your body starts getting creative about getting your attention. The discomfort intensifies. Concentration becomes difficult. Some people experience physical symptoms like lower abdominal pain or restlessness. Eventually—as actor Hugh Jackman famously discovered during a 1996 performance of Beauty and the Beast—your body may simply override your brain’s objections and release the urine anyway.

I should note that occasional bladder holding is completely normal and rarely causes problems. Sitting through a two-hour film, finishing a meeting, or waiting until you get home rather than using a dodgy public toilet—these are all reasonable situations where temporary holding is fine for healthy adults.

The problems start when holding becomes habitual or extreme.

The risks of chronic urine retention

Urinary tract infections

This is probably the most common consequence of regular urine holding. The urinary tract has several natural defence mechanisms against bacteria, and one of the most important is simply flushing everything out regularly. Urine itself is sterile when it leaves the kidneys, but bacteria can enter through the urethra and start multiplying.

When you hold your urine, you’re essentially giving bacteria more time to establish themselves. Research suggests that regular voiding helps clear bacteria before they can adhere to the bladder wall and cause infection 2. This is one reason why doctors often recommend urinating after sexual intercourse—it helps flush out any bacteria that may have been introduced.

People who frequently develop urinary tract infections are often advised to urinate at regular intervals rather than waiting until the bladder is uncomfortably full. If you’re prone to recurrent UTIs, chronic holding habits are worth examining.

Bladder dysfunction

The bladder is a muscle, and like any muscle, it can be affected by how you use it. Chronically overstretching the detrusor muscle may eventually impair its ability to contract effectively. When this happens, the bladder doesn’t empty completely, leaving residual urine that increases infection risk and can worsen symptoms.

This situation is sometimes called detrusor underactivity—the bladder muscle becomes weak and doesn’t squeeze hard enough to empty properly. In severe cases, people may need to strain to urinate or use techniques like double voiding (waiting a moment after finishing, then trying again) to empty their bladder more completely.

On the flip side, some researchers have wondered whether chronic holding might contribute to overactive bladder in certain people, though the evidence here is less clear. The relationship between voiding habits and bladder function is complex, and individual factors play a large role.

Kidney problems

In extreme cases—far beyond the occasional “I’ll wait until I get home”—severe urinary retention can cause urine to back up through the ureters and into the kidneys. This condition, called hydronephrosis, can damage kidney tissue if left untreated.

This is what may have happened to Tycho Brahe, assuming the historical accounts are accurate. Complete urinary obstruction is a medical emergency. But for most healthy adults who occasionally delay urination, kidney damage isn’t a realistic concern.

Psychogenic urinary retention and voiding difficulties

Some people develop anxiety-related urinary issues where the fear of not being able to urinate creates a self-fulfilling prophecy. Others become so accustomed to holding that they struggle to relax and void even when they want to. These psychological components can complicate what starts as a simple habit.

The condition known as paruresis—also called “shy bladder syndrome”—involves difficulty urinating in public or when others might be aware. While this is distinct from deliberate urine holding, the two issues can interact. Someone with paruresis might hold their urine for hours waiting to get home, which isn’t ideal for bladder health.

Who should be more careful?

Certain groups face higher risks from urine holding:

Older adults: Bladder capacity and muscle function naturally decline with age. Older men often have some degree of prostate enlargement, which can already impair urination. Adding voluntary holding to the mix isn’t wise.

People with diabetes: Diabetic bladder dysfunction is a recognised complication of diabetes. High blood sugar levels can damage the nerves controlling the bladder, leading to incomplete emptying and increased infection risk. Diabetics are already at higher risk for UTIs and shouldn’t compound this by holding.

Those with existing bladder conditions: If you already have interstitial cystitis, benign prostatic hyperplasia, or neurogenic bladder, your doctor has likely already advised you about voiding schedules.

Pregnant women: The growing uterus puts pressure on the bladder, and pregnancy hormones can affect muscle tone. Pregnant women are also more susceptible to UTIs.

Children: Kids sometimes hold their urine for extended periods—they’re busy playing, the school toilets are unpleasant, or they simply don’t want to stop what they’re doing. Chronic holding in children can contribute to daytime wetting accidents and recurrent infections.

Practical recommendations

So what does this all mean in practice?

First, don’t panic about the occasional delay. If you’re healthy and sometimes hold your urine for an hour or two longer than ideal, you’re almost certainly fine. The body has considerable reserve capacity, and occasional inconvenience isn’t going to wreck your bladder.

Second, try to urinate when you first feel the urge, within reason. You don’t need to sprint to the nearest toilet the moment you notice your bladder, but don’t habitually ignore the signal either. A reasonable rule of thumb is urinating every three to four hours during waking hours.

Third, ensure you empty your bladder completely when you do go. Don’t rush. Give yourself time, and if you feel like there might be more, wait a moment and try again.

Fourth, stay hydrated. Some people reduce their fluid intake to avoid needing the toilet, which is counterproductive. Concentrated urine is more irritating to the bladder and may increase infection risk. The NHS recommends drinking six to eight glasses of fluid daily for most adults 3.

Finally, if you notice changes in your urinary patterns—pain during urination, increased frequency, difficulty starting or stopping, blood in your urine, or a persistent feeling that your bladder isn’t empty—see a doctor. These symptoms can indicate treatable conditions, and early intervention is generally better than waiting.

The Tycho Brahe question revisited

Could you actually die from holding your pee, like the famous astronomer supposedly did?

Under extraordinary circumstances, theoretically yes. Complete urinary retention—where the bladder is physically unable to empty—is a medical emergency that requires catheterisation. Left untreated, it could lead to bladder rupture (extremely rare) or kidney failure (more realistic in prolonged cases).

But here’s the thing: your body has failsafes. Before reaching truly dangerous levels, most healthy people would simply lose voluntary control and urinate. The discomfort would become overwhelming. You’d wet yourself before you died.

Brahe’s death, if it really was caused by urinary retention, likely involved some underlying pathology—perhaps bladder stones, prostate problems, or another obstruction that made urination physically impossible rather than merely socially awkward.

For the rest of us, the lesson is simpler: when you need to go, go. Your bladder will thank you, and nobody at the dinner party will mind if you excuse yourself.

References

Lukacz ES, et al. “A healthy bladder: a consensus statement.” Int J Clin Pract. 2011;65(10):1026-1036.
Hooton TM. “Recurrent urinary tract infection in women.” Int J Antimicrob Agents. 2001;17(4):259-268.
NHS. “Water, drinks and hydration.” 2022.