Have you ever been in a situation where you felt like you needed to pee but could not use a restroom? A lot of times, especially in public, during an office meeting or an interview, we come across such circumstances, while sometimes we hold pee to not embarrass ourselves socially, or just because of the lack of facilities. Doing that often may not be good for our health.
The urinary bladder is a hollow, pear-shaped organ that forms part of the urinary system. The bladder's role while is to store urine, it also releases once the limit is crossed, which is around one pint or two cups of liquid. However, under certain circumstances, it can stretch to hold more than this.
We start to fee the urge to urinate when it is filled halfway.
When you hold your pee too often, your bladder stretches and the muscle weakens. As time pass by, it can become difficult for your bladder to empty it completely. This can lead to urinary retention, and being unable to fully emptying your bladder.
Ignoring the urge to pee regularly can lead to pain or discomfort in the bladder or kidneys. When you eventually make it to the bathroom, urinating might feel painful.
Additionally, the muscles involved in holding urine may remain partially tense even after you’ve emptied your bladder, potentially causing pelvic cramps.
One of the most common discomforts caused by holding in pee for too long is Urinary tract infection. It can cause bacteria to multiply.
As per the Urology Care Foundation, people should avoid holding in pee for extended periods, as it increases the risk of UTIs. Dehydration, poor personal hygiene, and certain medications can also increase the risk of developing a UTI.
As mentioned before, in long run, regularly holding in pee could cause the bladder to stretch and make it difficult or sometimes, impossible for the bladder to contract and release pee.
If someone has a stretched bladder, sometimes, extra measures like a catheter could also be necessary.
Regularly holding in urine can strain and potentially damage the pelvic floor muscles.
One key muscle, the urethral sphincter, helps keep the urethra closed to prevent leaks. Damage to this muscle may lead to urinary incontinence. Performing pelvic floor exercises, like Kegels, can help strengthen these muscles, repair damage, and reduce the risk of leakage.
For individuals prone to kidney stones or those with high mineral levels in their urine, holding in pee may contribute to stone formation. Urine naturally contains minerals like uric acid and calcium oxalate, which can crystallize and form stones over time.
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Arthritis can affect people at different stages of life, limiting their ability to walk, climb stairs or carry out everyday activities with ease. While treatment largely depends on the extent of joint damage and the patient's condition, treatment approaches ranging from joint-preserving surgery to knee and hip replacement can help restore mobility. Rehabilitation still remains an essential part of recovery.
On World Arthritis Day, doctors explain how arthritis is treated and managed at different ages using real-life cases and highlighting how they assess joint damage, choose strategies and use physiotherapy to help patients return to their routines.
A 42-year-old man with grade 3 osteoarthritis in his right knee had been experiencing pain and locking. His symptoms began after a knee injury six years earlier and worsened with time. X-rays revealed marked varus alignment, cartilage and meniscus damage. Earlier consultations had suggested knee replacement, but given his age, doctors opted for knee preservation surgery.
Dr. Tapish Ravindra Shukla, Consultant Orthopaedics and Sports Medicine, Fortis Escorts Hospital, Amritsar, told HealthandMe that he performed three procedures in a single sitting: high tibial osteotomy to correct alignment and shift weight away from the damaged inner compartment, bone marrow aspirate concentrate (BMAC) to treat the cartilage defect, and meniscus repair.
The patient walked with a walker for approximately three weeks, began jogging at six weeks and was running by three months.
The case brings us to an important point, i.e., assessing whether a damaged joint can be preserved, especially in younger patients who may otherwise face joint replacement early in life.
In another case, a patient developed pain in both hips after recovering from a major head injury. During prolonged rehabilitation, he had received steroids and anti-epileptic medication for an extended period. He was subsequently diagnosed with bilateral avascular necrosis, a condition in which compromised blood supply damages bone and can lead to joint destruction.
Initially, doctors performed core decompression to relieve pressure within the affected bone and attempt to preserve the joints. The patient experienced relief and continued his routine activities for nearly two years.
However, following a minor slip and fall, the pain returned. Further evaluation and X-rays showed significant progression of arthritis, prompting a recommendation for total hip replacement.
Dr. P Keerthivasan, Senior Consultant and Spine Surgeon, Kauvery Hospital, Alwarpet, Chennai, explained to us the importance of understanding the condition, accepting when treatment needs to change and planning for recovery. Following hip replacement, the patient began mobilising the next day and progressed well during the immediate recovery period.
The case illustrates that joint-preserving procedures may provide relief in selected patients, but progressive joint damage can make replacement necessary.
Also read: Joint Pain In Your 30s And 40s: When Should You Worry?
A 65-year-old woman with osteoarthritis in both knees had severe pain and difficulty walking, climbing stairs and performing daily activities. She had become dependent on painkillers, raising concerns about potential kidney damage with prolonged use. Doctors recommended total knee replacement.
Dr. Rishabh Tiwari, Consultant (JR), Orthopaedics, and Dr. Vivek Allahbadia, Consultant, Orthopaedic Surgery, P.D. Hinduja Hospital & Medical Research Centre, Khar, treated the patient using a minimally invasive technique in which the tendon was lifted rather than cut. The posterior cruciate ligament (PCL) was also preserved.
According to the doctors, these approaches can help reduce postoperative pain, limit bone loss and provide a more natural feel to the replaced knee.
The patient could lift her leg on the night of surgery. The following day, she was walking with full weight-bearing, bending and straightening her knee, and using the washroom independently. Training to climb stairs began on the second day, and she was discharged that day.
At one-and-a-half months, she could perform daily activities without pain and travel independently to nearby friends and relatives. The case stresses upon how surgical technique and early mobilisation can contribute to a patient's return to everyday activities.
In another case of knee replacement, a 62-year-old woman with severe osteoarthritis in both knees had spent nearly four years avoiding stairs, temples and long walks with her grandchildren. Pain, stiffness and fear of falling had increasingly restricted her activities. “She stopped joining family outings because I couldn’t keep up,” she told her doctor.
Dr. Bhushan Shitole, Consultant Orthopaedic Surgeon and Director at Vencer Hospital, told us that he recommended robotic-assisted total knee replacement using an imageless robotic system. The technology creates a three-dimensional plan of the joint before surgery and helps the surgeon plan implant positioning according to the patient's anatomy.
“Robotic planning lets us match the implant to the patient’s unique anatomy so the first steps after surgery are already better aligned,” Dr. Shitole said. “That first confident walk is often the real turning point.”
Following surgery, the patient began walking with minimal support within days. Structured physiotherapy focused on strength, balance and gait training. By the end of the first month, she was moving independently at home. Three months later, she boarded a cruise she had postponed.
“The robot didn’t just replace my knee. It gave her back the confidence to live the life she wanted,” Dr. Shitole said.
The case highlights that recovery involves more than replacing the damaged joint. Regaining balance, strength and confidence is also central to returning to normal activities.
Arthritis and joint destruction are not restricted to older adults. A 15-year-old boy with Morquio syndrome, a rare genetic disorder affecting skeletal development, developed severe arthritis in both hips. Pain and complex hip deformities made walking and everyday activities difficult.
Because of his small skeletal anatomy and the complexity of the deformities, doctors opted for staged bilateral hip replacements. The surgical team used CT scans to create a three-dimensional printed model of the pelvis and specialised R.I Hip software to simulate the procedures virtually. This helped them select correct sized implants, plan positioning and anticipate physiological challenges.
The two hip replacements were performed three days apart. The boy was able to stand and walk with support the day after each procedure.
The treating doctor, Dr. Vaibhav Bagaria, Director, Orthopaedics- Sir HN Reliance Foundation Hospital, Mumbai, told us that rehabilitation played a huge role.
“A successful joint replacement restores the mechanics of movement, but rehabilitation helps restore the confidence to move. Both are equally important for meaningful recovery, ” he said.
Physiotherapy focused on progressive walking, muscle strengthening, balance and functional independence, with the programme tailored to the boy's underlying skeletal condition.
The case also highlights the additional considerations involved in treating young patients, including implant longevity and the possibility of revision surgery in the future.
Across these cases, treatment ranged from procedures intended to preserve a joint to partial or total replacement of severely damaged joints. The choice depended on the patient's age, the extent of joint destruction, associated conditions and the likelihood of preserving function.
Rehabilitation was central to each case. Early mobilisation helped patients use their joints after surgery, while physiotherapy helped with strength, balance, walking and daily independence.
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With flu season setting in across countries, including the US and the UK, doctors are urging people to get their annual flu shots. October offers an opportunity to build protection before winter flu activity increases.
The UK Health Security Agency (UKHSA) reported above-average flu activity and urged at-risk groups to get vaccinated. England's flu vaccination program last winter is estimated to have prevented about 100,000 hospital admissions and 7,000 deaths.
The US Centers for Disease Control and Prevention (CDC) recommends annual flu vaccination for everyone aged six months and older. The seasonal vaccine targets influenza A(H1N1), A(H3N2) and B/Victoria viruses.
In September, the Indian Medical Association (IMA) also highlighted annual influenza vaccination and gaps in adult immunization.
Also read: Flu Activity Rises Early In US, UK And Japan: Why Experts Urge Vaccination Before Winter
The flu vaccine takes about two weeks to build protection, making October a good time to get vaccinated before winter, Dr. Bhawna Malik, Senior Consultant-Neonatologist and Pediatric Intensivist at Motherhood Hospitals, Greater Noida, told HealthandMe.
In India, flu activity can increase between January and March. Vaccination in October allows time for immunity to develop before this period.
However, October is not the only option. Dr. Vikas Maurya, Senior Director and HOD, Pulmonology, Fortis Hospital, Shalimar Bagh, told HealthandMe that vaccination can also be taken between April and mid-June, ahead of another period of flu activity from July to September.
He said one dose annually is generally sufficient, with timing depending on local flu patterns and the vaccine used.
Healthy adults and children, as well as people with underlying conditions, can benefit from flu vaccination. Influenza can cause pneumonia, hospitalization and other severe complications.
Older adults, particularly those aged 65 and above, and people with diabetes, heart disease, kidney or liver disease, asthma or chronic obstructive pulmonary disease (COPD) face a higher risk of complications.
“Flu vaccination doesn't protect just yourself against the risk of having influenza but it also prevents transmission of infection to other vulnerable people around ourselves like little ones, elderly family members and people with medical conditions,” Dr. Malik said.
Dr. Mohit Bhardhwaj, Consultant, Pulmonology, PB Health, Gurugram, told HealthandMe that annual vaccination helps protect individuals and reduce transmission, as flu viruses change and vaccine protection can decrease over time.
Read More: Flu 2026: Symptoms To Watch For As New Season Begins
The vaccine can be administered from six months of age. The schedule depends on age and previous vaccination history.
Dr. Malik recommends vaccination for parents, siblings and caregivers to help reduce the risk of transmitting influenza to infants who are too young to receive the vaccine.
Most flu vaccine side effects are mild and may include injection-site pain, redness or swelling, fever, headache, body aches and tiredness. These generally settle within a few days, Dr. Bhardhwaj said.
A cooling pack or an ice pack wrapped in cloth may help relieve injection-site discomfort. Nasal vaccines may cause a stuffy nose, cough or headache, Dr. Maurya noted.
The injected flu vaccine cannot cause influenza. Anyone experiencing persistent fever, breathing difficulty or unusual symptoms should seek medical advice. Those with a history of serious allergic reactions to a previous flu vaccine should consult their doctor before vaccination.
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A migraine attack is characterised by nausea, vomiting and sensitivity to light and sound. But early symptoms may surface long before the headache itself. Signs like fatigue, mood changes, food cravings and difficulty focusing may appear hours or even days before the pain.
The symptoms that occur during the attack reflect a complex neurological process that involves several interconnected brain networks, rather than just a headache.
A new Lancet Seminar review, looks deeper into how migraine develops, why its symptoms extend beyond head pain and how the better understanding of its biology are affecting treatment.
The study authors describe migraine as a chronic neurovascular disorder shaped by genetic susceptibility and interactions between the brain’s sensory networks, nerves, and blood vessels.
Also read: These Yoga Asanas Could Cure Your Migraine
Migraine is the result of the interaction of multiple systems responsible for processing sensory information and transmitting pain. Researchers are focusing more on other factors that drive migraine rather than just blood vessel narrowing or widening.
An important concept is the trigeminovascular system, which is a network involving the trigeminal nerve, tissues sensitive to pain that surrounds the brain and blood vessels. When this system gets activated, the patient experiences the peculiar head ache.
Chemical messengers called neuropeptides also play a key role. One of the most important is calcitonin gene-related peptide (CGRP), which participates in pain signalling in migraine. Treatments that target CGRP is an important development in migraine treatment and management.
The condition also involves changes in how the brain processes sensory information. This explains why light, sounds or smells can become intolerable during an migraine attack, and why some patients experience nausea, dizziness or difficulty concentrating along with severe headache.
Not an isolated abnormality triggering every symptom, migraine involves interactive neurological and vascular processes whose contributions can vary between individuals and across different phases of an attack.
Also read: Saba Ali Khan Opens Up About Brain Tumour: Can It Go Unnoticed If You Walk, Talk And Work Normally?
Migraine attacks typically occurs through several phases mostly:
The earliest phase can involve fatigue, yawning, mood changes, food cravings, neck stiffness and difficulty concentrating. The involvement of brain regions linked with homeostasis, including the hypothalamus, may help explain why an approaching attack can affect sleep, appetite, mood and other bodily functions.
Some people experience an aura before or during the headache. This can include flashing lights, zigzag patterns, blind spots, tingling or temporary difficulties with speech. Aura is associated with a phenomenon called cortical spreading depression, a wave of changing electrical activity that moves across the brain’s cortex.
During the headache phase, activation of the trigeminovascular system contributes to pain signalling. Patients may experience moderate-to-severe, often throbbing pain, alongside nausea, vomiting and sensitivity to light, sound or smells.
Movement can aggravate the pain, making routine activities difficult. The headache phase can last several hours to as long as 72 hours.
The end of an attack does not necessarily mean the attack is over. Some people experience exhaustion, dizziness, body aches and difficulty concentrating for hours or days afterwards. These phases can overlap, and their timing and severity differ from person to person.
The Lancet review also highlights the role of genetic and epigenetic factors that contribute to migraine risk. They interact with complex neurological networks, helping explain why some people experience occasional attacks while others develop frequent or chronic migraine.
Episodic migraine is characterised by fewer than 15 headache days per month. Chronic migraine involves headaches on at least 15 days per month for more than three months, including migraine features on at least eight days each month.
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