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Bravo
11-04-2007, 10:14 AM
this is the way its supposed to work:

sympathetics = fight or flight

para= rest and digest (and urinate or defecate)

so why do we pee when we're scared?

is it a mechanism to decrease blood pressure or is there something else here?

Bravo
11-04-2007, 10:14 AM
i just peed my pants in anticipation of the answer.

what caused that?

Tish Davidson
11-04-2007, 10:38 AM
maybe emptying the bladder makes flight easier?

joetrain
11-04-2007, 11:19 AM
is pissin when you're scared physiologically related to pissin when you're laughing, which, according to a joetrain straw poll*, mediated by a medical doctor, is more common among women?







*got on the subject drinkin with family. present was my aunt's boyfriend, a medical doctor.

JoNightshade
11-04-2007, 11:46 AM
I thought it had to do with loss of control. Holding your water actually requires a bit of control. When you're scared, your knees go rubbery, your hands shake, and other muscles spasm... including the one that controls your bladder.

I could be wrong.

Kathie Freeman
11-04-2007, 09:18 PM
It's nature's way of throwing a predator off your trail. The scent distracts the pursuer and gives the pursuee time to escape.

GeorgeK
11-05-2007, 12:19 AM
Leaking during laughter is not the same. That's usually for women a type of stress incontinence (if it's tiny spurts as you tighten up your belly muscles) or can be a variant of urge incontinence (if laughter sets off a contraction that empties the bladder) and sometimes evidence of damage to either the shpincter or its innervating nerves. The fear response is more dubious and has conflicting origins depending upon your source. It may have to do with the primitive brain when people were more prey than predator. The para = urination is for a voluntary urination. In the primitive brain (or maybe more correctly, the infantile brain) urination is simply a reflex set off by stretch receptors in the bladder muscle. Pressing on an infant's belly can stimulate urination. When done deliberately this is called a "Crede Maneuvre". Voluntarily NOT urinating requires inhibition from the brain. When the brain is disconnected from the bladder things are different. Unfortunately for paraplegics, a Crede does not always result in a coordinated urination and sometimes stimulates the bladder to contract without relaxing the sphincter. When done habitually, this sometimes results in high urinary pressures which can cause backpressure on the kidneys and eventually kidney failure. Ok, so that's probably more than you wanted to know.

JoniBGoode
11-05-2007, 05:02 AM
[quote=GeorgeK;1786628]Leaking during laughter is not the same. That's usually for women a type of stress incontinence (if it's tiny spurts as you tighten up your belly muscles) or can be a variant of urge incontinence (if laughter sets off a contraction that empties the bladder) and sometimes evidence of damage to either the shpincter or its innervating nerves. /quote]

Minor damage resulting in urinary incontinence is fairly common after childbirth, which is why it's more common in women. It may grow worse over time, and can require minor surgery.

(See George's entry below. I was wrong about this.)

reenkam
11-05-2007, 05:22 AM
You pee when you're scared as part of the fight or flight defence. It lessens your body weight making it easier to run, or to fight.

My psych teacher told us.

dpaterso
11-05-2007, 01:13 PM
Bravo: note that it's socially unacceptable to pee yourself. I thought I'd best mention this in case you're engaged in personal research.

-Derek

GeorgeK
11-06-2007, 01:12 AM
Minor damage resulting in urinary incontinence is fairly common after childbirth, which is why it's more common in women. It may grow worse over time, and can require minor surgery.

That's a myth that is unfortunately propagated by even some gyenecologists. It's not common as a result of normal childbirth. It's simply time. Short term dysfunction (less than 2 weeks) from pressure on the pelvic nerves by edema with prolonged labor is common. In mutiparity, there can be laxity of the anterior vaginal wall predisposing for an eventual cystocoele or enterocoele which very well might require an anterior vaginal repair (probably 30 years later). But that isn't stress incontinence, it's a variant of urge incontinence. True sphincteric damage even with a major tear is rare. If I recall correctly, everyone I was ever asked to see for sphincteric damage after childbirth, turned out to have diabetes, or a ruptured disc, mutiple sclerosis or some other systemic neurologic process. The childbirth wasn't the true cause.

The common stress incontinence that women get isn't from childbirth. It's from the normal gradual and relative decrease in sex steroid production that happens with age irrespective of the parity. That's why women who've never been pregnant also develop it with time. The problem with treating it with estogen is that they don't sell human estrogen on the market. They sell Horse estrogen and it is just different enough that the skin around the urethra doesn't take it out of the blood stream. Also almost all topical applications are alcohol based, and alcohol on that skin will burn and dry it out so that the estrogen isn't absorbed. There are a variety of surgeries for stress incontince, but it can be treated with water based topical estrogen. The problem is that it takes 6-12 months to work, and it depends upon how dry you want to be. A New York Banker may find that wearing a pad "just in case" is intolerable, whereas a farmer may consider having to change a damp pad once a day with no overflow onto clothes is worth not having the surgery.

Petroglyph
11-06-2007, 01:18 AM
Listen to GeorgeK. He is wise.

JoniBGoode
11-06-2007, 04:06 AM
That's a myth that is unfortunately propagated by even some gyenecologists. It's not common as a result of normal childbirth. It's simply time. Short term dysfunction (less than 2 weeks) from pressure on the pelvic nerves by edema with prolonged labor is common. In mutiparity, there can be laxity of the anterior vaginal wall predisposing for an eventual cystocoele or enterocoele which very well might require an anterior vaginal repair (probably 30 years later). But that isn't stress incontinence, it's a variant of urge incontinence. True sphincteric damage even with a major tear is rare. If I recall correctly, everyone I was ever asked to see for sphincteric damage after childbirth, turned out to have diabetes, or a ruptured disc, mutiple sclerosis or some other systemic neurologic process. The childbirth wasn't the true cause.

The common stress incontinence that women get isn't from childbirth. It's from the normal gradual and relative decrease in sex steroid production that happens with age irrespective of the parity. That's why women who've never been pregnant also develop it with time. The problem with treating it with estogen is that they don't sell human estrogen on the market. They sell Horse estrogen and it is just different enough that the skin around the urethra doesn't take it out of the blood stream. Also almost all topical applications are alcohol based, and alcohol on that skin will burn and dry it out so that the estrogen isn't absorbed. There are a variety of surgeries for stress incontince, but it can be treated with water based topical estrogen. The problem is that it takes 6-12 months to work, and it depends upon how dry you want to be. A New York Banker may find that wearing a pad "just in case" is intolerable, whereas a farmer may consider having to change a damp pad once a day with no overflow onto clothes is worth not having the surgery.

Wow, thanks George! Who woulda known!?

Melanie Nilles
11-06-2007, 11:24 PM
That's a myth that is unfortunately propagated by even some gyenecologists. It's not common as a result of normal childbirth. It's simply time. Short term dysfunction (less than 2 weeks) from pressure on the pelvic nerves by edema with prolonged labor is common. In mutiparity, there can be laxity of the anterior vaginal wall predisposing for an eventual cystocoele or enterocoele which very well might require an anterior vaginal repair (probably 30 years later). But that isn't stress incontinence, it's a variant of urge incontinence. True sphincteric damage even with a major tear is rare. If I recall correctly, everyone I was ever asked to see for sphincteric damage after childbirth, turned out to have diabetes, or a ruptured disc, mutiple sclerosis or some other systemic neurologic process. The childbirth wasn't the true cause.

The common stress incontinence that women get isn't from childbirth. It's from the normal gradual and relative decrease in sex steroid production that happens with age irrespective of the parity.

And uh...you know this, how? (and I don't care if you are a doctor--YOU have a baby and tell me it's only hormones changing with age!)

Following may be TMI for some people:






I didn't have any problems until the birth of my first child. Incontinence CAN be caused by birth, normal vaginal birth, or maybe the pregnancy. Not sure which. But I, for one, had no problems whatsoever until after the first child. I regained some control with exercise, but I still have problems when the bladder has a certain amount in it and I laugh too hard, sneeze, or cough. I don't care what any doctors say, having kids is what ruined my body. I'm still young.

/soapbox

Kathie Freeman
11-11-2007, 03:05 AM
Hormones usually aren't necessary, there are exercises you can do to strengthen those muscles even if they are damaged by childbirth.

maxmordon
11-11-2007, 04:31 AM
The other day I pissed myself of scare when my Latin Professor started a sreaming nag against me

veinglory
11-11-2007, 04:41 AM
Peeing while fleeing is part of the general sympathetic activating, it may be to lighten the load, it might simply be a side effect of systemic processes aimed at other goals.

CACTUSWENDY
11-11-2007, 06:50 AM
Because it is not ladylike to poo in my pants?

(just a thought)

Bravo
11-11-2007, 06:52 AM
sympathetics are supposed to tighten the ureter sphincters and prevent peeing.

so it's still confusing.

Poohcat
11-11-2007, 07:07 AM
You feel the urge to urinate (as well as evacuate your bowels and vomit) when scared because of the surge of adrenaline (epinephrine for US) that is released as part of the "Fight or Flight" effect.

The adrenaline starts what is known as a cascade. This is like a series of tripped dominoes. The adrenaline causes other endocrine glands to release hormones that in turn causes other hormones to be triggered.

The end result is the "Fight or Flight" effect. Basically the effect is for the body to cut down blood supply to what are unessential organs and shunt the blood to essential organs. This is essential for survival.

Essential organs are the brain, heart, lungs and the sense organs. Non essential organs are the digestive, elimination and reproductive systems. Hence the blood is shut off from these organs, and if full the body triggers emptying. Thus your bladder and bowel loosen and you testicles become smaller.

At the same time blood is pumped faster to the brain, limbs and lungs. The brain gets it supply increased so it is able to process information faster, the lungs so they can increase the flow of oxygenated blood to the vital organs. Blood pressure rises (blood vessel get smaller), heart rate increases, eyes dilate so more light floods in therefore more visual stimuli, face either flushes (fight) or gets pale (flight). The legs get more blood in case you run, the arms in case you fight. the result is heat, flushing of the skin, sweating etc.

This reaction takes place in micro seconds. The most common reaction is the sick feeling you get when you get a fright. This is the "Fight or Flight" effect starting and finishing in a couple of seconds.

Other hormones are released as the cascade proceeds, such as atropine, endorphines etc. Any good physiology book will give your greater detail. You will find them in any good library and most school libraries as well.

Hope this helps.

veinglory
11-11-2007, 07:24 AM
That general tendency is often mild. in comparison to the way that sympathetic activation sends resources elsewhere and the neglected bladder/bowels release involuntarily. It is used as a standardised test of fear in rodents.

Vanatru
11-11-2007, 07:26 AM
It's nature's way of throwing a predator off your trail. The scent distracts the pursuer and gives the pursuee time to escape.

That would explain why the cats suddenly pause when they're charging me as I stand before the almighty toilet of confusion and relief.

Sleeply shuffling towards the toilet I sense them stalking me. Then, I can glimpses of their sleek bodies as the race for the kill, to pounce upon me and purr me to death.

BUT, I'm saved by the simple process of urinating into the toilet and they're thrown completly off target.

Thank god for that. I'm sure I've escaped a furry death many times as I shuffle back to the bed at 3am.

arrowqueen
11-12-2007, 02:02 AM
So that whatever eats me gets left with a bad taste in its mouth.

dpaterso
11-12-2007, 02:21 AM
So that whatever eats me gets left with a bad taste in its mouth.
:eek:

-Derek

Poohcat
11-12-2007, 05:05 AM
I suppose that would depend on whether you frightened it when it ate you!!!!!!

GeorgeK
11-12-2007, 07:05 PM
(and I don't care if you are a doctor--YOU have a baby and tell me it's only hormones changing with age!)
/soapbox

Believe what you want. You obviously think you know more than a Board Certified subspecialist in this particular field and I don't have the energy to bother, so why don't we just put each other on ignore. But for the record, from what you describe, you should probably see a specialist and have formal Urodynamics done.

GeorgeK
11-12-2007, 07:16 PM
Hormones usually aren't necessary, there are exercises you can do to strengthen those muscles even if they are damaged by childbirth.

Actually they are, just not in the way that the drug companies would have you believe, and not in the doses or formulations that they would like to be prescribed. Kegel Exercises will usually help with the sphincter tone, but not with the overall health of the surrounding soft tissues which is where the innervating nerves run. They will also not help with the base of the bladder (sometimes referred to as the internal urinary sphincter) which is not under voluntary control.

GeorgeK
11-12-2007, 07:33 PM
sympathetics are supposed to tighten the ureter sphincters and prevent peeing.

so it's still confusing.

Urethra, the ureters are something different, it's a common mistake. Again, the confusion has to do with the differences in nerve function between voluntary and involuntary. The fight or flight overrides things. The same nerves can have different functions in different situations, depending upon varrying electrolytes or hormones. We are a bit more complex than undergrad biology can devote time to. What Poohcat describes is a very concise and functional way of looking at it. It's oversimplified if you are the sort of person who would read a three volume treatise on that one topic, but if you don't want to spend 13 years in school to study that one rather esoteric thing then look at it her way.

Jeff Colburn
11-15-2007, 09:30 PM
Dogs do this to show submission, and hopefully prevent or minimize an attack by the aggressor. It may be the same in people.

Have Fun,
Jeff

Poohcat
11-16-2007, 11:51 AM
Thanks George. I did make it very simplified. I figure if people need in depth detail then they can go to path-phys class like the rest of us.

But thanks for the support.

By-the-way I am a he not a she. And only a RN with 20 years critical care so for detail George sounds like the fella (that's Kiwi for man).

Interesting chat though.
Pleased to help.

Mac H.
12-06-2007, 04:03 PM
Statement: "Minor damage resulting in urinary incontinence is fairly common after childbirth, which is why it's more common in women. It may grow worse over time, and can require minor surgery."

GeorgeK: "That's a myth that is unfortunately propagated by even some gyenecologists. It's not common as a result of normal childbirth. It's simply time"

Melanie: "And uh...you know this, how? ...Incontinence CAN be caused by birth, normal vaginal birth, or maybe the pregnancy"

GeorgeK: "Believe what you want. You obviously think you know more than a Board Certified subspecialist in this particular field and I don't have the energy to bother"
George - as a Board Certified subspecialist in this particular field - you must realise that there is a WEALTH of studies that show that childbirth IS an important factor. (See a quick sample below)

No matter how I look at the results, Melanie's statement that 'Incontinence CAN be caused by birth .. normal vaginal birth' seems to be supported by the studies. A doubling of prevalance up to 21% is big enough to be counted as a 'fairly common' downside. It certainly doesn't support the theory that "It's only time"

Since you disagree, and you are a subspecialist in this field .. which studies am I missing? How did these studies come to the wrong conclusion? (They already corrected for age)

Mac
Sample studies listed below:

(1) "CONCLUSION: Not only the process of childbirth itself but also processes during pregnancy seem to be strongly associated with prevalent urinary incontinence" Ref: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1508519

(2) "Results: No children: 10.1% prevalance of incontinence.
Cesarean: 15.9%.
Vaginal Delivery: 21%.
All figures age-standardized. Study of 15,307 women"
Ref: http://content.nejm.org/cgi/content/abstract/348/10/900

(3) "CONCLUSION: Vaginal delivery is independently associated with a significant long-term increase in stress urinary incontinence symptoms, as well as urinary urgency, regardless of maternal age or number of deliveries. LEVEL OF EVIDENCE: II-2"
Ref: Risk of urinary incontinence after childbirth: a 10-year prospective cohort study (http://lib.bioinfo.pl/pmid:17012448)

(4) "Work in recent years has identified pregnancy and childbirth as major risk factors for subsequent urinary incontinence. Specifically, vaginal delivery, operative delivery and a prolonged labour all increase the risk of postnatal urinary incontinence. "
Ref: Antenatal screening for postpartum urinary incontinence in nulliparous women: Results of a pilot study (http://clinmed.netprints.org/cgi/content/full/2000090001v1)

GeorgeK
12-06-2007, 05:46 PM
George - as a Board Certified subspecialist in this particular field - you must realise that there is a WEALTH of studies that show that childbirth IS an important factor. (See a quick sample below)

No matter how I look at the results, Melanie's statement that 'Incontinence CAN be caused by birth .. normal vaginal birth' seems to be supported by the studies. A doubling of prevalance up to 21% is big enough to be counted as a 'fairly common' downside. It certainly doesn't support the theory that "It's only time"

Since you disagree, and you are a subspecialist in this field .. which studies am I missing? How did these studies come to the wrong conclusion? (They already corrected for age)

Mac

Sorry Mac, but none of these are valid studies to address the issue. There is a reason that these articles are not in repudable Urologic journals. Most medical articles are a rite of passage to get through residency or medical school as opposed to an in depth scientific evaluation. They deal with population statistics which are meaningless when it comes to the idividual. People also routinely confuse correllation with causality. A subjective unmonitored questionairre is not the same as objective urodynamic testing. Peoples' memories are a tricky thing and they tend to lump less memorable stuff with the more memorable and so they forget that they were having urinary symptoms long before their pregnancy. They also tend not to know what are significant urologic symptoms. Most medical doctors also get easily confused with regard to urologic problems because it is not a required field of study during medical school or residency unless you intend to go into that field. A careful history and physical combined with objective urodynamics has in my experience and everyone I've ever talked to who does actual urodynamics shows that a NORMAL UNCOMPLICATED VAGINAL DELIVERY causes no long term urinary problems. Evolutionarily speaking it would be a terrible design to have potentially life threatening problems arise as a routine with pregnancy for creatures that reproduce relatively slowly.

Poohcat, sorry for assuming the wrong gender, no offense intended. Actually it wasn't your being a nurse that lead me falsely to that assumption. It was your screen name. I associate cats with feminine. I know it's illogical. It's leftover from childhood indoctrination.

Mac H.
12-06-2007, 08:36 PM
Sorry Mac, but none of these are valid studies to address the issue. ... A careful history and physical combined with objective urodynamics has in my experience and everyone I've ever talked to who does actual urodynamics shows that a NORMAL UNCOMPLICATED VAGINAL DELIVERY causes no long term urinary problems.Can you give the studies which DO back up your case?

I understand that urodynamic measurements show the same pressure characteristics between post & pre-pregnant ladies - however, taking all the pressure measurements doesn't change the fact that there is a higher incidence of incontinence after pregnancy than before ... even if we only look at normal, uncomplicated vaginal deliveries.

Perhaps the simplest explanation is that the increased prevalance is caused by issues that don't show up on urodynamic measurements ... indicating a limitation of the technique.

Another explanation might be the big gap (http://www.co-urology.com/pt/re/courology/abstract.00042307-200607000-00003.htm) in the perceptions of the patient's suffering between doctor and patient. Perhaps the doctors need to understand that even if 'objective measurements' indicate that the patient doesn't have a problem ... the patient might disagree!

Evolutionarily speaking it would be a terrible design to have potentially life threatening problems arise as a routine with pregnancy for creatures that reproduce relatively slowly.Evolutionarily speaking, would it matter? In Afghanistan, women have a 1 in 6 chance of dying as a result of childbirth. A simple doubling of the incidence of incontinence may not be species threatening ...

Mac
(PS: Which are the reputable Urologic Journals? Would the journal 'European Eurology' be good enough?)
Dare I go to that journal and search for the phrases 'Risk factors for urinary incontinence (UI) in women' 'Clinical consensus' & 'vaginal delivery'?)

Rolling Thunder
12-06-2007, 08:40 PM
*watches pissing contest, refrains from ordering popcorn*

Melanie Nilles
12-07-2007, 03:25 AM
Thank you, Mac, for taking up the debate. I don't care what a specialist says. I know my body. I live with many things now that weren't there four years ago, before the birth of my first child (both were normal, healthy births, btw). George can argue till he's blue in the face. I don't accept that it's just my age. Until a man gives birth, he'll never know what it's like and what it does to a woman. George wants his studies and you gave him something disproving his statement about birth and incontinence. Some people will never accept statistics unless they say what they want them to say.

Obviously a woman with personal experience doesn't know what a man does who relies on studies and has no experience with the issue of a personal nature.

I'm done. I said my piece. Not coming back, because I won't change my mind.

PastMidnight
12-07-2007, 03:44 AM
Another explanation might be the big gap (http://www.co-urology.com/pt/re/courology/abstract.00042307-200607000-00003.htm) in the perceptions of the patient's suffering between doctor and patient. Perhaps the doctors need to understand that even if 'objective measurements' indicate that the patient doesn't have a problem ... the patient might disagree!



I think this is an interesting point. I don't know if I can count the number of women that I know in their 20s or 30s who consider themselves to have urinary problems after pregnancy and vaginal delivery. Whether or not these problems are measurable or are serious enough to make them seek medical care, they do exist for these women. A pregnant woman accepts that there is a risk of incontinence after childbirth.

I wonder if the disagreement here on this thread stems from differences in definition and in degree of incontinence.

GeorgeK
12-07-2007, 07:07 PM
*watches pissing contest, refrains from ordering popcorn*

Thank you, you're right. It is a waste of my time.

zornhau
12-11-2007, 10:07 PM
this is the way its supposed to work:

sympathetics = fight or flight

para= rest and digest (and urinate or defecate)

so why do we pee when we're scared?

is it a mechanism to decrease blood pressure or is there something else here?

Well, according to the definitive "On Combat (http://en.wikipedia.org/wiki/On_Combat)", it's the body clearing decks for fight/flight. It's very common for even the bravest men to foul themselves in danger situations.

But why exactly does this help?

notpc
12-11-2007, 10:16 PM
You will also puke in combat situations, not because of the carnage, that part comes later, but because your body needs that blood you are using to digest food. Basically in a fear response you need more oxygen, this means more blood. The body shuts down all non-essential operations to get that blood. It’s not uncommon to crap, pee and puke all at once when you’re about to be killed, especially when the life threatening situation is drawn out over minutes as in combat assaults.

zornhau
12-12-2007, 12:22 AM
You will also puke in combat situations, not because of the carnage, that part comes later, but because your body needs that blood you are using to digest food. Basically in a fear response you need more oxygen, this means more blood. The body shuts down all non-essential operations to get that blood. Itís not uncommon to crap, pee and puke all at once when youíre about to be killed, especially when the life threatening situation is drawn out over minutes as in combat assaults.

I believe Special Forces types try to get in a "combat dump" before going into action - something most knightly field armour seems to take into account.

notpc
12-12-2007, 02:01 AM
And seeing as we're on the subject of being scared shitless, when you're under continuous long term stress, say, being posted to Nam at the ripe age of 20, nothing works right. You puke at most meals and have the runs, or constipation, for a month. (I just picked Nam out of the air. I believe the guys in WW2 had it worst.)

Angelinity
12-12-2007, 02:12 AM
Why do you pee when you're scared?


who told you?

HeronW
12-17-2007, 08:53 PM
Urination when excited, negatively or positively, is from stress which can be based on muscle weakness that can occur for pregnant women or the elderly, or incontinence due to infection.

It can also be as simple as the need for flight--and it's so much easier to run with an empty bladder than a full one! Also for rehydration later on, you can drink while running, and drink more with an empty bladder but drinking while the tanks already full will add uncomfortable pressure unless it's sweated out.

Angelinity
12-17-2007, 10:00 PM
actually....

dogs -- do pee when they are scared.

i hold it. 'til danger passes. then, i can r - e -l- e- a- s- s- s -s -e

scarletpeaches
12-17-2007, 10:05 PM
What happens if you're scared of peeing yourself?

Angelinity
12-17-2007, 10:08 PM
What happens if you're scared of peeing yourself?

you XXX--e--XXX----------XX------------eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee eeeeeeeeeeeeeeeeeeeeeeeeeeee ??

scarletpeaches
12-17-2007, 10:11 PM
Regarding certain comments further up the page - it always makes me piss myself with laughter to hear men tell women how their bodies react to childbirth.

Uh...yeah, okay. Head knowledge is obviously far superior to experience with that one...:rolleyes: