To pee or not to pee? That is a question for the bladder—and the brain

The basic urge to pee is surprisingly complex and can go awry as we age.

Jun 2, 2024 - 20:50
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To pee or not to pee? That is a question for the bladder—and the brain
Cut view of man covering urine with hands. He has some pain and problem. Isolated on striped and blue background

Enlarge (credit: Estradaanton/Getty Images)

You’re driving somewhere, eyes on the road, when you start to feel a tingling sensation in your lower abdomen. That extra-large Coke you drank an hour ago has made its way through your kidneys into your bladder. “Time to pull over,” you think, scanning for an exit ramp.

To most people, pulling into a highway rest stop is a profoundly mundane experience. But not to neuroscientist Rita Valentino, who has studied how the brain senses, interprets, and acts on the bladder’s signals. She’s fascinated by the brain’s ability to take in sensations from the bladder, combine them with signals from outside of the body, like the sights and sounds of the road, then use that information to act—in this scenario, to find a safe, socially appropriate place to pee. “To me, it’s really an example of one of the beautiful things that the brain does,” she says.

Scientists used to think that our bladders were ruled by a relatively straightforward reflex—an “on-off” switch between storing urine and letting it go. “Now we realize it’s much more complex than that,” says Valentino, now director of the division of neuroscience and behavior at the National Institute of Drug Abuse. An intricate network of brain regions that contribute to functions like decision-making, social interactions, and awareness of our body’s internal state, also called interoception, participates in making the call.

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