Incontinent Churnalism
Briefly sounding off...
If you are anything like me, you have said, or thought, something like this in the last couple of weeks:
I’m just going to pee before we leave.
Wait, let me use the bathroom before we get in the car.
I’m gonna run to the men’s room before we board.
I therefore rolled my eyes when I read the headline of a New York Times article, Is Going to the Bathroom ‘Just in Case’ Bad for You? Just from the title, I knew it was a piece of churnalism, and I swore I wouldn't read it or write about it. Then my daughter read the article and told me I had to read it because it would make me nuts. I read it. She was right.
Then the Times began trolling me, first feeding me the article on the website and then sending it as an alert. I was goaded into writing about it.
You can read the article if you want, though I wouldn’t recommend it. The article suggests that “just in case” voiding could, conceivably, lead to urge incontinence. Urge incontinence is one of the four classes of incontinence. Often referred to as an overactive bladder, the primary symptom of urge incontinence is a sudden need to void, frequently so intense that it is impossible to make it to a toilet in time. The author supports the contention that “just in case” voiding is risky, with quotes from some well-meaning experts.
…when you pee “just in case,” your bladder starts alerting your brain too early, before having the standard amount of urine. This disruption can reduce “the volume your bladder can hold over time.”
Somewhat curiously, after making this argument, the article devotes about half its real estate to discussing ways we treat diverse urinary concerns (not just urge but also stress incontinence).
This article barely even qualifies as churnalism. For those who haven’t been following our articles, churnalism refers to the careless, incurious, and uncritical reporting of poorly done biomedical research. This brand of churnalism trades a real story — why a study is unimportant or proves something other than it contends — for the easy headline.1 This article doesn’t even begin with data; instead, it starts with a random question:
Q: A urologist recently told me I shouldn’t go to the bathroom “just in case.” Is that true?
Following Betteridge's law that "Any headline that ends in a question mark can be answered by the word no," you would think this article could have been one word long.
To understand why this article has no merit, consider the trial you would need to perform to prove that going to the bathroom “just in case” was bad for you. You would need to take a group of adults and randomly assign them into three groups. The “normal urination schedule” group would go about their business. The mandatory “just in case voiding” group would be forced to urinate every time they planned to leave a place with a bathroom. The “hold it in group” would be prohibited from ever peeing before going out.2 The endpoint would be some validated measure of urinary-function-related QOL after 1, 3, and 5 years.
Obviously, no study like this has ever been, or will ever be, done. The Times article would have been helpful, more educational, and more interesting if it had pointed out that any effect of “just in case” voiding – also called convenience or proactive voiding – is at best theoretical. That article could have gone on to reproduce the classic 2X2 table of chronic incontinence and discuss the causes and treatments of each.
I reproduce this as a reminder to any student who might work with me in the future, as I often quiz them on it. I will withhold the famous DIAPER mnemonic for causes of acute incontinence or our podcast on the topic for those genuinely interested.
If you want to explore all our churnalism content, it's all indexed here. This article and this video summarize the seven deadly sins of churnalism.
I’ll be right back.
Ha! Resist the urge to read anything in the New York Times!