Why Do You Need to Pee as Soon as You Get Home?

You’ve been out running errands all morning, and now you have to pee. Like, you really have to pee. You barely make it home without bursting. But as you put your key in the front door, the floodgates open.

Suddenly, you’re leaking urine before you can hobble to the bathroom. What gives?

The phenomenon known as “latchkey incontinence” affects thousands of people. Urologist Emily Slopnick, MD, explains why you might have an accident when you get home and what you can do about it.

What is latchkey incontinence?

Latchkey incontinence is also called key-in-the-door syndrome or turnkey incontinence. And just like the name implies, it happens when you unlock your door or step inside your house.

“Latchkey incontinence is a type of urge incontinence, meaning you feel a sudden, strong urge to urinate,” says Dr. Slopnick. “With latchkey incontinence, coming home or opening your door triggers this urge.”

Urge incontinence isn’t a disease but it’s often a symptom of another bladder issue.

“Overactive bladder (OAB) is the most common reason people have latchkey or urge incontinence,” she explains. “If you have OAB, you may feel the urge to pee more often than usual, or the urge may be sudden and strong.”

Latchkey incontinence rarely appears by itself. In other words, you probably have urinary frequency or urgency at other times but haven’t noticed.

“Latchkey incontinence happens at a specific time, so it grabs your attention,” she continues. “But usually, people with latchkey incontinence are also peeing more often throughout the day or during the night. They may also be having occasional accidents.”

Causes of latchkey incontinence

Your brain and bladder have a close relationship. Signals from your brain tell your bladder when to hold urine and when to release it. This connection explains why it’s sometimes difficult to hold your pee when you get home.

“If you always go to the bathroom after you walk in the door, your brain and bladder get used to this pattern,” says Dr. Slopnick. “Then, your brain sees the trigger — like your key in the door — and tells your bladder it’s time to go. It sends a signal to your bladder before you’re ready.”

But not everyone who hits the loo as soon as they get home will have latchkey incontinence. Certain factors increase your risk, including:

• Age. People over age 40 are more likely to have any type of urge incontinence, including latchkey incontinence.
• Constipation. A buildup of hard stool in your colon can put pressure on your bladder, making incontinence worse.
• Menopause. People who are past menopause have a higher risk of urge incontinence.
• Neurological conditions. Medical conditions that affect your nerves can make your bladder nerves more sensitive or trigger your brain to send unwanted signals to your bladder. Such conditions include diabetes, multiple sclerosis, Parkinson’s disease or a previous stroke.
• Urinary tract infections (UTIs). A UTI can irritate the lining of your bladder, which could trigger your bladder muscles to squeeze when you don’t want them to.

Can you train your bladder to stop latchkey incontinence?

Latchkey incontinence can be embarrassing and inconvenient, but you’re not powerless against it. Bladder training can help stop the urge to pee as soon as you get home.

“Latchkey incontinence happens at a specific time, so you can plan ahead,” says Dr. Slopnick. She recommends:

• Avoid or minimize bladder irritants. Caffeine, carbonated beverages and acidic or spicy foods can irritate your bladder, increasing the risk of urgency and accidents. “Try to cut back on coffee, tea or soda when you’re away from home,” she suggests. “Avoid acidic or spicy foods and artificial sweeteners, too.”
• Empty your bladder. Use a bathroom while you’re out, even if you don’t feel like you need to go. “You might be so used to holding it that you don’t feel the urge to go when you’re in a public place,” says Dr. Slopnick. “Try to go anyway to avoid having a full bladder when you get home.”
• Keep a diary. Do some detective work to determine whether certain things might make latchkey incontinence worse. “Write down your meals, drinks and activities each day for about a week,” she advises. “Record whether you had urgency or accidents and when these things happened. You might find some underlying triggers that are making it harder to control your bladder.”
• Stop and relax. When you arrive home, don’t immediately rush to the door and head to the toilet. Instead, sit outside or in your car for about 10 seconds and see if the urge to go passes. “Try some relaxation exercises, like deep breathing, or do some Kegel exercises,” she recommends. “A few seconds may calm the urge and help break that habit. But don’t push your bladder too hard — you should still go to the bathroom once you’re inside.”

It may take several weeks to notice a difference with these changes, so stick with it. Many people find that their symptoms improve with these steps. “Lifestyle changes may be enough to keep you from having accidents as soon as you open your door,” notes Dr. Slopnick.

Other treatments are available

Dr. Slopnick says that if these at-home steps don’t work, don’t panic. Your healthcare provider is there to help.

“We can determine what’s causing the incontinence and offer treatment options,” she reassures. “Many people benefit from pelvic floor physical therapy, where you learn specific exercises to regain bladder control. There are also medications, injections and procedures to calm abnormal nerve signals to reduce urgency.”

Finally, don’t assume you have to live with incontinence.

“Many people mistakenly think that bladder leakage is normal as you get older,” says Dr. Slopnick. “It’s common, but it’s not a normal part of aging. Urge incontinence is treatable, and avoiding accidents can greatly improve your quality of life.”