Did you know that there are normal bladder habits? Like how often you should go to the toilet, if you should go as soon as you feel the urge or hold it in? Let’s break down these normal bladder habits!
WHAT IS THE URINARY SYSTEM?
The urinary system’s main role is to remove waste from the blood by excreting them as urine.
The urinary system is made up of four primary organs.
- Kidneys: The left and right kidneys’ main role is to remove waste from the blood and regulate water or fluid levels.
- Ureters: These are the tubes which connect the kidneys to the bladder, and where urine passes through.
- Bladder: This is also known as the storage tank or the balloon. The bladder is a hollow muscular organ in the pelvis, just above the pubic bone. The role of the bladder is to store urine until you are ready to go to the toilet.
- Urethra: Also called the tap, the urethra is a thin tube which urine passes through when you relax your pelvic floor muscles as you go to the toilet.
WHAT IS THE ROLE OF PELVIC FLOOR MUSCLES DURING NORMAL VOIDING AND BLADDER FUNCTION?
The pelvic floor muscles are a group of muscles that begin from the pubic bone, and extend to the rear, attaching to the tailbone. These muscles also extend between our sitting bones, known as the ischial tuberosities.
Contracting your pelvic floor muscles serves two key purposes:
- It keeps the urethra closed, preventing urine leakage.
- It sends signals to your bladder to remain ‘relaxed’, so it can continue to fill and store urine.
WHAT IS NORMAL BLADDER SENSATION AND FILLING? WHY IS THIS IMPORTANT?
The bladder is made up of a muscle known as the detrusor. As urine enters the bladder, the detrusor muscle slowly expands to accommodate the increasing volume of liquid. Normally, there is no sensation of liquid in your bladder until there is about 100-200 ml of urine. As more urine fills the bladder, the detrusor muscle further expands, creating a stretch that signals to the brain, leading to an increasing urge to pass urine. This stretch generates a signal to the brain as an increasing urge to pass urine. When the bladder reaches a volume of 300-500 ml most people have a reasonably strong urge to urinate.
WHAT ARE NORMAL BLADDER HABITS?
A Bladder can hold up to 1L (or more in some) of urine. In a person that approximately drinks 2L/day, they will:
- Visit the toilet every 3-4hrs
- Will pass 300-500mls each void
- Making a total of 4-6 trips during the day
- Go to the toilet no more than 1 trip at night (woken by the bladder not because you woke up and you thought it was a good idea to or the baby woke you up)
- Experience no burning, pain, blood or odor
WHAT ARE NORMAL BLADDER HABITS?
A bladder can usually hold up to one liter of urine. For someone who drinks approximately two liters a day, it is normal to:
- Visit the toilet every three to four hours
- Pass about 300-500 mls each time
- Make a total of four to six trips during the day
- Go to the toilet no more than once a night (woken by the bladder, not by personal choice or external factors).
- Feel a gradual sensation to void (not delayed and not urgent)
- Experience no burning, pain, blood, or unusual odour
- There should be no need to strain and you should feel fully empty
WHAT ARE THE SYMPTOMS THAT THERE MAY BE CHANGES TO MY BLADDER FUNCTION?
- Frequency: Going to the toilet more often.
- Urgency: Sudden and strong desire to urinate.
- Nocturia: Woken by the bladder to urinate at night more than once.
- Incontinence: Refer to our blog on urinary incontinence for more information.
- Hesitancy: Delayed start to the flow of urine.
- Slow stream: Slower or interrupted urine flow compared to your normal.
- Deviation or spraying: Urine flow doesn’t go straight down.
- Straining: Difficulty in initiating urination.
- Post-Micturition Dribble: Urine dribbling after drying yourself.
- Double voiding: Feeling the need to urinate shortly after having done so.
- Feeling incomplete emptying: Sensation that the bladder is not fully emptied.
WHAT ARE SOME EXAMPLES OF GOOD BLADDER HABITS?
- Stop going to the toilet “just in case”
- Sit, don’t hover.
- Stop practicing Kegels whilst urinating.
- Avoid constipation.
- Learn how to connect with your pelvic floor muscles properly.
- Don’t strain or rush.
Remember that good bladder habits may look different or may not be suitable for everyone. If it starts to bother you, seeking help is advised!
WHAT SHOULD I DO IF I AM BOTHERED BY MY BLADDER HABITS?
It is recommended to seek guidance from your women’s health physiotherapist or general practitioner. Depending on your symptoms, physiotherapy can help manage them, incorporating strategies such as:
- Education and advice
- Voiding dynamics education
- Pelvic floor muscle training
- Pelvic floor down-training
- Management of constipation
- Exercise or movement strategies
- Bladder retraining
- Pessary
In other instances, we may recommend referral to a urogynecologist or urologist.
If your bladder habits don’t feel normal to you, trust that instinct. A women’s health physiotherapist can help identify what’s driving your symptoms.
Note: While I am a physiotherapist, I am not your personal physiotherapist. The contents of this website are for informational purposes only and are not intended to serve as individual medical advice.
Thank you to Taryn Hallam for inspiring this blog content.
References
- https://www.embracephysio.sg/what-is-urinary-incontinence/
- https://www.hopkinsmedicine.org/health/wellness-and-prevention/anatomy-of-the-urinary-system
- https://www.nia.nih.gov/health/bladder-health-and-incontinence/15-tips-keep-your-bladder-healthy
- https://www.health.gov.au/sites/default/files/good-bladder-habits-for-everyone_0.pdf
- https://www.ics.org/glossary/symptom/normalbladderfillingsensation
- https://www.ncbi.nlm.nih.gov/books/NBK482181/#:~:text=The%20detrusor%20muscle%20is%20located,again%20in%20the%20outer%20layer.
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