Have you ever wondered about what’s normal for your bladder? Like how often you should go to the toilet, should I hold my wee or should I go as soon as I feel the urge? Yes, its a ‘thing’. So, today ladies I want to get you acquainted with your bladder.
WHAT IS THE URINARY SYSTEM?
The main role of the urinary system is to remove waste from the blood and to excrete them from the body as urine.
The urinary system is made up of four main organs.
- Kidney: You have two kidneys (left and right), their main role is to remove waste from blood and regulate water/ fluid levels.
- Ureters: are the tubes which connect the kidneys to the bladder. Their main role is to transport urine from the kidney to the bladder.
- Bladder: aka ‘storage tank or the balloon’. The bladder is a hollow muscular organ which is 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: aka ‘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 originate from the pubic bone at the front and attach to the tailbone at the rear and extend side to side between our sitting bones (ischial tuberosities).
Contraction of your pelvic floor muscles help to:
- Keep the urethra closed which helps prevent urine from leaking out and
- Contraction of the pelvic floor muscles sends a message to your bladder for it to stay ‘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 for the increasing volume. When the bladder is expanding normally, there is usually no sensation that there is anything in your bladder until there is approximately 150-200mls of urine. As more urine continues to enter the bladder, there is further expansion of the detrusor muscle and this results in an increase in the stretch of the muscle. This stretch generates a signal to the brain whereby you register this as an increasing urge to pass urine. When the bladder reaches a volume of 300-500mls most people have a reasonably strong urge to pass urine.
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 odour
WHAT ARE THE SYMPTOMS THAT THERE MAY BE CHANGES TO MY BLADDER FUNCTION?
- Frequency- going to the toilet more often
- Urgency- sudden, strong desire to wee
- Nocturia- woken by your bladder to go for a wee at night more than once
- Incontinence- read this blog: what is urinary incontinence?
- Hesitancy- delayed start to the flow of urine
- Slow stream- compared to your normal or it is interrupted
- Deviation or spraying of the urine flow (i.e. doesn’t go straight down)
- Straining to do a wee
- Post Micturition Dribble- dribbling of urine after you’ve dried yourself
- Double voiding- feeling like you need to wee again shortly after you’ve been
- Feeling of incomplete emptying
WHAT ARE SOME EXAMPLES OF GOOD BLADDER HABITS?
These may not be appropriate for all. If you do experience changes to your bladder function or are bothered by it, it is best to reach out to your Women’s Health Physiotherapist or general practitioner for individualised assessment and care.
- 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
WHAT SHOULD I DO IF I AM BOTHERED BY MY BLADDER HABITS?
You should definitely consider reaching out to your Women’s Health Physiotherapist or general practitioner for further guidance. Depending on symptoms most can be managed through physiotherapy with management strategies such as:
- education and advice
- voiding dynamics education
- pelvic floor muscles training
- pelvic floor down-training
- management of constipation
- exercise/movement strategies
- bladder retraining
- pessary
In other instances, we may recommend referral to a urogynecologist or urologist.
If you are suffering from changes to your bladder function, please do call/WhatsApp on 9780 7274 or get in touch over email to discuss your concerns. Rest assured, help is available.
You can also visit our website to learn about other women’s conditions we treat through physiotherapy and how we can help you.
Thank you to Taryn Hallam on providing the content for the blog.
