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Aug 29

Bladder health – Am I normal?

We never talk much about our bladders, do we? We pick up habits in childhood from well meaning parents, that we then teach our kids without much knowledge as to what is healthy for our bladder.

The bladder is a stretchy, muscular storage bag that has two jobs – the storage phase and the empty phase. Being a muscle, it slowly lengthens as urine is produced by the kidneys and then stored in the urine. The pressure within the bladder doesn’t rise at it fills, unlike a balloon. When it has reached a ‘good’ volume, we often get a message from the bladder to the brain letting us know that we are part way full. We usually ignore this message, and wait until an appropriate time to go to the toilet to empty the bladder.

A while later – perhaps an hour later, a stronger message from the bladder to the brain indicates some fullness of the bladder. This feeling of comfortable fullness is easily tolerated, and our bladder stays relaxed and in storage mode until we are sitting on the toilet with our pants down .

Any feeling of an insistent or uncontrollable sense of urgency is not normal. If you do have this irresistable feeling of urgency, it becomes very difficult to resist, and you may find that you repeatedly go to the toilet at the first sensation from the bladder – going to the toilet ‘just in case’. This can mean that you get into a habit of preventing the bladder from filling up properly, and a smaller bladder volume may result. Speak to your doctor or pelvic floor physio for more advice if you suffer from very strong bladder urgency.

Once seated on the loo, the bladder muscle contracts and empties the bladder of urine. We don’t need to ‘push’ to start the flow, to keep it going, no to finish. It is usually a ‘good’ stream, not slow, nor having a more staccato / ‘stop / start’ pattern to empty.

Measuring the output of your bladder is a very important step in working out how normal your bladder behavior is. Your Vital Core physio may ask you complete one as part of your assessment. Typical day time volumes are 250 -400ml, with 500 – 600ml overnight. It is typical to void about 5-6 times during the day, with 0-1 overnight, plus an extra one if you are pregnant or post menopausal.

Most of us should drink 1500 – 1800ml per day, including all liquids – tea, coffee, soup, juice, alcohol and water. Drinking more than this can overload our urinary system, making symptoms of urgency or leakage far worse.

We hear terms like ‘light bladder leakage’ and think that it’s normal to leak, especially after having a baby. Unfortunately, ‘LBL’ is incontinence. Incontinence isn’t normal, although it is common, and there is much that can be done to treat it, depending on the causes. You may need to learn how to do pelvic floor muscle exercises properly with the help of a pelvic floor physio, you may need to modify how much you are drinking, you may benefit from some bladder training to get the brain back in charge of the bladder, or you may need medication or surgery. Your Vital Core Pelvic Floor physio can help!