Why are we talking about this?
Bladder problems are a common concerns in women after giving birth. It can range from increased frequency, having to rush to the bathroom, urinary leakage or difficulty emptying. There are many factors responsible for these bladder issues but often we find that unhealthy bladder habits perpetuate bladder problems.
What is normal bladder behavior?
Bladder is an organ of storage, its job is to hold our pee until we are ready to empty it. The bladder is generally able to hold about twenty oz of urine. It typically needs to empty itself 6-8 times during the course of a day. The bladder is supported in the pelvis by a muscular hammock called pelvic floor muscles. Pelvic muscles maintain tension to help with bladder muscle relaxation and bladder filling. During micturition the pelvic muscles relax allowing the bladder muscles to effectively squeeze out its contents. This seemingly easy mechanism is controlled by many intricate muscle and nerve pathways that are regulated by our brain.
What are some common bladder problems?
Urinary frequency- peeing too often typically more than 8times/day
Urinary urgency- needing to rush to the bathroom or inability to hold
Difficulty voiding- incomplete emptying or having a post-void dribble of urine
Urinary leakage- involuntary loss of urine
How can I help my bladder?
We often limit our fluids to avoid uncomfortable bladder situations. It seems intuitive to decrease fluids if you want to avoid leakage or decrease your bathroom trips. Lack of adequate fluid intake creates concentrated urine. Usually it is dark , has a strong odor and has small amount.Concentrated urine irritates the inner lining of the bladder creating frequent need of emptying and urgency. Restricting your fluid intake does not solve the bladder problems and might put you at risk of dehydration, tiredness, muscle cramps and constipation.
Different sources recommend different guidelines for daily water intake. Most common recommendations by health sources is 64 oz of water every day. This comes to about two liters or 8 cups of water. Limiting the intake of bladder irritants can help curb frequency/urgency. Common bladder irritants are caffeine , alcohol and carbonated beverages.
Take your time in the bathroom
Our bladder is busy storing pee all day when we are moving. When we sit down to pee our leg and pelvic muscles relax allowing the bladder to effectively empty itself. Most of us hover over a toilet seat in public bathrooms. If you are avoiding to relax your bottom on the toilet seat it makes it harder for your bladder to empty itself.It interferes with the muscle coordination and higher neural reflexes and can lead to ineffective emptying.Even in the comfort of our own home some of us forget to relax and breathe on the toilet seat. Maybe you are constantly rushing to get to the next task , maybe you have a toddler unattended outside the bathroom door or maybe you are running late. When you rush your pelvic muscles can not relax and it leads to incomplete emptying. Incomplete bladder emptying is a leading cause of frequency, post void dribbling, infections.
Don't ignore your bladder
Bladder needs to empty itself at regular intervals , typically every 3-4 hrs. Often during busy life moments we adopt unhealthy bladder habits and teach our brain to ignore the needs of our bladder. We can get caught up with work , kids keep us occupied or sometimes we avoid peeing because it is not convenient in the moment. If you frequently delay peeing , it can cause overstretching of the bladder muscle and make it weak.Weak bladder is not effective with emptying.
Avoid just- in case voiding
We often find ourselves peeing “just-in case” before you hit the road for a long drive, before you enter a movie theatre, before you leave for a party, before you work out and the list goes on. By training ourselves to go when not needed, we are decreasing the ability of the bladder to store pee. Typically we should be able to maintain at least a three hour voiding interval unless you chugged an entire bottle of water or had lots of coffee. If you notice that you are guilty of peeing just in-case too many times or you find yourself creating that habit for your kids, it is time to rethink that!
Do NOT normalize leakage
Abdomen and pelvis create a pressure system. We increase pressure in our belly when we sneeze / cough/ laugh/ lift things/exercise or have a full bladder.Pelvic floor muscles preemptively squeeze to cradle our bladder and counteract the abdominal pressure to prevent leakage. Any deficits in this pressure system will cause excessive downward pressure on the bladder causing urine leakage. Incontinence or leakage is more common after having babies and it gets normalized far too often. Leaking is common but it does not have to become your new normal.If you are experiencing urine leakage consult a pelvic floor physical therapist. In the meantime support your bladder with pelvic muscle lift during high pressure activities such as sneezing or lifting.