Bladder Dysfunction

Bladder Dysfunction

The bladder muscle is a balloon-like structure that holds urine. It expands to fill and contracts when it is ready to empty, this sends a signal to the brain via our nerves and spinal cord and gives the sensation of needing to ‘go’.

The average adult empties the bladder 6 to 8 times in the day and up to once at night. As we age it may be considered normal to wake up more than once in the night to urinate.

If you have problems with bladder function you may experience one, or a combination, of the following symptoms:

  • Frequency: this is when we have a need to pass urine more often than normal.
  • Nocturia: this is a more frequent need to empty the bladder that wakes us up multiple times at night.
  • Urgency: this is a sudden urge to pass urine that is difficult to control or ignore, and it sends us rushing to the toilet. This may result in Urge Incontinence which is a wetting accident caused by not making it to the toilet on time.
  • Any combination of frequency, urgency and nocturia, with or without urge incontinence, is called Overactive Bladder or OAB.
  • Stress Incontinence: this is a leakage that occurs due to an increase in intra-abdominal pressure such as coughing, sneezing, laughing, lifting, or exercise.
  • Additionally, changes in bladder function may also cause symptoms such as bed-wetting (Nocturnal Enuresis) in children and teens; leakage during intercourse (Coital Incontinence) in adults; pelvic or bladder pain; or urinary retention (difficulty emptying).

It is important that you are individually assessed to ascertain the type of dysfunction that is causing your symptoms in order to follow the best course of treatment but the following tips may be useful in most cases;

  • Do not restrict your fluid intake as this can irritate the bladder further. Adults should drink approximately 1.5 – 2 litres of fluids each day, the majority of which should be water. Try to sip small amounts spread throughout the day.
  • Avoid alcohol, caffeine and fizzy drinks, which are known bladder irritants. Eliminate tea, coffee, green tea, energy drinks and soft drinks. Drink decaffeinated tea and coffee if you must! Reducing juices and artificial sweeteners can also help.
  • Reduce fluid intake 3-4 hours before bed, just having a few sips of water if you are thirsty.
  • Watch your weight, aim for a BMI of 19 – 25 ideally. Being overweight or obese has been shown to significantly affect bladder symptoms.
  • Avoid constipation as this puts pressure on the pelvic floor, may cause irritation of the bladder and worsen your symptoms. Adequate water intake will help, as will a balanced diet with enough fibre, vegetables and fruit.
  • Regular physical activity can also keep the bowels moving regularly and optimise bladder and bowel function overall.
  • Try to avoid going to the toilet ‘just in case’.
  • If you struggle to hold on or suffer with incontinence your physiotherapist will assess you and provide you with specific pelvic floor muscle exercises and bladder retraining strategies. It’s important that these are specific to you as every bladder is individual!