How wee works. A guide to your bladder…(part 1).

Bladder-Blog

I love sharing the information in this blog with my clients. I think it’s because it’s always this light bulb moment when they finally get the facts about how they are meant to wee. If I had a dollar for every time someone has said to me “We should be taught this when we are kids!” I’d probably only have a medium-sized tower of dollar coins.…But even so, it’s powerful stuff! So here you are: spread the good word and lets all get our wee working!

How often do you wee? More than 6 times a day? Do you wake up overnight to wee? Do you make sure you go to the toilet before you leave the house? Do you rush to the toilet as soon as you get in the door?

If you answered yes to any of the above questions, you are not using your bladder correctly, and you could be setting yourself up for conditions such as:

The bladder’s job is to fill, store and then empty urine. The bladder is a muscle, called the detrusor muscle. Which means it’s really good at stretching, then forcefully contracting and rebounding to it’s normal shape. And it does this over and over and over, every day of our lives. Within the wall of the bladder, there are baroreceptors, or ‘pressure receptors’ that feedback information to our brain about how the bladder is filling. Once these messages get loud enough, they come to our conscious attention, and we get the urge to go to the toilet. Once on the toilet, our brain sends a message to the bladder to contract, and the bladder muscle squeezes all our urine out.

Sounds simple right?

And it can be. But the bladder muscle, like every muscle in our body, contracts best within a certain range of motion. Or, in the case of the bladder, within a certain volume of urine. So, why do we care if our bladder is, or isn’t contracting at it’s best?

If the bladder is not filled enough, then the detrusor muscle is unable to generate sufficient force to expel all the urine, and we can experience; poor urine flow, increased post-void residual (the amount of urine left in the bladder after emptying), urinary frequency, and increased risk of urinary tract infections.

Additionally, over time, if the bladder is never allowed to fill up and stretch, the detrusor muscle becomes stiff and can become unable to hold decent urine volumes. This can progress to symptoms such as urinary urgency, urinary frequency, nocturia (waking more than once per night to urinate), and urinary urge incontinence.

Now, don’t get too carried away on the big wee’s, bigger is not always better. If you repeatedly over-stretch your bladder muscle, you end up with lazy pressure receptors that forget to send your brain the message that your bladder is filling. Also, your bladder ends up looking like a deflated balloon and this also can result in poor urine flow, poor emptying and urinary urgency.

So, hopefully now you are asking “What is this magic volume that I need to be wee-ing at every toilet stop?” Drum roll please…..Optimal bladder habits are as follows:

250-500mls per wee

5-6 wee’s per day

0-1 wee per night.

It was worth waiting for wasn’t it!?

So, how do you find out if this is what you are doing? Grab yourself a measuring device (preferably a dedicated one you have purchased for the task, and not the kitchen measuring cup), measure and write down your wee’s for at least a 24hour period. If you fall within the above range, give yourself a pat on the back (or bladder) and move on. If not, make the time to speak to a continence professional such as a urologist, continence physiotherapist or continence nurse and find out what is causing your less than optimal bladder habits, and how to fix them. Unfortunately, we know that poor bladder habits or urinary symptoms such as urgency, frequency and incontinence get worse over time unless they are treated. So seek treatment sooner rather than later.

The Continence Foundation of Australia provide a fantastic resource to find professionals close to you. Visit the website at www.continence.org.au or call the free helpline 1800 33 00 66.

This is the first in a series of blog I will be publishing about how to use your bladder optimally. Keep posted for information on appropriate fluid intake, effects of caffeine and alcohol on urinary symptoms, how to control and suppress urinary urgency, and preventing urinary tract infections.

kym head shot blog photo

Kym Veale practices at Inform Physiotherapy in Fairfield, Victoria with Women, Men and Children to optimise all aspects of continence and pelvic floor health. She graduated from Melbourne University in 2007 with a Bachelor of Physiotherapy. Since then, she has completed two post-graduate certificates; Advanced Rehabilitation in Pelvic Floor Physiotherapy, and Exercise for Women. Outside of work, Kym runs around after her two daughters and husband, stays active with crossfit, tries to keep up with a bookclub, and in her spare time (who are we kidding) does a lot of housework and laundry!

To book an appointment with Kym, log onto www.informphysio.com or call 03 9481 6312