First, let’s review basic bladder anatomy and the process of bladder emptying. The bladder is a hollow structure that receives waste fluid from the ureters, which carry urine from the kidneys. The bladder is lined with muscle tissue called the detrusor, which contracts to expel urine. Urine then flows through a tube called the urethra. The opening at the end of the urethra is controlled by pelvic floor muscles, specifically the external urethral sphincter. In other words, when you urinate, the bladder detrusor contracts to empty the bladder, and the pelvic floor muscles relax to allow urine to exit the body. This process, although seemingly simple, can be negatively affected by our daily habits. Bladder dysfunction can manifest in many ways, including stress urinary incontinence (leaking when you cough, sneeze, laugh, or jump), urge urinary incontinence (leaking when you feel the urge), incomplete emptying (urinating again shortly after having gone to the bathroom), inability to detect a full bladder, and urinary tract infections.
Today, I am going to give you some general tips to remember to help optimize your bladder health and your brain-bladder connection.
Just In Case peeing – Just In Case peeing (JIC-ing) is exactly what it sounds like, and you may be wondering, “What is wrong with this? At least I am making it to the bathroom!” Before our bladder is full, it sends messages to the brain that alert us we will have to empty soon, and another message when the bladder is nearly full, saying we have to empty right now! Over time, this practice leads the bladder to think it needs to empty even though it is not full. There may be a handful of times when “JIC-ing” is appropriate, but it should be avoided as much as possible to maintain a happy, functional bladder.
Hovering over toilets – Do you ever find yourself using a public restroom and hesitating to sit fully on the toilet seat to avoid germs? I used to do this in all public restrooms until I learned how harmful it can be to our pelvic floor. When cisgender females urinate, the detrusor contracts and the pelvic floor relaxes, allowing urine to be expelled from the body. When we hover over a toilet, our pelvic floor muscles remain engaged to maintain the position. When we urinate, it is important to adopt a position that supports complete pelvic floor muscle relaxation. If germs worry you, wipe the toilet seat with antibacterial wipes, use a toilet seat cover if available, or line the seat with toilet paper.
Pushing while you pee – When you sit down to urinate, do you feel like you have to bear down to expel urine? Some people may feel rushed and try to empty their bladder as quickly as possible. For others, the pelvic floor is so tight that the only way to lengthen the muscles for urine expulsion is to bear down or push lightly. We should not forcefully push out urine for the same reason we should not hover over toilets. In healthy bladders, the pelvic floor relaxes as the bladder contracts to expel urine. When we force urine out, we prevent the pelvic floor muscles from fully relaxing. Next time you go to the bathroom, pay attention to your effort. Try to just sit back, relax, and breathe, and your body will take care of the rest.
Pop, coffee, and energy drinks! – Caffeine in many delicious drinks like pop, coffee, and energy drinks can negatively affect the bladder. Specifically, caffeine irritates the bladder lining. In addition to being a bladder irritant, caffeine acts as a diuretic, prompting the kidneys to produce more urine. If cutting out your favorite drink(s) of the day seems impossible, do it in moderation. Instead of having 4 cups of coffee, have 3 cups, and then drink warm water when you would usually drink your 4th!
Neglecting hydration – We often hear how important it is to stay hydrated, but did you know that hydration is also an important part of keeping the bladder healthy? The bladder lining helps detect how much urine is in the bladder and sends signals to the brain for when it is time to empty. However, when we are dehydrated, the bladder lining becomes irritated and is less supportive of bladder function. This can be complicated, because many people who experience incontinence try to limit their liquid intake in an effort to avoid incontinence. However, to maintain a healthy bladder environment, staying hydrated is crucial for keeping tissue healthy, functional, and reliable.
All in all, bladder dysfunction can be annoying and significantly impact our ability to participate in activities of daily living. Do yourself a favor and start implementing some of these strategies and knowledge into your daily life. You never know how it will change your symptoms or protect against future dysfunction until you give it a try!