Taking the Pee: Women’s Physiotherapist Answers Common Questions About The Female Bladder

It is estimated that 9.6 million women in the UK suffer with bladder issues like urinary incontinence, cystitis and overactive bladder – which can have a huge impact on a woman’s confidence and wellbeing.  However, many women are not aware that Women’s Physiotherapy and Diet changes are among the most effective first line treatments.  Women’s Physiotherapist,  Kirsten Barrett, from Neurophysio Wales, explains for Urology Awareness Month how the female bladder functions and answers some of the questions she is most often asked in her practice in South Wales.

What does the bladder look like?

Image Copyright: National Institute of Diabetes and Digestive and Kidney Diseases – NH

The bladder looks like a balloon. As it fills, the sides stretch which gives you the sensation that you need to empty.

How much should the bladder hold?

The bladder should hold up to 750mls if working properly.

How often should I need to empty my bladder?

You should need to empty around 4-6 times a day and no more than 1-2 times over night. If this is not your experience, you may need to
(A) Discus your bladder with your GP to rule out water infection
(B) Change what you are drinking.
(C) Change how much you are drinking.

What drinks are ‘Bladder Irritants?’

Some drinks make you need to empty more often. If you drink large amounts of caffeinated drinks (tea, coffee, hot chocolate and some energy drinks); citrus drinks (orange, lemon, lime or
blackcurrant); fizzy drinks or alcohol, you might be advised to replace these with less irritating alternatives such as decaf options, caffeine free options, still juices or water.

How much should I drink?

This varies depending on how active you are but should be around 2L daily for a quiet day, more if doing hard physical exercise and during breast feeding.

Dehydration

Sometimes, people avoid drinking because they are afraid of having an accident – however, if you are dehydrated, this irritates the bladder and can have the opposite effect. It can also lead to
constipation.

What is ‘Just in case Voiding’?

Sometimes, people empty too often because they are afraid of accidents. Doing this regularly can make your bladder hypersensitive which increases the risk. Only empty when you need to not every time you see a toilet.

What help is available?

If your bladder has changed or if it is painful to pass water, you should first consult your GP who will take a sample to rule out water infection. Water infections can be treated with antibiotics by your GP.
If there is no infection, you can either refer yourself or be referred to a Physiotherapist for bladder training and pelvic floor advice.  There can be a waiting list on the NHS and some women will choose to see a private Women’s Physiotherapist, but the advice will be the same.

What happens if Physiotherapy doesn’t work?

If bladder training and pelvic floor exercises don’t improve the problem, your Physiotherapist may recommend that you discuss other options with your GP or may recommend referral to a consultant.
However, for many people, exercises and changes in diet/fluids are really effective – and clinical studies have determined them to be the preferred first line treatment.