How Wee Works: A guide to your Bladder

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:

  • urinary urgency 
  • urinary frequency 
  • urinary urge incontinence 

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.

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 continence or pelvic floor physiotherapist, urologist 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.

Kym Veale – Director of Womankind Physiotherapy.
Telephone: 9431 2530