Do You Push to Pee?

The bladder consists of three interfacing layers of smooth muscle that tighten together to empty the bladder when we sit, relax the pelvic floor and pass urine. After the pelvic floor relaxes, the bladder muscles contract and pull the bladder neck and urethra open making it wider and shorter for easier emptying of the stored urine. The bladder contraction generates the urine flow. When the flow is finished the bladder relaxes and the urethral sphincters and pelvic floor resume their closing pressure.

When the abdominal wall and pelvic floor do not relax, the urethral sphincters remain tensed. To overcome slower bladder emptying some women learn to bear down using the valsalva maneuver (abdominal bearing down action) that may contribute to ongoing bladder urgency. Slower urine flow and incomplete emptying are also affected by some medications, neurological problems, diabetes, pain, infection, prolapse, obstruction, anxiety and aging with loss of bladder muscle strength and endurance. If an urgent bladder is causing frequent voiding along with annoying urge sensations and urine loss, try a simple test next time your bladder empties.

Sit tall on the toilet and relax your abdomen forwards (with associated pelvic floor relaxation) to allow your bladder muscles to contract without resistance from tight sphincters. You may need to practice abdominal wall relaxation by placing a hand over your tummy and feeling the action of releasing the tummy forwards. Women who bear down to void often have poor or little bladder muscle contraction and could notice a slower flow rate when they void without bearing down.

Determine if a urinary tract infection or any foods or additives (e.g. sweeteners, caffeine, and spicy food) are causing bladder urgency which results in pelvic floor muscle over activity from tightening to control urgency and urine loss.

Visit this Interstitial Cystitis site for the list of foods and drinks which are acceptable or known to irritate the bladder.