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Up Down, Up Down...

Posted Jul 09 2010 1:48pm

Have you ever thought you were "done"? Have you ever stood up, only to have to sit down and go again? Do you feel like a "Jack in the Box"? Do you feel like you don't quite empty your bladder when you urinate? Do you tend to push or strain to empty to the last drop only to find you have to go again once you stand up?

So what's a girl to think?
Do I have a secret chamber in my bladder? Do I have two bladders?
Where is all this urine coming from?

Good news! You don't have a secret chamber in your bladder, you only have one bladder and bladders can store one cup of urine or more.

But what's going on?

Back to the bladder basics. In this picture you see normal pelvic alignment. The pelvic organs are nicely upright where the belong. Unfortunately time can take it's toll and gravity is not our friend. Bladders, just like breasts and faces, can sag in a downward direction.

Over time, your bladder can lean into the neighboring wall of the vagina. When the bladder leans into the wall of the vagina, the bladder can create a small bulge into the wall of the vagina. Urine can collect in the space that is created by this bulge. This is called a cystocele. A cystocele can occur because of weakened pelvic floor muscles and straining.

But remember Anytime you have a change in your normal bladder habits or anatomy you should contact your professional health care provider to be evaluated. The intent of this blog is to be informational only. It is not a substitute for professional medical evaluation or treatment.

Imagine you are sitting on the toilet and you empty all but this little extra pocket of urine. As you lean forward to stand up, the urine in this pocket shifts forward towards the urethra. As you are zipping up your pants or skirt, DRAT! you have to go again. So, you sit down again, and lo and behold there is more urine to empty. Although you thought you were empty, you were not. So the next time you go to the bathroom you might be tempted to really push to get all the urine out it one fell swoop. This maybe sort of a good short term solution but really over time straining will just make the problem worse.

So what's a girl to do:
  • Before you sit down to urinate, lean forward for 5-10 seconds to bring the urine forward in your bladder so it is easier to completely empty.
  • Lean forward after urinating (while still sitting on the toilet) to help empty that small pocket of urine before you stand up.
  • After you urinate, stand up and then sit down again to help move the urine out of that small pocket ( this is called double voiding!).
  • Don't strain- it will only make the problem worse.
  • Contract your pelvic floor muscles when you are done urinating to signal your bladder that you are done.

Hope this helps,

Mary and Kathleen
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