Feeling the need to go to the toilet frequently is much more common than most people realise. This can be accompanied with or without urinary leakage. This leakage can be only a few drops and others may experience larger amounts to almost complete emptying of the bladder.
What is increased urinary frequency?
As with many things in life, everyone is different. This also applies to normal urinary frequency (the amount of times you need to empty your bladder a day). For most people, the normal number of times is between 6-7 in a 24 hour period. However, between 4 – 10 times a day can also be normal if that person is healthy and happy with the number of times they visit the toilet. It can also depend on the amount of fluid you drink, what you drink or if you take certain types of medications.
What is increased urinary urge?
Urinary urgency occurs when the pressure in the bladder builds suddenly, and it becomes difficult to hold in the urine. This pressure can cause a strong and immediate sensation that you need to urinate. Urinary urgency can occur regardless of whether the bladder is full or not. It can also make a person want to urinate more frequently than usual.
What causes increased urinary frequency and urinary urge?
There can be several reasons why you may experience this and one should always seek advice from the appropriate health care provider. Your GP is a good start however, sometimes a pelvic health physiotherapist may be able to assist further.
Commonly urinary frequency and urinary urge are caused by a miscommunication between the brain and the bladder. When we don’t have any issues, the bladder will fill up to an appropriate amount before telling the brain that it’s time to go to the toilet. With increased frequency and urge this pathway is disrupted. This can be caused by several factors and a good place to start finding the route problem is by filling in a bladder diary.
How do I fill in a bladder diary?
A bladder diary is used to record how much liquid you drink, how often you need to urinate and how much urine you pass. It can be extremely helpful to understand your bladder habits. When writing a bladder diary you should include the exact time for intake of both fluids and solids, the amount voided (urinary output) and the sensation of urge at the time. Any leakage should be included, ideally in detail ( quantity/ did you have to change your underwear/sanitary towels?). Remember: the more detailed the better. It can be useful to complete the bladder diary over a minimum of 3 days, ideally both weekdays and weekends to get a good idea of what your “normal” is.
I’ve completed my bladder diary – what now?
Ideally you will now have seen a pelvic health physiotherapist to help guide you at this point. This is to see whether you are voiding appropriately or not and what the suggested plan of action may be to address the frequency issue, or if there are any other factors contributing to your symptoms.
Parts of the treatment can be bladder retraining. This is based on teaching the bladder to only tell the brain that it’s appropriate needing the toilet when there is an appropriate amount of fluid in the bladder. The treatment may also include pelvic floor muscles strengthening or relaxation.
How do I retrain the bladder for increased frequency?
You may get asked to try to delay going to the toilet when treating increased frequency and urge. This can feel extremely overwhelming and lead to increased anxious behaviour for many. Feeling anxious and stressed can often make the problem worse. Therefore, when starting to retrain the bladder you can do this when in the comfort of your own home at first.
When you know you have recently been to the toilet and it’s not appropriate to go again so soon, try to delay but only aim for 5 minutes. If you set the bar low at a manageable level, this will help reduce the risk of feeling stressed and increase your symptoms. Trying to divert your thoughts is helpful. Find a small and easy task, such as emptying the dishwasher or checking your email. Try to relax as much as possible and breathe calmly.
Now, if after 5 minutes you still feel the urge to go, allow yourself to go. You will gradually increase the time you are able to delay and you should focus on being as calm and collected as possible when you take yourself to the toilet.
Having good control of your pelvic floor is also extremely helpful when treating increased urinary frequency and urge. You can read more about the pelvic floor here.
We always advise seeking help when experiencing these symptoms, we know their common but also know that there’s much to be done about this. A specialist pelvic health physiotherapist is a good start. Don’t let your bladder dictate your day! Here at Physiofit we have some expertly trained pelvic health physiotherapists and if you would like to discuss any symptoms further please contact us on 01223 914140 or e-mail us on enquiries@vineryroadstudios.co.uk
