Urinary Frequency & Bladder Function – What’s Normal? 

Mountain-Biker
PT, DPT
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“The length of a film should be directly related to the endurance of the human bladder.” This quote, attributed to Alfred Hitchcock, brings to light one of the ways that we have structured life around one of the most basic functions of being human — having to use the bathroom at semi-regular intervals throughout the day (and sometimes night). When body systems are working together, we don’t give this much thought. However, sometimes things happen that can lead to changes in bladder functioning. This can significantly interfere with daily life and assistance from a healthcare provider can be extremely beneficial. To understand these symptoms as well as their treatment and the role of pelvic floor physical therapy, it’s helpful to understand how the bladder functions normally.

What does the urinary bladder do?

The urinary bladder is a balloon-like organ within the pelvic cavity that serves to collect, store, and eliminate fluid waste from the body. Urine is formed in the kidneys and funneled to the bladder via ureters. The bladder then stores this urine until it is eliminated from the body via the urethra. While urine is being collected and stored in the bladder, the detrusor muscle, which is a muscle that forms one of the layers of the bladder itself, is relaxed. As the bladder fills with urine, it stretches, much like a balloon being filled with air. This stretching sensation is interpreted by the brain as an urge to urinate. When being emptied, then, the detrusor muscle activates, contracts, and thereby squeezes to empty the bladder. 

What is normal bladder function?

When functioning normally in an adult, the bladder can hold more than 2 cups of urine but the first urge to urinate occurs when the bladder is about half full. After the first urge, the bladder will keep filling and can be held until an appropriate time to urinate. It takes approximately 2-4 hours for the bladder to fill, and thereby it is considered normal to urinate between 5-8 times in a 24-hour period (and hence, many movies time in at around the 2-hour mark).

Sometimes, however, this does not function as smoothly as described above which can result in an increase in urinary frequency. In other words, dysfunction can lead to the feeling of needing to urinate more (sometimes much more) than 5-8 times per day. This can happen for a variety of reasons, some of which are described below, and can lead to feelings of frustration and helplessness. Significant mental health consequences can also be experienced including anxiety and avoidance or fear of being in situations where going to the bathroom is not an option. 

Staying-Hydrated

What causes increased urinary frequency?

Below are descriptions of four common causes of increased urinary frequency. Note that this is not an exhaustive list and more serious causes of urinary frequency (including an infection, bladder cancer, bladder stones, and diabetes) should be ruled out by a trained healthcare provider.

When functioning normally, the bladder can hold substantial amounts of urine as it fills and then empty when the time is appropriate. However, this process requires normal function of many different body systems and when one is not working properly, can have many physical as well as psychological consequences. If you are struggling with an increased frequency of urge to use the bathroom, pelvic floor physical therapy may be able to help you get back to living a life untethered to your bladder!

Pelvic floor physical therapy can help.

Many people suffer unnecessarily with increased urinary frequency. Treatment options depend on the underlying cause of a person’s frequent urination, but once serious underlying problems are ruled out by a trained healthcare provider, a pelvic health physical therapist can help by addressing pelvic floor muscle disfunction.

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