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Let's get you feeling good again

Pelvic floor exercises

Exercising your pelvic floor should be as important a part of your daily routine as brushing your teeth. Read more

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Retrain your bladder to develop good habits by practising the Bladder Drill. Read more

When your bladder rules you..

We often talk of women having a ‘weak bladder’ but what does this actually mean? 

A woman and 2 children

We usually use the term to refer to women who always need to rush to the loo or have difficulty holding onto their urine but the term ‘weak’ is actually quite misleading.

Having to rush to the loo or going more often than you feel you should is actually caused by the bladder being over-active. In fact the medical term for this condition is Over Active Bladder or OAB. It is caused by the bladder becoming more sensitive and trying to empty itself even when it is not full.

The bladder is simply a bag made up from a type of muscle that we don’t have direct control of, elastic tissue and nerves. The nerves control how full the bladder is before we feel that we need to empty it. These nerves send muscles to your bladder muscles telling them not to contract until you are ready to do so. In cases of Over Active Bladder, these nerves become over-sensitive and send messages to your muscles and brain before your bladder is full. The bladder should normally hold around a pint of urine but if you have an over-active bladder then you may find that you are only passing dribbles each time you empty your bladder, despite having a really strong urge to go. So, rather than only going to the loo between 4 and 7 times  a day, you may find that you are going every hour or half hour.

What causes a bladder to become over-active?

Many conditions can cause this condition including diabetes, stroke, pelvic surgery, the menopause or weak or tight pelvic floor muscles. If your pelvic floor muscles are weak, you may find that you empty your bladder more often in an attempt to prevent leaking. This can cause your bladder to shrink over time which can then lead to an over-active bladder. Some women also try to cut down on the amount they drink. This causes the urine that comes into your bladder to be more concentrated which then irritates the sensitive nerves. This can also lead to an over-active bladder.

What can I do about this?

If your bladder is over-active then you need to retrain the nerves and muscles to become less sensitive and to allow your bladder to hold onto more urine for longer. Following Bladder Drill Advice is your first line of attack against this problem. If you have tried Bladder Drill Advice for 6 weeks and things have not improved then you should see your GP. The next step is either to try some medication and to see if electrical stimulation can help. The medication works to block the messages to the bladder to keep it calm. Examples include oxybutinin, solifenacin (vesicare), tolteridine (detrusitol). Stimulation works to dampen down the sensitivity of the bladder and its nerves. After being shown how to use the machine in clinic, you then use the machine in your own home every day for at least 6 weeks. Many hospitals and clinics hold the Pericalm in stock for loan to patients but you can also purchase your own unit if this is not available.

If your pelvic floor muscles are weak then this can make an over-active bladder worse. If your muscles and very weak and you have an over-active bladder, the Neen Pericalm can be programmed to treat both conditions at the same time. Your health professional will be able to program the machine to ensure it is treating all aspects of your pelvic floor problem. 

By Alison Bourne MA (Cantab) BSc MCSP ACPWH