If you’re struggling to empty your bladder completely when you go to the toilet, you’re not alone. Discover why this is happening and try these tips to better empty your bladder.
Why doesn’t my bladder empty completely?
The most common type of urinary retention is chronic, meaning it occurs slowly over time, and may be quite progressed before you notice.
Urine retention is more common in older men, with an enlarged prostate the typical cause. The prostate gland sits below the bladder, and the tube that transports urine from the bladder to outside the body (called the urethra), runs through it. As men age, the prostate gets larger, squeezing the urethra and restricting urine flow which can result in urine being left behind.
Women also experience urine retention, often due to a prolapse . A prolapse is when organs in the pelvis (the vagina, bladder, and colon) drop out of position, causing a ‘kinks’ or placing pressure on the urethra, restricting optimal urine flow. Prolapses can also occur slowly over time.
The other common factor causing the bladder not to empty completely is poor bladder and bowel habits. Persistent constipation, for example, will reduce your ability to void your bladder entirely as accumulated and hardened faecal matter in the bowel presses against the bladder and urethra.
Less common issues include nerve damage and neurological diseases that inhibit clear messages between the brain and bladder or interfere with the sensations that indicate when the bladder is full or empty.
Sudden (known as acute) and complete urinary retention is extremely rare and usually caused by a blockage such as a kidney or bladder stone. If this happens, you must go to the emergency department immediately, as it can be fatal.
Why completely emptying your bladder is important
Urine left in the bladder can cause problems, including incontinence.
Retained urine is susceptible to bacterial infection, which can trigger a urinary tract infection (UTI), a bladder infection (cyclitis), and potentially lead to a kidney infection (pyelonephritis). Infections can cause the bladder to contract involuntarily, resulting in a sudden, urgent, and uncontrollable need to urinate.
Similarly, if the urine is or becomes highly concentrated, it can irritate the bladder and lead to involuntary contracts. This is known as urge incontinence
Long-term urine retention can damage the bladder and kidneys, so don’t ignore it.
Tips and techniques to fully empty your bladder
Know when you need to go. Pay attention to the signals from your bladder and avoid going to the toilet ‘just in case’ or hanging on for so long that you only just make it in time. When you receive the first indication that you need to void soon, it’s fine to ignore that until the signals become more pronounced. Ideally, wait until the signal is clear and you can comfortably make it to a bathroom.
Take a seat. If you’re having trouble emptying your bladder, sit on the toilet, don’t stand and don’t ‘hover’ above the seat. Research of men with enlarged prostates . found sitting down allows muscles in the pelvis to relax and improve urine flow.
Elevate your feet and lean slightly forward. Use a couple of books (or even a rolled-up towel) to elevate your feet and shift your knees to 90 degrees or higher. Rest your hands on your thighs and tilt forwards. Like sitting, this position takes any strain off the abdomen, allowing everything to relax and release the urine.
Breathing deeply into your tummy reduces internal tension and expands the space in your abdomen. Focus on relaxing your thighs, buttocks, and pelvic floor muscles.
Don’t push. Allow your bladder to do its thing. Pushing applies pressure and can be counterproductive.
Try double voiding. Once you’ve finished urinating, stand up for a few seconds, take a deep breath and exhale slowly, then sit down again and see if you release more urine. This technique is often surprisingly effective!
Take your time but don’t hang around either. With everyone leading such busy lives, it’s perhaps not surprising that we often rush when we go to the toilet. Sometimes, we don’t completely empty our bladder because we’re in a hurry, inadvertently stopping the flow before it’s finished and getting on with our day. Not paying attention adds to this, as we’re thinking about other things rather than ensuring our bladder is empty. Another trap is spending too long on the toilet – often looking at a phone! Once you’ve finished single or double voiding, wash your hands and go.
Good bladder habits
If the cause of your retention is poor habits, a few easy lifestyle changes should correct the issue and keep it at bay.
Drink plenty of water. While it can seem counterintuitive, especially if you’re experiencing incontinence, drinking lots of water is helpful. It keeps urine diluted and helps the bladder habitually hold and void larger amounts of urine, flushing out bacteria as it goes. Exactly how much water you should drink depends on the weather and how much you exercise but aim for at least two litres.
Avoid bladder irritants. In addition to overly concentrated urine, the bladder can be irritated by caffeine, alcohol, fizzy drinks, and spicy food. Avoid these foods and drinks as they can cause the bladder to send urgent messages to void and even involuntarily contract.
Avoid constipation. Constipation can cause incontinence , as well as making it difficult to empty your bladder completely. Drinking plenty of water, exercising, and eating a diet high in fibre all help to keep your bowel regular.
Practice pelvic floor exercises. While strong pelvic floor muscles may not have a significant impact on your ability to fully emptying your bladder, exercising them will make you aware of where they are and allow you to focus on relaxing them when urinating. Exercise will also extend your ability to ‘hold on’ and maintain continence. Learn pelvic floor exercise to improve and maintain bladder and bowel control.
When to see the doctor
If you’re not emptying your bladder fully because you’re rushing and not paying enough attention or have constipation, you can correct that yourself. However, if the cause is an enlarged prostate or a prolapse, you must see a doctor. Neither of these conditions will fix themselves and, without medical attention, will continue to progress. Your doctor will determine the best treatment.
If you’ve become aware that your bladder is not completely emptying when you go to the toilet, try these tips and techniques. However, if the problem persists, there is likely an underlying cause that should be checked by your doctor.
Asaleo Care makes no warranties or representations regarding the completeness or accuracy of the information. This information should be used only as a guide and should not be relied upon as a substitute for professional, medical or other health professional advice.