I often hear women say, “I have a pea sized bladder. . . I have to go to the bathroom all the time!” or “I have to get to the bathroom right when I feel the urge or I will wet my pants!” A lot of women think that these bladder problems are normal but they are not! So what is normal bladder behavior?
The bladder is located in the lower abdomen right behind the pubic bone. The bladder is a muscle that changes shape as it fills with urine and can fill up to 400-600ml (half a liter of coke). The urethra is a small tube that starts from the floor of the bladder and exits the body. In women, the urethra is about 1.5 inches long and is next to the front wall of the vagina. The opening of the urethra is located between the clitoris and the vaginal opening.
Normal voiding is urinating once about every 3-4 hours or about 5-7 times a day. Night time urination is about 0-1x. After about 3-4 hours your bladder fills with enough urine (about 150-200ml) to activate a stretch reflex in the wall of the bladder. The bladder muscle, called the detrusor muscle, starts to contract and sends a message to your brain that says “I gotta go.” You make a conscience decision to go to the bathroom at that moment or delay it for a while. Muscles around your bladder, called the external sphincter, stay tight so your bladder or detrusor muscle does not push the urine out. If you choose to go at that moment, you should be able to calmly walk to the bathroom and sit on the toilet. The sphincter muscles around your bladder then relax so you can urinate. No straining or pushing is necessary because the bladder is doing the work for you and all your body has to do is relax.
If you choose to delay going to the bathroom, the urge will slowly go away as your sphincter muscles stay contracted around your bladder. Your bladder will continue to fill with more urine and a little while later you will get your second urge. This contraction of your bladder is stronger and more intense; it gets your attention a little more. You might choose to go at this point. You should still be able to stay calm and not be running to the bathroom! The sphincter muscles stay contracted so that no urine leaks out on the way to the bathroom. Again, you should be able to calmly pull down your pants, sit on the toilet, and then the sphincter muscles relax so your bladder can empty.
The sphincter muscles prevent urine leakage with sneezing, laughing, coughing, or exercising as well. These muscle stay tight around the floor of the bladder so that increased pressure from above does not push urine out or cause leakage.
I hope that your bladder habits are similar to above. If not, there are options to help you gain more of a normal bladder pattern. Please consult your doctor for advice.