The myth of the small bladder

Have you ever heard someone say, “I need to go to the washroom all the time because I have a small bladder”? I thought this was a reasonable explanation before I started diving into the world of pelvic floor physiotherapy. Now that I have been working in this field for a while, I would have to disagree with this statement. In fact, there is no such thing as a small bladder. The bladder 🎈has the capacity to hold up to 4 cups of liquid (This doesn’t mean that you should wait until it’s this full before emptying 🤣). A healthy bladder will tell the brain it needs to empty when it’s around 2 cups full. By the time it’s around 3 cups full, you really need to go. However, if you find yourself needing to go to the washroom constantly and emptying way less than 2 cups at a time, this may mean that you have urge incontinence.

Another way that you can tell whether you are emptying prematurely is by counting “Mississippis” while peeing. If your pee flow lasts 8-20 seconds at a full stream (not weak or hesitant), that’s normal. However, if you find that it’s less than this, your bladder may be signalling your brain to empty prematurely.

Urge incontinence can be disabling if you are not able to leave the house for fear that you need to go constantly.

Some common causes of urge incontinence are:
👉🏼 Just-in-case peeing (i.e., you have unknowingly trained your bladder to empty early)
👉🏼 Pregnancy (there is a baby sitting on your bladder)
👉🏼 Anxiety (think of the times you need to pee before exams, interviews, public speaking)
👉🏼 Pelvic organ prolapse (your bladder sits lower than it should)
👉🏼 Excessive abdominal and pelvic floor tension
👉🏼 Abdominal surgery (eg., a Cesarean section)

Your pelvic floor physio can help you pinpoint the cause of your urge issue and come up with a plan to normalize your bladder function again.

By Mia Dang, PT / a registered physiotherapist with extensive supplementary training in pelvic floor physiotherapy and perinatal care