Amber Roche, Physical Therapist, Southwest Health

Do you ever feel a sudden, intense urge to urinate and worry that you may not make it to the bathroom in time? Do you feel like you need to know the location of every bathroom because of this sudden urge? You may be experiencing issues with urinary urgency, also known as having to go right now!

Urinary urgency is a sudden, compelling urge to urinate. Urge incontinence has urinary leakage following the sudden urge to urinate. These symptoms can be frustrating because it forces people to change their behavior by having to use the bathroom frequently, going “just in case” to avoid an urge, mapping out all the bathrooms in stores, avoiding long road trips, and much more. Sometimes the urge can happen so often that you feel an urge occur again shortly after urinating.

The cause of urinary urgency can be a variety of factors, including poor bladder habits, pelvic floor and hip musculature weakness or dysfunction, water intake, and even the relationship between the brain and bladder!

First, let’s discuss the relationship between your brain and your bladder. The brain and the bladder can get into bad “habits” where the system starts to give you an improper signal that your bladder is full when it may only be at half of its capacity. If you urinate consistently when your bladder is 50% full, then both your brain and your bladder will be trained to send the urge to urinate every time it is 50% full. This leads to more frequent urination. This is one example of how urinary urgency can occur, but there are many other reasons that this can happen. Luckily, there are also many ways to treat urinary urgency.

Pelvic floor and hip musculature weakness or dysfunction can create pressure on the bladder, causing urgency and leakage. Having weakness or tension in the muscles can make it more difficult to activate the muscles when you need support from them. Specific strengthening and stretching to these areas may help decrease pressure on the bladder to reduce symptoms.

So what can you do if you are suffering from urinary urgency?

The following five tips may help to decrease the feeling of urinary urgency:

• Stop “just in case” urinating. If you urinate every time you leave your home, go to the store, etc., your brain will associate those events with urination. Your brain will recognize that you are at a time/location where you typically will urinate and send an urge signal, even if your bladder isn’t truly full.
• If you feel a strong urge, try to take three deep breaths and complete a few pelvic floor contractions (also known as kegels). Imagine squeezing like you are pulling your tailbone up and forward to tell your brain it is not time to urinate. This may help you have more time to get to the bathroom without leakage.
• Drink an adequate amount of water. Proper hydration prevents urine from being concentrated so that it is not an irritant to the lining of the bladder, which can feel like burning or having the urge to urinate.
• If you suffer from constipation, this can cause pressure on the pelvic floor and bladder. It would help if you addressed your constipation, which may help your urinary urgency symptoms.  
• If you have tried these and are still struggling, see a pelvic health physical therapist to evaluate what contributes to urinary urgency fully.

Guidelines say that normal urination is every three to four hours with 10-14 seconds of urinating. Urinating more than seven times per day and more than one time at night indicates bladder dysfunction. If you are experiencing any of these symptoms, consider seeing a Pelvic Health Physical Therapist.

One Pelvic Health Physical Therapist that you can seek advice from is Southwest Health’s, Dr. Amber Roche. Amber became interested in pelvic health from having pelvic floor dysfunction following having her daughter and being exposed to pelvic health on her first clinical. She saw how beneficial pelvic PT can be and how grateful people were to have someone listen to what they were experiencing and not feel alone in their struggle. Amber completed a clinical in pelvic health and continuing education courses in pelvic health evaluation and treatment. She is very passionate about pelvic health and would love to help people feel better again! To talk with Amber or any Physical Therapist at Southwest Health about possible pelvic floor therapy or other concerns, call the Rehab Services line at (608) 342-4748.