Difficulty Initiating Urine Stream or Emptying Bladder
Condition Overview
The pelvic floor muscles have many roles, but one in particular is sphincteric control. This means they maintain a certain amount of tone when we are performing daily activities so urine and stool do not escape. On the other hand, they also need to have the coordination and ability to relax when we sit on the toilet in order to fully empty our bladder and rectum without straining.
Symptoms
Hesitant urine stream (“shy bladder”)
Interrupted urine flow
Pelvic pain or urethral burning
Post void urinary dribbling
You may need to sit on the toilet for longer and continue to feel urgency when you leave the bathroom
Why Do I Have Difficulty Emptying My Bladder
There are a variety of reasons that you may have difficulty emptying your bladder, including
Pelvic floor tension
Urethrocele (urethral prolapse)
Cystocele (bladder prolapse)
Dyssynergia (lack of coordination)
Scar tissue at urethra or bladder neck from trauma or pregnancy/childbirth
Enlarged prostate
Constipation
Urinary tract infections.
These issues cause a blockage or narrowing of the urethra making it difficult for urine to pass through.
There are a number of neurological conditions that can also cause an underactive bladder and may require catheterization in order to empty the bladder fully.
These can include:
Multiple sclerosis
Stroke
Parkinson’s disease
Brain injury
Pelvic health therapy can help with the neurological diagnoses, though your treatment may look different from a strictly musculoskeletal condition
How Can Physical Therapy Help Me With This?
During a physical therapy evaluation we will assess your bladder/bowel habits, exercise routine, breathing, and pressure system. We will also perform an in-depth muscle examination including an external and internal pelvic floor assessment with your consent. With this, we will determine your abdominal, hip, and pelvic floor muscle strength, endurance, and coordination. With this we will determine what is required for your treatment going forward.
After your initial assessment, we will set-up a treatment plan depending on your pelvic floor characteristics!
We will educate you about optimal bladder and bowel health, give techniques to improve your pressure management and bladder habits, provide manual treatment as necessary, and outline pelvic floor exercises to begin with.
Manual treatment can include but is not limited to dry needling, myofascial release, cupping, and connective tissue mobilization.
Exercises can include but are not limited to kegels, hip and abdominal strengthening, downtraining/pelvic floor stretches, and functional mobility exercises. With each session we will reassess and progress as appropriate!
Schedule an appointment today if you feel like any of this could pertain to you!