Urinary Urgency and Urinary Frequency
Condition Overview
Urinary urgency is the immediate need to empty your bladder as soon as you get the urge to go. If you are unable to make it to the toilet in time, you may experience leakage.
Urinary frequency refers to the need to empty your bladder at an increased rate during the day, at night, or both. If you urinate more than 8 times during the day or if you wake up 2 or more times per night you could be experiencing urinary frequency.
Urinary urgency and frequency go hand in hand. Feeling a strong sense of urgency causes us to void more frequently, which can create a cyclical issue that we need to break.
Typically, urinary urgency occurs when stretch receptors in our bladder notice filling and tell our brain to tell our pelvic floor to contract to hold our sphincters tight. This ensures we make it to the restroom without leaking. We should use the restroom every 2-4 hours during the day and 0-1x during the night. So if this is not occurring for you, what could be going on with your pelvic floor and/or bladder?
Causes
Bladder irritant intake/diuretics
Decreased bladder capacity
Anterior vaginal wall prolapse
Incomplete bladder emptying
Increased pelvic floor or abdominal muscle overactivity
Suprapubic scar restrictions following a cesarean or abdominal surgery
Constipation
Decreased estrogen (during menopause, breastfeeding)
Pregnancy
How PT Can Help
In physical therapy, we will discuss your symptoms and go over each of the systems of the pelvic floor (bladder, bowel, sexual health and if necessary, gynecological health). With your consent we will perform an in-depth muscle examination including an external and internal pelvic floor assessment. With this, we will determine your pelvic floor muscle function, resting tone, and pelvic floor tenderness. We will also assess your abdominal, hip, and low back muscle strength, endurance, and coordination.
We will set-up a treatment plan depending on your pelvic floor characteristics.
We will educate you about optimal bladder and bowel health and hygiene habits. Depending on when/why your urinary urgency and frequency began, we may integrate bladder retraining to improve bladder capacity and the rate at which you void. This does take time and consistent practice, but it works!
We may also perform manual treatment that 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!