How to Empty Your Bladder and Overcome Incomplete Bladder Emptying (Online Video)

Empty your bladder and overcome incomplete bladder emptying with this instructional video by Michelle Kenway Pelvic Floor Physiotherapist.

This video shows you:

  • Bladder emptying position and technique
  • Double void technique for incomplete emptying
  • Tips for effective bladder emptying

Suitability:

This bladder emptying video is suitable for everyone including women with:

  • Difficulty initiating emptying (hesitancy)
  • Incomplete bladder emptying (urinary retention)
  • Slow flow
  • Chronic bladder infections with incomplete emptying.

Incomplete Bladder Emptying

Bladder emptying problems can result from a range of medical causes including:

  • Some medications e.g. opioids 
  • Incomplete bladder emptyingNerve problems e.g. stroke
  • Reduced bladder contractility
  • Blocked urine tube e.g. pelvic organ prolapse
  • Pelvic floor muscle spasm

Symptoms of incomplete bladder emptying include:

  • Slow stream (i.e. urine flow)
  • Lower abdominal discomfort
  • Inability to void

If you suffer from undiagnosed bladder emptying problems, please consult your medical practitioner.

Emergency 1If you’re unable to empty your bladder after having already tried to do so, please attend your local hospital emergency department. Bladder overfilling can have serious long-term consequences and needs to be treated promptly.

Normal Bladder Emptying

Female bladder emptyingNormal bladder emptying involves:

  • Easily starting the flow of urine
  • Strong continuous flow to empty
  • A sensation of having completely emptied when finished
  • No straining to empty the bladder.

Straining to empty your bladder can damage your pelvic floor which can worsen bladder problems. Urine retained in the bladder after emptying can increase your risk of bladder infection.

Correct Bladder Emptying Position

1. Sitting Position

Using the correct sitting position is very important for emptying your bladder and overcoming incomplete bladder emptying.

  • Start by sitting on the toilet seat and never hover or stand leaning over the toilet seat
  • Position both feet fully supported on the ground or on a footstool (1)
  • Keep your knees and hips apart
  • Lean forwards and support your trunk in this position by resting your hands or elbows/forearms on your thighs (2,3)
  • Keep the inward curve in your lower back during bladder emptying. (2,3)

2. Squatting Position

Squatting to empty the bladder over a squatting toilet at ground level is practiced widely in some countries e.g. India and Asia. Squatting is an ideal position for bladder emptying and it’s the position that the human race used prior to the development of the modern day sitting toilet. If you’re able to squat and have the facilities to do so, this position is ideal for bladder emptying. (4)

Correct Bladder Emptying Technique

  • Visit the bathroom when you feel an appropriate urge to empty your bladder rather than emptying ‘just in case’
  • When you sense the urge to empty your bladder relax your pelvic floor openings while sitting on the toilet seat. This action can be achieved by relaxing your lower abdomen and allowing your belly to bulge forwards as you empty.
  • If you can’t start bladder emptying then you may try turning on a tap to produce the sound of running water. This is because sometimes the sound of tricking water can help trigger bladder emptying.
  • Keep your belly relaxed forwards until the stream stops.
  • Avoid straining to empty.
  • When you sense you’ve finished emptying your bladder, lift and squeeze your pelvic floor muscles.

Double Void Techniques for Incomplete Bladder Emptying

If you feel that your bladder isn’t completely empty you can try any of the following double void techniques:

  • Rock side to side sitting on the toilet seat
  • Stand up and rotate your hips clockwise and counterclockwise to move your hips in a circular motion as if you’re using a hula hoop
  • Stand up and walk around for 15-30 seconds
  • Gently press inwards above your pubic bone with your fingers over your bladder. Do this gently but not if you have urine tube obstruction (blockage).

Physiotherapy Tips to Improve Bladder Emptying

  • Avoid overfilling your bladder, when it’s too full it can be very difficult to empty this means knowing that you need to empty 3-4 hourly (or around 250-400 mls of urine) depending on your fluid intake
  • Stay well hydrated and drink at steady intervals during the day rather than all at once to avoid sudden bladder filling
  • Take your time to empty your bladder completely every time you empty rather than rushing
  • Avoid emptying ‘just in case’ and empty with the appropriate urge
  • If you have trouble emptying your bladder because of reduced bladder sensation you may need to go on a timed voiding (emptying) program that involves attempting to empty your bladder at scheduled time intervals regardless of whether or not you feel the urge to void (5)
  • Reduce your intake of diuretics such as caffeine and alcohol because they draw extra fluid into the bladder.

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References

1.Wennergren HM, Oberg BE, Sandstedt P. The importance of leg support for relaxation of the pelvic floor muscles. A surface electromyograph study in healthy girls. Scand J Urol Nephrol. 1991;25(3):205-13. https://doi: 10.3109/00365599109107948. PMID: 1947848.

2. Sapsford R. The pelvic floor. A clinical model for function and rehabilitation. Physiotherapy. 2001;87(12):620–630. doi: 10.1016/S0031-9406(05)61107-8.

3. Clothier JC, Wright AJ. Dysfunctional voiding: the importance of non-invasive urodynamics in diagnosis and treatment. Pediatr Nephrol. 2018;33(3):381-394. https://doi:10.1007/s00467-017-3679-3

4. Rane, Ajay (2011) Does posture affect micturition? PhD thesis, James Cook University. https://researchonline.jcu.edu.au/29819/1/29819_Rane_2011_thesis.pdf

5. Jean-Jacques Wyndaele (2008) Conservative Treatment of Patients with Neurogenic Bladder european urology sup plements 7 (2008) 557–565 https://doi.org/10.1016/j.eursup.2008…

ABOUT THE AUTHOR, Michelle Kenway

Michelle Kenway is a Pelvic Floor Physiotherapist and author of Inside Out – the Essential Women’s Guide to Pelvic Support, along with Dr Judith Goh Urogynaecologist.

We Welcome Your Comments

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Comments

  1. I am a vargin but I realized that my libia have started becoming loose. I want to know if that is normal.

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Yes Awa all different shapes and sizes exist and this is the ‘normal’, we’re all unique

  2. I was having urinary retention problem after delivery and used catheter for almost 1 month now I can pee but i am unable to completely empty my bladder. Can you please help me. I am very tensed about it

    • Michelle Kenway Physiotherapist says

      Hi Shreya
      I’m sorry to hear of your bladder problems. This really is an issue for your specialist. Using the technique in this video leaning forward and bulging the abdominal wall is important. Some women find that standing and sitting repeatedly can help them to empty more completely. It’s also important not to overfill the bladder when the catheter is removed.
      Michelle

    • Great ,thanks you so much

  3. hi i am a young woman of 27 years old i have bladder problems. my bladder problems are i dont feel the urge too pee. i just going and empty my bladder with no feeling. i hope somebody here can help me this is frustairing !

  4. Hello Michelle:
    I wonder if you can help me.
    I have trouble emptying my bladder completely due to anxiety which then causes me so much in the pelvic area and the tummy.
    Have been checked — everything is normal.
    Mostly I have difficulty releasing the last few drops which does not allow the muscles to relax and therefore it triggers pain all over.
    I will appreciate your feedback. I have watched your video but it does not help me because of my anxiety state.
    Thanks,
    Sally

    • Michelle Kenway says

      Hi Sally

      Have you done any breathing and relaxation training? Sometimes something as simple as relaxed deep breathing can help to relax the pelvic floor and deep abdominals. With anxiety there can be a tendencey to overbrace some muscles including the abdominal and pelvic floor muscles. Learning to relax these muscles is vital for complete bladder emptying. This pelvic floor and whole body relaxation CD may be useful to you in helping you to manage both problems Sally. I think if you can address muscle tension caused by anxiety you may be able to improve your bladder emptying.

      All the best
      Michelle

    • hi sally i have bladder problems too maybe for anxiety too i dont know

    • Hi, I am 26 and have the same issues, probably not caused by anxiety but certainly exacerbated by it. I am awaiting an ultrasound to check for prolapse or other issues. One thing that sometimes helps if things are really dragging on is listening to a podcast to distract myself while sitting on the loo. However, sitting on the toilet for too long also seems to make it worse — I sometimes also go off and have some camomile tea or something and try again 5-10 minutes later.

      I feel like it is under-recognised because most information about pelvic floor issues in women is about incontinence — I didn’t even know that retention and issues with emptying were possible until it happened to me.

  5. Thank you for your excellent info on emptying the bladder. I have had 3 operations and lining up for the 4th and no one has told me what I have learned from you

    • Hi Sheryl
      Thanks so much for taking the time to provide this feedback, so glad to be of help to you!
      Best wishes
      Michelle