BELIEVE it or not, there is a right and wrong way to empty your bladder.
Not done correctly and at best, you’re reliant on constant toilet trips, and at worst, you’re at risk of nasty infections – some which could be life-threatening.
We spoke to Prof Stergios Stelios Doumouchtsis, a consultant obstetrician and gynaecologist and leading expert in urogynaecology.
He said the female anatomy makes women more prone to problems down there for a few reasons.
Firstly, their urethra (the tube that urine passes through) is shorter, making it easier for germs to travel up.
“Also having a shorter urethra, from the biomechanical point of view, has a major impact on continence.
“If a woman has a urinary infection or urinary incontinence, compared to a man, she may have more accidents.”
Secondly, Prof Stergios told The Sun: “The women’s life course is associated with a lot of changes in the area related to hormones and reproductive events, like pregnancy, childbirth, postnatally and menopause.”
These, in addition to ageing, can also lead to pelvic floor disorders, like prolapse, that can influence the function of the lower urinary tract.
All that said, it’s important for women to pay close attention to their peeing habits, to both prevent disorders and make sure they are treated fast when they occur.
1. Wiping from the back to the front
Prof Stergios said: “It is important to avoid wiping from back to front.
“There is a rich bacterial flora around the anus and perianal area, vagina, labia and genital tract.
“Wiping may transfer bacteria from one area to another.”
Wiping from back to front could move faeces and bacteria from the back passage to the front, where the urethral opening is.
This is a hard-fast way to invite a urinary tract infection, which can cause burning with urination, pain and a constant urge to use the toilet. It needs treatment with antibiotics.
2. Wiping too much
“Wiping can sometimes cause irritation of very sensitive skin,” Prof Stergios said.
“Sometimes when you wipe, remnants of the toilet paper stay there, which is less hygienic and can cause irritation and potentially infection especially if these remnants stay there for hours.
“This is from using poor quality paper or wiping in excess.”
Keep it simple and use only a couple of sheets to gently wipe (NOT from back to front!).
3. Having set times for peeing
Try not to get into the habit of going to the toilet “just in case” or timing visits to the toilet – unless you’ve been told to by a specialist.
Called “preventive voiding”, Prof Stergios says this may be common in certain jobs.
As a teacher, for example, you may go to the toilet at the same time every day (before every class), even if you don’t need it, to avoid the urge to pee during class.
Prof Stergios warned: “The bladder may get used to not storing enough urine.
“The bladder would normally store at least 450-500ml. But if you go to the toilet every half an hour, or every hour, the bladder is used to storing smaller volumes that could be 200ml or less.
“So the role of the bladder as a reservoir, as a storage organ, could be compromised. Then the bladder will be asking you to go every hour even if you don’t want to.”
Prof Stergios said there is no harm in holding your wee until you actually need to go.
It does not cause urinary tract infections, as some might claim, otherwise the condition would be more frequent in people such as nurses and other health care professional who work on shifts and cannot always take regular breaks.
“Preventive voiding is acceptable as a circumstantial kind of practice,” Prof Stergios said.
Going for a pee before a long train journey or before watching a movie, for example, is acceptable.
“But doing it regularly as a habit is not a great habit.”
Sometimes habitual voiding is associated with stress or anxiety, and not just directly bladder issues.
4. Waiting until you’re desperate
Although you shouldn’t take regular, habitual toilet trips, you also don’t need to hold your urine until you’re busting.
Prof Stergios said to go to the toilet when “your bladder is comfortably full and gives you a strong desire”.
Explaining the process of a filling bladder, he said: “The first signal is first sensation of filling of the bladder.
“The second is the first desire, when you start “thinking” about going to the toilet.
“Then you have a strong desire, when you wish to interrupt what you’re doing, such as pausing a movie.
“Then you may experience “urgency”, when you feel that an accident is imminent or you’d have to run.
“You don’t need to reach that stage, to experience urgency, because it could be an unpleasant sensation.”
5. Drinking too much water
Prof Stergios suggests drinking gallons of water is not necessary, regardless of claims it will help you gain health improvements.
He said: “Normally in this country, 1.5 to 2.5 litres a day is good. Obviously if you do a lot of exercise or it’s a hot day, drinking more is fine.
“I see a lot of women carrying around a bottle or tank of water, having like six or seven litres a day, believing that it ‘is good for you’ to overhydrate.
“Fluid overload is not going to help the bladder as it can cause polyuria, meaning production of too much urine.
“It is not likely to cause any health problems, but it will result in more visits to the toilet.”
He said the average amount of toilet trips in the day is six to eight, with one to two trips at night.
6. Not emptying your bladder fully
You may not realise that your bladder is failing to empty properly every time you use the toilet.
“There could be an underlying cause of voiding dysfunction,” Prof Stergios said.
“If the bladder is not emptying properly, it may cause stasis of urine [also known as urinary retention] and result in infections or bladder stones.
“Because infections can result in sepsis, or kidney infections, if you have symptoms of incomplete bladder emptying, it needs to be checked by a specialist.”
Symptoms include a slow stream of urine, straining to urinate, intermittent stream, double or multiple voids in a sequence and taking a while for urination to start.
“The sensation of incomplete emptying is a feeling of bladder fullness even after you have been to the toilet,” Prof Stergios said. “You may also have bloating above the pelvic area.”
You may sit two, three or even four times on the toilet to feel you have emptied the bladder.
“It can happen occasionally, but if it happens each time, there may be a cause.”
Causes could include a blockage of some kind, such as prolapse of the bladder or womb or scarring in the urethra.
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