When you pee, your body empties the bladder, but sometimes you can push and more pee will come out. So how come your body doesn’t get rid of all the pee at once?
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Your bladder is sort of like a balloon. If you blow up a balloon, then just let it go, most the air comes out on its own. But, to “completely” empty it of air, you need to squeeze it. Bladders are the same. They can empty most the way just by relaxing, but to get the last little bit out, you need to squeeze it
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Ever made Mac n cheese from the sauce pouches? Ever seen someone squeeze their fingers over it to get the last remnants of cheese off of the walls and eat it?
It’s a lot like that, just because we call something “empty” doesn’t mean it’s truly empty, just practically empty 🙂 kinda like ypu never *truly empty your bowels. If you did you’d have some other problems.
This also works for “clean” surfaces, most of the time something is left behind, even if we can’t see it.
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A friend of mine said they were getting their bladder imaged once and noticed that when they coughed, they could see some urine entering.
My understanding is that the kidneys constantly process urine, and some can kind of be squeezed out of them if you add pressure. So when you ‘push’, you’re probably pressing some extra urine through your kidneys’ filters and into your bladder.
So the answer is sorta complex.
1. Generally speaking, it’s kinda painful. Your bladder is an organ and if it changes shape quickly it can hurt. If you’ve ever been cathed at the hospital and had your entire bladder emptied at once you already know this. Nurses trick for patient comfort is to let it out slowly, pause to let the bladder adjust, and then let more out.
2. Your bladder is sort of opposite in terms of how we view musculature. You can’t flex your ‘pelvic’ muscles to pee because muscle flexing means you are retaining urine, while relaxing them causes urination. When you have sympathetic activation “fight or flight” you have urine retention (muscles tense). But when you are back into a parasympathetic state i.e. the “breed, feed, peed” state, you relax those muscles and can urinate. It’s also generally speaking, why men don’t urinate when they ejaculate. Ejaculation is a sympathetic activating activity. Your muscles are flexed, and thus no pee escapes. It also may be why female ejaculation takes a fair amount of manipulation/relaxation (although that part is just my speculation).
3. It’s hard to ‘relax your way’ into peeing more. When the bladder senses it’s no longer stretched, it just goes back to normal. The way around this, should you want to get it all out is to increase intrabdominal pressure leaning forward/rocking. Sidebar: sometimes when people do this (called double voiding) it can also cause an ache.
Your pelvic floor has enough resting tone to prevent passive leakage from occurring as your bladder fills; in other words, your pelvic floor is contracted when you’re doing daily activity, sleeping, walking, etc. When you sit on the toilet, you volitionally tell your pelvic floor muscles to relax, which in turn, tells your bladder to contract and you pee. It is normal to have some degree of what’s called post void residual or urine left over in the bladder, but reasons you may not be emptying completely include if you’re not relaxing optimally (i.e. if you hover over the toilet or power pee) or you may have some degree of cystocele, urethral laxity, or some other anatomical variation that prevents you from emptying fully. Cystocele is where the bladder starts to tip backwards into the vagina. When this happens, you can kind of think of it like a coke bottle on its side; most of the fluid would empty out, but there is a little residual fluid and standing up, bending forward or bending side to side may help you to empty the rest of the way.
While we’re on the topic, here are some points that may help with optimal emptying. It’s not good to get in the habit of “JIC” or “just in case” peeing. Bladders can hold over two cups of fluid and when we get in the habit of peeing as soon as we experience that first urgency signal, we are training our bladder to be overactive; In other words, the bladder starts sending urgency signals earlier and earlier, and before you know it, you really feel like you have to pee, but when you go, only a small amount comes out. For a healthy bladder, you should be peeing 1x every 3-4 hours. You should drink about half of your body weight (in lbs) in ounces of water, minimize bladder irritants that increase urgency, and make sure you are fully relaxing your pelvic floor when you go. If you have an overactive bladder and you’re trying to postpone for longer periods before going, try kegels — pelvic floor contractions decrease bladder urgency by temporarily stopping signals being sent to the bladder that tell you that you have to go. You can also try distraction techniques such as walking out of the bathroom, counting backwards, reading, etc.
Sorry if that was TMI, but we rarely get taught about pelvic floor, bowel or bladder function in our lives, so there is lot of misinformation, and I think it’s super important to know this stuff BEFORE it becomes problematic.
Source: Pelvic floor physical therapist
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