We often hear about women struggling to hold urine in as they age. But struggling to squeeze it out? It’s more common than you think.
It’s called “female voiding dysfunction,” “urine voiding problems” or “non-neurogenic voiding dysfunction.” Essentially, it means you sit on the toilet and can’t get your bladder to empty. Maybe nothing comes out. Maybe your flow is meager and slow. You might have to push hard to get the job done, or may find that bits dribble out afterward.
Help! I Can’t Pee!
Your urine voiding problem can be anywhere from annoying to awful. Get medical attention no matter the severity so you can fix the issue before it gets worse.
You’ll be more likely to curb this problem if you know why you have it. Start finding that information by visiting your primary care specialist and requesting a urinalysis. That’s a quick urine test that will show if you have a urinary tract infection. If so, antibiotics might solve the problem.
If you don’t have a UTI, go see a urogynecologist. That’s a doctor who specializes in challenges related to women’s pelvic floors — including urinary struggles. That doctor might perform other types of tests such as:
- Pelvic exam. The doctor may test your pelvic area for weakened muscles and other issues. You might be sent for an ultrasound for a different kind of view.
- Uro-dynamic testing. This is a bladder test that lets the doctor see your bladder’s capacity — how much urine it can hold, how stable it is, and when and where it leaks.
- Cystoscopy. In the office, the doctor will peer inside your bladder via camera using a special device. It’s painless and you’ll be awake. It will show if you have bladder stones, cancer or other masses that can lead to urinary challenges.
Pinpoint the Cause
Several issues can lead to female voiding dysfunction, and doctors often struggle to find the root reason. But any specialist will know the primary culprits.
The fault likely lies with the bladder, vagina or urethra — the tube that leads urine out of your body. Here are some common causes:
- A recent urinary tract infection.
- Pelvic organ prolapse, which is when your pelvic muscles, tissues or ligaments get weak or tear. Your uterus or bladder might drop into the weakened area.
- Painful bladder syndrome. If your bladder hurts sometimes or always with no known cause, this may take the blame. It’s most common in younger women and is also called interstitial cystitis.
- Pelvic reconstructive surgery. If you’ve had surgery in the gynecological area, such as a sling insertion, that might have led to your trouble expelling urine.
- Constipation. If you defecate infrequently and therefore have a lot of stool built up in your bowels, that can physically put pressure on your bladder, which can then behave in random ways.
- Overactive bladder. If you frequently feel an urgent need to urinate, you might also fail to urinate on demand. Both issues can be related to trouble managing your bladder muscles.
Here’s Your Game Plan
Once you figure out what’s causing your urination to stop and go, you can find and begin the appropriate treatment. Unless you have an obstruction that needs to be removed, physical therapy will likely be your best bet. See a physical therapist who specializes in women’s pelvic floors. That professional can teach you how to urinate more effectively, and how to have a bowel movement in a more productive way. Both techniques can help solve your situation. For example, the physical therapist might teach you to “double void,” meaning to stay on the toilet until you’ve emptied your bladder completely, and why and how to relax your pelvic floor while doing that.
Best of all, the physical therapist will teach you tricks so the voiding issues won’t get worse or return. You can change your voiding habits and that might solve your problem for good. If that isn’t sufficient, your urogynecologist will suggest other routes to success.
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