Bladder Problems


Unless we have a problem with our bladder function we remain largely unaware of the multiple, complex, interacting systems that work to maintain subconscious control and allow effortless voluntary oversight. We are not born with these systems working effectively. During early childhood the appropriate neural networks become established and increasing conscious brain control allows the transition from functioning as a baby to developing control over when and where to empty the bladder.

It should come as no surprise that many women who seek help for their bladder problems, incontinence especially, do so because of a fear of returning to this childhood state as they get older. This fear may be exacerbated by an experience of either seeing their mother or another female relative devolve into a situation of incontinence with its’ myriad social and hygienic sequelae or had personally suffered an accident in public circumstances.

In order to appreciate what might constitute a bladder problem, we need to have a basic idea about that the bladder should do:

  • A residual urine volume of less than 50ml.
  • The first desire to void occurs when there is between 150-200ml of urine in the bladder.
  • A bladder capacity between 400-600ml.
  • No rise in bladder pressure during bladder filling or when standing.
  • There are no unprovoked spasms of the detrusor muscle of the bladder.
  • No leakage of urine during activities such as coughing, sneezing and laughing.
  • The amount of urine voided should be at least 150ml.
  • The peak flow rate during voiding should be greater than 15ml/sec.

You should not have to constantly worry about having a bladder accident. During the day emptying should not take place more than 7-8 times and no more than 1-2 times (age dependent) at night. If you feel the need to empty your bladder, you should be able to wait without fear of having an accident. When you do emptying your bladder, the urine should not trickle out, with you sitting on the toilet for what seems like ages. You should not have to do any specific manoeuvres (such as sitting forwards or straining) in order to empty your bladder.

Dr Onuma is the author of So, You Want A Labiaplasty and The Ultimate V. These books are unique and aimed at women considering their options for labial, vaginal and pelvic floor improvement.

What are bladder problems?

Bladder problems (dysfunction) is a collective term for abnormalities of how urine enters the bladder (filling), is stored and emptied.

Excellence in Form and Function. Prevent, Treat and Maintain.

Dr Oseka Onuma has a particular interest and expertise in female bladder problems using non-surgical therapy and surgery to restore continence, alleviate pain and prevent recurring bladder infections. He is highly trained and experienced treating lower urinary tract problems in women and is on the Expert Witness register of the Australian and New Zealand College of Obstetricians and Gynaecologists for urogynaecology.

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