Bladder Behaving Badly? Find Out What's Normal (and What's Not)

Have you ever wondered whether your bladder is functioning properly? For example, is it “normal” to wake several times every night, or have a strong sudden urge to urinate as soon as you pull into your garage after running errands? Is it considered abnormal to have discomfort as your bladder empties, or to have difficulty emptying completely?

Our urology team at CHI Health can answer questions like these (and many others), and will usually use the following guidelines as they consider the symptoms you describe:

What is Considered Normal?

Normal Bladder Function

• Fewer than 7 voids in 24 hours
• Voiding every 2-5 hours
  • >65 years old every 2-3 hours
  • <65 years old every 3-4 hours
• Nighttime voids
  • >65 years old 1-2x/night
  • <65 years old 0-1x/night
• No episodes of urinary urgency

Normal Fluid Intake

• 8 glasses of 8 ounces/24 hours (64 ounces)
  • Dehydration irritates the bladder
• No more than 12 glasses of 8 ounces/24 hours (96 ounces)
  • Too much fluid irritates the bladder
• 0-1 irritating fluid/day
• Space fluids evenly through the day
• Minimal amount after 7pm

If your bladder function is not within these ranges, despite taking in “normal” amounts of fluid, or if you are having any of the following symptoms, it would be appropriate to see a specialized health care provider such as a urologist or urogynecologist.

• Leaking urine
• Inability to completely empty the bladder
• Pain or burning with urination
• Blood in the urine
• Frequent urinary tract infections (UTIs)

Testing

You may be advised to consider some testing to see where the problem lies. Often a urinalysis will help the team understand whether there is bacteria present, or other abnormal factors in the urine itself.

An additional test that could be considered is a cystoscopy. In this test, a small camera is inserted into the urethra (the tube that allows urine to pass from your body). The camera helps the provider see the lining of the urethra and bladder to determine whether there are any abnormalities.

Urodynamics testing is another way that a health care provider can find out what’s going on with the bladder function. In that test, sensors are placed within the bladder and rectum, and the bladder is filled with fluid. A patient is asked to tell the provider when they feel the bladder is full, and then the sensors measure pressure changes as the patient empties their bladder.

Based on the results from these tests (or others), your urology team will work with you to determine an appropriate plan of care. Options may include medication, referral to a specialized physical therapist, changes to nutrition habits, or other lifestyle modifications. Surgical procedures may be considered as well, depending on a patient’s unique needs and goals of care.

Your input is very important in determining the right pathway for you, so please feel free to ask any questions that will help you come to an informed decision. Our team is here to help! To connect with a specialist, call the Pelvic Health Center at (402) 717-7358.