Bladder problems

What can you do?

• Read the NHS Fife SUI patient advice page
• Strengthen your pelvic floor muscles using the NHS Fife Pelvic Floor Exercises patient advice page
• Remember to do your exercises by setting reminders on your phone, keeping an exercise diary or using a pelvic floor exercise app. Some are freely downloadable, while others can be purchased for a small fee such as the NHS Squeezy App
• Squeezy, the NHS Pelvic Floor Muscle Exercise App
• If you have been doing pelvic floor exercises but still have symptoms, this is often due to the exercises not being progressed. In order to see further improvement the muscles need to be progressively challenged over 6 months. Once you have mastered stage 1 of the pelvic floor exercises you can progress to stage 2 and then stage 3.
  • NHS Fife Pelvic floor exercises stage 1
  • NHS Fife Pelvic floor exercises stage 2
  • NHS Fife Pelvic floor exercises stage 3

Overactive bladder 

Overactive bladder or irritable bladder is a condition which can give you a sudden urge to pass urine which is difficult to control. You might leak urine or feel the need to go many times during the day or night.

What can you do?

• Learn about your bladder habits by filling in the NHS Fife Bladder Diary to record information about your drinking and bladder habits. (It is helpful to complete a bladder diary before any appointments with bladder specialists).
• Find out more information about bladder drills and bladder training in the NHS Fife Overactive Bladder Leaflet
• Fill in another bladder diary when you have finished the training programme to compare or just before your physiotherapy appointment to show us how well you have done

Mixed urinary incontinence

Mixed urinary incontinence is a mix of overactive bladder symptoms and stress urinary incontinence. You can follow the advice above to address mixed urinary incontinence.

Incomplete bladder emptying

Incomplete bladder emptying is when you do not empty your bladder properly. Common symptoms include needing to go soon after you have been to the toilet, passing small volumes of urine, getting no warning to go to the toilet, or a slow and weak flow. This commonly happens due to changes in your pelvic floor muscle function and bladder prolapse in women.

Incomplete bladder emptying in men can be due to prostate changes and therefore this needs to be assessed by a GP.

If you have recently (in the past 6 weeks) started to experience this (men or women), please see your GP to rule out other causes before continuing with the advice below. 

What can you do?

Find out more about incomplete emptying and how to manage it in the NHS Fife Incomplete Bladder Emptying Leaflet 

Other factors that impact on the bladder:

Constipation: Having a full bowel puts extra pressure on the bladder and is a common cause of the above conditions. People with constipation often strain ineffectively causing unnecessary pressure on the pelvic floor muscles. You can find out more about constipation and how to manage it on our Bowel problems page or read the NHS Fife Constipation Leaflet.

Being overweight: Increased body weight can put extra pressure on the bladder and pelvic floor muscles leading to difficulty controlling urine. Research has shown that a weight loss reduction of 5% - 10% of body weight has a significant benefit when it comes to managing urinary incontinence. It is important to speak to your doctor or access the NHS Fife Specialist weight management support service to assist with healthy weight loss.

Smoking: Smoking is a bladder irritant leading to overactive bladder and urgency as outlined above. Smokers often develop a chronic cough which puts increased pressure on the pelvic floor muscles leading to stress urinary incontinence. It is important to reduce or stop smoking all together to see an improvement in your bladder symptoms. Please speak to your doctor or access the NHS Fife Stop Smoking Service.

Exercise: A lack of exercise leads to weakening of the muscles around the outside of the pelvis which increases the strain on the pelvic floor muscles. Gradually increasing your exercise levels can help to strengthen your abdominal and gluteal (buttock) muscles to help reduce the load on the pelvic floor. An increase in physical activity can also help with weight loss. See this link for access to free workouts Fitness Studio exercise videos - NHS

Improving any of these will start to reduce strain on your bladder and pelvic floor muscles, making it easier to become dry or less urgent.

Nice Guideline NG123
Urinary incontinence and pelvic organ prolapse in women: management