Incomplete Bladder Emptying
Condition Overview
Typically, there will be a small amount of urine left in the bladder after urinating called the post void residual (PVR). A normal PVR is 50 ml of urine or less. When an increased amount of urine is still present in the bladder following urination, this is referred to as incomplete bladder emptying.
Incomplete bladder emptying may be a result of poor coordination or overactivity of the pelvic floor muscles.
Two of the most common tests for assessing PVR include ultrasound imaging or catheterization. Ultrasound imaging will use images of the bladder to calculate the amount of remaining urine while bladder catheterization will remove and measure any urine left in the bladder after voiding.
Potential Causes
Increased pelvic floor muscle tone
Poor voiding techniques
Bladder prolapse
Neurological conditions
Obstruction
Injury
What are the Signs of Incomplete Bladder Emptying?
Incomplete bladder emptying can present as a variety of symptoms including:
Increased urinary frequency- urinating more often than you normally would or getting the urge to go shortly after urinating;
Urinary urgency- sudden, strong, and overwhelming urges to urinate;
Nocturia- waking up multiple time per night to urinate
Hesitancy or weak urine stream- taking a long time for your urine stream to start or feeling like the flow of urine is slow or stops and starts midstream
Abdominal discomfort and pressure
Urinary tract infections
Urinary leakage
What to Expect in PT?
Physical therapy will be tailored to address the underlying cause of incomplete emptying.
A full examination will be performed to assess your breathing mechanics, hips, low back, and abdominal wall. In addition, the physical therapist will also assess coordination, strength, and endurance of the pelvic floor muscles as well as palpation of the muscles to assess for increased tension.
Physical therapy can optimize body mechanics during voiding and provide strategies to assist with bladder emptying. Physical therapy can also help improve awareness and control of the pelvic floor during urination. If incomplete emptying is due to tension or overactivity in the muscles of the pelvic floor, manual therapy, stretching, and relaxation techniques can be utilized. Most likely, a combination of the above techniques will be used to set you up for success!