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Parents may remember a period in the lives of their young children when visiting the toilet was the main topic of conversations and jokes. It turns out that saying the word “pupa” out loud is the height of courage and a source of great joy. For good reason. Interest in this area in young children is one of the physiological stages of development. Although using the toilet seems to be one of the most natural, everyday activities, we still don’t talk enough about correct toilet habits, and it is worth talking about them to the youngest children.
- Although urinating or stooling is a natural activity that we do every day, we do have some problems with them
- We make a lot of mistakes that can lead to health consequences
- This is e.g. with expelling the last drops of urine or pissing “in reserve”
- More current information can be found on the Onet homepage
Urogynecological physiotherapist after a multi-module training accredited by the Polish Urogynecological Society, therapist of urogynecological prophylaxis according to the Bebo concept.
He treats patients of all ages who report problems with women’s health. A large group of women are those in the perinatal period, preparing for the birth of a child, but also after childbirth or caesarean section, taking advantage of preventive visits. He works with women with urinary incontinence, depletion of the reproductive organ or rectus abdominis. Her special professional interests include the care of women who report pain during intercourse, perimenstrual pain, as well as those of a chronic nature related to endometriosis, vulvodynia or vaginismus. In therapy, she is a companion of women, she believes in their autonomy and competences.
Passionate about psychology, thanks to which she completed postgraduate studies in psychosomatics and somatopsychology at SWPS. She is fascinated by motivating dialogue as a way of communicating with people based on empathy and respect for others. A speaker at congresses and conferences, but above all, Wojciech’s wife and mother of three daughters – Gabrysia, Ola and Łucja. You can read more at www.pelvimama.com
In order to understand the value of proper toilet habits that can prevent urinary incontinence, you need to understand the physiology of urination and stool, as well as take a closer look at the anatomy, at least in this basic edition.
Bladder and surroundings. How does this chip work?
The urinary bladder is located just behind the symphysis pubis. Its walls are flexible and wavy. Thanks to this, it has the ability to change its volume under the influence of urine accumulated in it, which is supplied from the kidneys through the ureters. The opening of the bladder is the sex urethra of various lengths. Behind the bladder, women have the uterus with the vagina, followed by the rectum with the anus. This means that parts of the three systems: urinary, reproductive and digestive systems meet in one place, i.e. in the smaller pelvis. They are supported from below, among others pelvic floor muscles, which play an essential role in the holding process, i.e. continence, urine and stool, as well as excretion.
The bladder muscle is not subject to our will (i.e. we cannot consciously tense and relax it), however thanks to the efficient muscles of the pelvic floor, the work of which we are able to control, we can influence the process of urine excretion. The more the bladder fills with urine, the harder the muscles surrounding the urethra work to seal it, preventing it from emptying prematurely.
During this time, i.e. when urine is stored, the muscle that lines the bladder is relaxed. Thanks to this, it can increase its volume and provide us with peace between visits to the toilet. The time of its activity, i.e. contraction, falls on the moment of micturition. Then we can also experience complete relaxation of the pelvic floor muscles.
Pelvic floor muscles in and out of the toilet
Anyone looking for ways to reduce the symptoms of urinary incontinence has probably heard about the muscles of the pelvic floor. The appropriate level of their activity is a necessary condition for the absence of unpleasant surprises, but in the context of urinating, it is worth paying attention to their relaxation.
One of the signals required to start urinating is that the pelvic floor muscles are fully relaxed, thereby opening the urethra. It can be associated with a feeling of relief when, after a long search for a toilet with a full bladder, we can finally sit on the toilet. When the muscles are not relaxed enough, it may be difficult to start a stream of urine or completely empty the bladder. This is well illustrated by the example of an attempt to urinate while on a moving train.
How often do I use the toilet?
The frequency of urination is an individual matter and depends on many factors, including bladder capacity or the amount of fluids you drink. However the correct number of micturitions per day varies between six and eight assuming that we sleep peacefully at night, with tolerance of one wake-up call for a trip to the toilet, especially in the elderly.
The first signal encouraging to urinate is felt when the bladder is filled to 200 ml, but usually we are able to reduce the need for pressure without any problems, for example by using the muscles of the pelvic floor or distracting attention with an important activity. Only filling it up to 350 ml or even half a liter gives a clear sign that you should urinate.
The time between visits to the toilet is extremely important. The increasing pressure in the bladder, caused by the increasing volume of urine, stimulates the muscles surrounding the urethra to work, providing them with mechanical stimulation. It is a kind of training by which the mechanism that closes the urethra remains operational. Little girls intuitively sit on their heels during engaging play to reflexively strengthen this system and postpone the visit to the toilet.
Therefore, it is worth emphasizing clearly that preventive use of the toilet before leaving the house is not a desired habit, and we acquire it sometimes in childhood. Who among us does not remember the words of our parents: “pee or we’re going out”? Someone may remember the golden advice for quickly emptying babies whose nervous system is only ready to control urination until they are around 2 years old. It happens that these seemingly innocent situations affect the functioning of the bladder for many years.
Too frequent urination and overfilling the bladder can have negative consequences for intimate health and quality of life. The latter are sometimes forced by the profession that makes it difficult to use the toilet, for example during a police patrol or in the event of a full schedule of customers in a hairdressing salon.
How to use the toilet correctly?
What if we didn’t silence the few-year-olds laughing at faecal jokes or show the atlas of anatomy and encourage friendship with the bladder? Or to provide peace and support to a child waking up from wet pajamas? And finally talk openly about how to pee and poop in support of intimate health, especially in girls? Below are some solutions that are worth knowing and implementing.
We learn about toilet habits at home through the observations of parents and their attitude to the subject of expulsion. From an early age, children can be taught an appropriate attitude to these matters, for example in the form of play, but above all thanks to an empathetic relationship and reaction to failure.
It is worth knowing that often the most important thing is the method of “emptying” the child. Conscious control of excretion inhibition does not appear until the age of 2 to 3, so trying to seat your baby on the potty beforehand, without clear signals about his readiness, will not be successful and can become a tedious and frustrating process for both parties. It is only in the third year of life that the child consciously feels the pressure on the bladder and is able to postpone the visit to the toilet. There are children who, however, need more time for this.
An educational element from early childhood, in the spirit of empathy and closeness, is a conversation about the physiology of urination and defecation. A frequent incentive to urinate is to provoke this act by running a stream of water. However, an undesirable consequence of such conditioning, which may occur in the future, is the difficulty of maintaining continuity when washing dishes or watering the garden.
The position taken in the toilet is also important. She should be reasonably relaxed but upright with her feet resting on the floor. Remember about children’s footrests. It’s incredibly hard to relax your pelvic floor muscles when your legs are hanging in the air! In public toilets, we can find toilet covers more and more often. It is also worth getting a disinfectant. The position with the buttocks elevated above the toilet makes it difficult to relax the pelvic floor muscles and forces pressure, preventing effective emptying of the bladder, significantly reducing the comfort of longer journeys. The stay in the toilet itself should be relatively short, not extended by reading a book or browsing the phone.
Don’t hold back your urine flow!
Pelvic floor muscle training, which consists in stopping the urine flow, is still a common practice among women. There are a number of arguments against the use of this method. Here they are:
- the pelvic floor muscles should be fully relaxed during micturition. When we tighten them, the nervous system gets the wrong signal that could disrupt this mechanism. The consequence may be an increase in the tone of the pelvic floor muscles and the muscles of the bladder;
- The risk of urine remaining in the bladder increases, and therefore the risk of urinary tract infections;
- The tense muscles of the pelvic floor during micturition, and also outside it, may be the source or intensify symptoms of urinary incontinence, pollakiuria or urgent urgency, ie the necessity to urinate “here and now”;
- It is a form of not very effective training. However, an occasional attempt to stop the urine flow in order to increase the awareness of their own muscles among women who have difficulty activating them by means of visualization is acceptable.
- The lack of full relaxation of the pelvic floor muscles during micturition results in a greater need to use the abdominal press. This, in turn, can cause hemorrhoids or depletion of the reproductive organ.
Stress is not good for the urinary system
Some women see a clear correlation between stress levels and the functioning of the urinary system. For example, they observe an increase in the number of visits to the toilet before an important event, difficulty in fully emptying the bladder or initiation of voiding, urinary incontinence, or even symptoms that may indicate an infection, such as burning or itching. One possible cause may be the increasing tension in the pelvic floor muscles under stress.
Similar reactions can be observed, for example, in the muscles of the neck or face. In such situations, the key is to be able to relax the body through breathing techniques, “letting go of the belly” or opening the mouth. Sighing before starting micturition will also work well – it makes it easier to “release” the pelvic floor.
Additionalo it is worth remembering during various activities of daily living to build awareness of the pelvic floor by feeling the pelvic floor more often and deliberately relaxing it in case of feeling of increased tension. Contact with the body, the ability to perceive signals is an important, if not a key element of taking care of the quality of intimate life, and certainly the first point of any therapy for pelvic floor problems.
Do not force urination
In addition to the relaxed pelvic floor muscles, it is worth observing the state of tension in the abdominal muscles. The belly in and out of the toilet should be relaxed. This is in contrast to the flat belly pattern that has been entrenched over the years. The contraction of these muscles leads to an increase in pressure in the abdominal cavity, which results in the acceleration of the urine stream, but causes overloading of the vaginal walls and perineum.
This “expulsion” of the last drops of urine usually accompanies women as a strategy to prevent urinary incontinence or delay the next visit to the toilet. However, this method rarely brings satisfactory results. If you feel that the bladder is not emptying completely, you can alternately roll or shake the pelvis, but above all remember to fully relax the muscles.
When urinating is a challenge
There can be many situations in life in which this seemingly simple activity becomes a challenge. This may be the case during pregnancy, when the bladder, due to mechanical pressure and hormonal changes, more often calls for visits to the toilet, also at night, and although it is quite burdensome, we treat it as a physiological state.
The proper functioning of the bladder may be hindered by postoperative adhesions, e.g. after caesarean section, as well as reduced mobility of the pelvic organs in relation to each other and their too high mobility. Stress can also have a significant impact, as can certain medications. The urinary bladder does not function in isolation from other structures. Its well-being is influenced by the function of the organs closest to it, therefore, in any difficult situation, comprehensive diagnostics is important, most often involving consultations with cooperating specialists in the field of urology, gynecology, proctology, physiotherapy or osteopathy.
Urogynecological physiotherapy is the first-line treatment for many problems in the pelvic floor area. Its effects are satisfactory not only in reducing the symptoms of urinary incontinence, gas or pain during intercourse. Interdisciplinary and individual approach to each patient, selection of therapeutic techniques and methods of self-therapy give a chance for success. It is worth reaching for them.
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