Incomplete emptying of the bladder

Information for patients, relatives and carers

Emptying or 'voiding' your bladder is important. Failure to empty the bladder completely can cause problems such as incontinence, discomfort, the need to go to the toilet frequently or even bladder and urinary tract infections. If this becomes an ongoing, chronic problem it can lead to over-distension of the bladder and various further complications including kidney damage. It is a problem which can affect both men and women.

There are various causes. Some, such as injury, surgery or disease – including various neurological disorders – can stop the muscles of the bladder squeezing effectively and so enabling effective emptying. Alternatively, it may be due to some sort of obstruction – such as an enlarged prostate in men, a kidney stone, a stricture or prolapse or even constipation.

Indications that you may not be emptying your bladder completely include leakage after passing urine, going to the toilet frequently, recurrent bladder infections or simply the feeling that the bladder has not emptied after going to the toilet.

While your doctor may want to investigate the reasons behind such difficulties, there are several things which you can do to help empty your bladder as fully as possible. (These techniques are sometimes referred to as 'double voiding').

Techniques to help empty the bladder

  • Take time and do not rush. Comfort and privacy will make voiding easier.
  • Make sure that you sit on the toilet. Do not “hover” over the seat. Men are more likely to be able to empty their bladders more completely if they sit down to urinate instead of standing up.
  • Make sure your feet are flat on the floor and not 'dangling.' This will help the muscles of the legs and pelvis relax properly. If the toilet is too high, use a stool or box for your feet to rest on.
  • Rest your hands on your knees.
  • Relax your abdomen and breathe into your lower tummy.
  • Try to pass urine in the normal way.
  • When you have finished urinating rock backwards and forwards or from side to side a few times to see if any more urine comes away. Do not strain or push and do not worry if you are unable to pass any more urine.
  • Stand up and walk around the bathroom for a few seconds.
  • Now sit down and try to pass urine again.

Further useful tips

Drink well

As a general rule adults should drink around two litres per day – more during hot weather or if they are exercising. Drinking water is especially beneficial and can bring many different health gains. In relation to your bladder and bowels it can reduce the risk of urinary tract infections, reduce urinary frequency and help ease constipation. If you have a medical condition that requires you to restrict your fluid intake, then discuss this with your clinician before increasing your fluids.

Try to avoid constipation

Constipation can make emptying your bladder more difficult. Frequency of bowel movement can vary widely between individuals and it is by no means essential to have one bowel action per day.

However, failure to empty the rectum can act as an obstruction to effective bladder emptying. Ensure that you have sufficient fibre in your diet and that you keep well hydrated. Consult your pharmacist or GP if you think you may require medication to help you open your bowels and maintain a regular bowel habit.

Bladder infections

These can mean that you are unable to empty your bladder properly. Symptoms can include pain or a burning sensation on passing urine, frequency or urgency, cloudy or bloody urine, pain in your lower tummy or back or a high temperature. If you think you may have an infection then you should contact your GP who may then test your urine and who will decide whether a course of antibiotics might be needed.

Acknowledgements

Kent Community Health NHS Foundation Trust, Royal Berkshire NHS Foundation trust, Southern Health and Social Care Trust.

Dorset Bladder & Bowel Continence Service