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Urinary Urgency & Frequency

How do Bladders Work?

Your bladder is a bag-like organ that stores and empties urine. Pelvic floor and sphincter muscles control the opening and closing of the bladder and nerves send message between your muscles, bladder and brain.

When your bladder is filling up, your pelvic floor and sphincter muscles gently contract to hold in the urine. When your bladder starts to stretch, a message is sent from your bladder to your brain to let it know, “I’m full!” When you go to the toilet, your brain tells your bladder to squeeze out the urine and your pelvic floor will relax to let the urine out. When your bladder is empty, your pelvic floor contracts again.

What is Urinary Urgency & Frequency?

Urinary urgency is the strong, sudden desire to pass urine without prior warning, or the feeling of being ‘busting for the toilet’. Urinary frequency is defined as the need to empty the bladder often, with only short times between toilet visits. Frequency is characterised by more than ten visits to the toilet per day. Urgency and frequency may or may not be accompanied by bladder leakage or incontinence.

Urgency and frequency can cause distress for your child and your family, particularly when day-trips, shopping expeditions and car drives start to revolve around the location of toilets! Although these problems often improve with age, children do not necessarily ‘grow out of it’. The underlying bladder, muscle or nerve problem can lead to problems later in life. If your school-aged child has urinary urgency and frequency that is interrupting their quality of life, professional advice is essential.

What Causes Urgency & Frequency?

Much urgency and frequency occurs because the bladder, muscles or nerve messages are not working normally, although urge and frequency is not yet fully understood. Common causes include:
  • Overactive Bladder: This occurs when the bladder has problems storing urine. Symptoms include: wetting, urgency (‘busting’) and frequent toileting (more than eight times per day).
  • Underactive Bladder: This occurs when the bladder is large and the bladder muscle is floppy. Symptoms include: infrequent toileting (less than four times a day) and occasional wetting without any warning as the bladder overfills. Urinary tract infections are common.
  • Voiding Dysfunction: This occurs when your bladder and pelvic floor muscles are not working well together and you develop habits such as not emptying your bladder completely. This can led to wetting and urinary tract infections.
  • Triggers: This can include psychological factors (sitting on a bus, waiting in an aeroplane) and dietary factors (soft drink, caffeine) which can influence urgency and frequency.
  • Constipation: This occurs when you are not able to empty your bowel, or are having difficulty doing so. Bowel habits can have a significant impact on bladder function.
  • Structural Problems: related to your bladder, kidneys, muscles, nerves and urethra are rare. A medical specialist should be consulted if your child is identified as having an anatomical or neurological cause for wetting.

Treatment for Urgency & Frequency

Assessment and treatment at the Mars Clinic are provided by advanced-trained Physiotherapists. The type and duration of treatment for urgency and frequency will vary depending on the cause of the problem and the needs of the individual. Treatment may include:
  • Teaching correct bladder and bowel habits
  • Voiding deferment techniques including distraction and pelvic floor activation
  • Practical advice and strategies for management at home
  • Timed voiding and drinking programs
  • Urostym™ biofeedback computer games to teach pelvic floor muscle control and relaxation
  • Uroflow voiding biofeedback to encourage correct voiding habits
  • TENS neuromodulation to retrain nerve pathways
  • Referral to a medical specialist, or other allied health professional, as required
*Some content kindly adapted from the CFA Website:

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For details regarding Physiotherapy for the management of Men’s and Women’s Continence, please view our Active Rehabilitation Physiotherapy website