Bladder muscle fatigue?
- Thread starter Saz94
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Jonathan Edwards
Senior Member (Voting Rights)
Are you sure this is what it is?
Bladder has smooth muscle in. its wall, which presumably helps it empty, together with gravity. I doubt this gets 'fatigued'. It is involuntary so not sure how you would tell. Neural control might be a problem. Pelvic floor voluntary muscle contributes to emptying the urethra.
Be aware that this is a key " this is where your body holds stress" area . .....
The cynic in me attributes this to being a speciality with a large female patient cohort, though trauma from sexual abuse may have a role to play .
This happened to my daughter after a cervical spasm .
The cynic in me attributes this to being a speciality with a large female patient cohort, though trauma from sexual abuse may have a role to play .
This happened to my daughter after a cervical spasm .
I did have a problem with this for many years, and often felt I was getting a UTi. Very unpleasant. I just assumed it was a symptom of fibromyalgia, which I have alongside ME.
Then I bought a book written by a consultant urologist from Bristol. It was a book about bladder issues more generally. He advised that urine needs to be expelled as forcefully as possible. Not sure if you are male or female, but according to him, women should urinate without sitting on the toilet seat. Instead they should kind of hover or squat above it. Sounds difficult for someone with ME I know, but it definitely improved the state of my bladder. If you are female, and physically able to, it might be worth a try.
Otherwise, you genuinely have my sympathies. It is a horrible feeling.
BrokenBeaktheBrave
Senior Member (Voting Rights)
No but maybe this could be related? When I'm sick or my body is fighting something, I lose "pee pressure". It was my very first symptom that appeared - and years before PEM - and it took me awhile to realise it's related to whether my immune system is fighting a virus. I had some testing done at the time and the only irregularities I've ever had have been macrocytosis, significantly elevated prolactin (which I still have 12 years later), high cholesterol and low cortisol.
Utsikt
Senior Member (Voting Rights)
Can’t you squeeze some muscles to get it to empty quicker?
When I have bad stomach issues the muscles I activate when on the toilet really struggle in the days after. It gets to the point that I can’t help it along and just have to wait for things to happen.
But I think that would happen to any muscles I used too much.
Chandelier
Senior Member (Voting Rights)
I found several sources that explicitly advice against this.
Women: Don’t hover over the toilet seat
Hovering over the toilet seat can lead to urinary tract infections and weaken the pelvic floor. A pelvic health therapist at The Ohio State University Wexner Medical Center explains why taking a seat is better for your health.
wexnermedical.osu.edu
Sit, Don't Hover, When Using the Toilet
You may think you're doing the smart thing when you don't sit down on a public toilet, but you may be unwittingly causing damage to your pelvic floor and pelvic girdle muscles.
www.healthywomen.org
MrMagoo
Senior Member (Voting Rights)
Not quite what you asked, but I get occasionally what I called “irritated bladder” and it means I need to keep going every five to ten minutes. Just like cystitis without the burning.
After various efforts with daily medications for incontinence (which made it much, much worse) and some research, I think it’s actually caused by spasms which are forcing the bladder to empty, and a smooth muscle relaxant (hyoscine butylbromide - brand name Buscopan sold over the counter and marketed for IBS/Period pain) absolutely relieves it in under 15 mins.
I think the bladder is one of those things where sometimes the opposite is happening, of what you imagine.
For me it seemed like it wouldn’t hold water, but it was actually constantly pushing any bit of water out. It wasn’t that I didn’t empty properly, it was that minutes after emptying, it started to fill but couldn’t relax enough to fill up fully over the next hour or two.
Tensing to try and “train” it to hold it in was making things worse, as it was then stuck in a big hold/push exercise loop working against the spasms, when what they needed was to relax. This is of note because a lot of advice to improve continence or bladder functions is to try and hold it/wait longer, or do pelvic exercise, try stopping mid-stream etc - not always helpful.
This was just my experience, it’s just food for thought. Also of note , I also am probably hypermobile, and my bladder has gone downhill at doing its job since the ME got worse.
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MrMagoo
Senior Member (Voting Rights)
Hovering isn’t a good thing.I found several sources that explicitly advice against this.
Women: Don’t hover over the toilet seat
Hovering over the toilet seat can lead to urinary tract infections and weaken the pelvic floor. A pelvic health therapist at The Ohio State University Wexner Medical Center explains why taking a seat is better for your health.
Sit, Don't Hover, When Using the Toilet
You may think you're doing the smart thing when you don't sit down on a public toilet, but you may be unwittingly causing damage to your pelvic floor and pelvic girdle muscles.
Squatting is different and half the world does it. You see footprints on toilet seats sometimes!
Jonathan Edwards
Senior Member (Voting Rights)
Contracting abdominal muscles and diaphragm will do that by increasing abdominal pressure but most of us don't do that and I cannot see any point unless you are in a terrible hurry. Increasing abdominal pressure is more relevant to emptying the bowel.
I doubt any of the advice on posture for urinating is based on any reliable evidence. Generally speaking physio-type advice on mechanics of things is pseudoscience.
I know. It is very strange. We are advised not to do this, yet when I tried doing it, it fixed my problem. Make of that what you will.I found several sources that explicitly advice against this.
Women: Don’t hover over the toilet seat
Hovering over the toilet seat can lead to urinary tract infections and weaken the pelvic floor. A pelvic health therapist at The Ohio State University Wexner Medical Center explains why taking a seat is better for your health.
Sit, Don't Hover, When Using the Toilet
You may think you're doing the smart thing when you don't sit down on a public toilet, but you may be unwittingly causing damage to your pelvic floor and pelvic girdle muscles.
Cedar
Established Member
I don’t think it’s specifically fatigue related, but my son’s bladder trouble began during a severe PEM crash after he had another episode of listening to the BPS crowd and deciding he could positive-think himself into not having ME anymore and went out to do the things he wanted to do. He crashed severely (and has never recovered his previous baseline), and started having daily incontinence during this crash, which was something that had never happened to him before (he’s only in his mid twenties).
He had a urodynamics study after a few months of this and was found to have DSD (destrussor sphincter dyssynergia—a form of neurogenic bladder). It is one of many neurological signs he has and I’ve spent a lot of time looking to see if this (and his other neurological stuff) is a known issue for other people with ME or if he may have another concurrent condition. He has had brain and upper spine MRI about 18 months ago (prior to the new onset DSD) that was “normal”. The neurologist insists GET is “the only thing shown to help ME” so we’re not feeling like he’s a good avenue to pursue the neurological issues further with.
He has bowel difficulties as well and working with a pelvic floor pt on that does seem like it has helped with some of the bladder stuff, but also he just makes sure he is using the restroom more frequently to reduce leakage episodes. This is difficult since getting out of bed to get to the bathroom is a lot of energy for him.
No. Only incontinence. Like, three drops. As if simply walking to the loo were incompatible with proper bladder control. And even when I don’t feel the need to urinate, I get random episodes of micro-incontinence. (past). I think it is common because it was in one of the questionnairies I filled.
On the other hand, the automatic thing that stopped working for me was yawning.
On the other hand, the automatic thing that stopped working for me was yawning.
StellariaGraminea
Senior Member (Voting Rights)
I've something up with bladder emptying too but don't think it's fatigue. My instinct was there is limited space for my bladder, and if it "over" fills (i.e. normal amount) it over stretches and then it takes ages to empty. It bothers me at night waking to pee frequently but daytime is fine.
GP suggested I try to ignore the urge to pee when it wakes me up, that works sometimes early in the night when I have enough sleep pressure to get back to sleep, but is a disaster later in the night, it just adds to insomnia. But it also doesn't work because the next time I wake to pee (after ignoring the first time if possible) my bladder (subjectively) feels it has over-extended and then takes forever to empty... Last time I followed that advice it took me 8 solid minutes of continuous peeing to empty & no chance of getting back to sleep then, was fully awake.
I read somewhere urinary issues are associated with ME but not sure how solid the research on that is. It does seem to be something people mention.
Peter T
Senior Member (Voting Rights)
After the first few years of my ME, the need for frequent urination became a feature of PEM for me, at its worst as much as every 15 minutes. When not in PEM it returned to normal. So I don’t think for me there was any suggestion of bladder muscle fatigue, though trying to hold out longer could result in leakage.
It did wonder if my prostate became swollen during PEM, as with swollen lymph nodes, but it was never confirmed and my PSA levels then were normal. Now I am getting to a certain age, I have benign enlarged prostate which masks any current relationship between PEM and urinary frequency or urgency.
It did wonder if my prostate became swollen during PEM, as with swollen lymph nodes, but it was never confirmed and my PSA levels then were normal. Now I am getting to a certain age, I have benign enlarged prostate which masks any current relationship between PEM and urinary frequency or urgency.
StellariaGraminea
Senior Member (Voting Rights)
That's good to hear. Hope that's my experience too & it just clears up.