Small capacity bladder
What is a small capacity bladder?
Healthy adult bladders can generally hold 300-500 ml of urine before feeling the need to urinate, or up to 800ml overnight. In people with small capacity bladders, the urge may become uncontrollable with as little as 150 ml.
In most cases, the actual size of the bladder is not smaller than usual. Instead, its capacity may be reduced by irritation, muscle stiffness, pressure, tumours, or many other bladder function disorders. Cases where the bladder is physically below size usually result from previous trauma, such as after surgery to remove bladder cancer.
Sandhurst Urology offers diagnosis, management, and medical intervention for small capacity bladders from our clinic in Bendigo. To book an appointment, please ask your GP for a referral.
Symptoms of small capacity bladder
Low capacity bladders can have varying symptoms, depending on their cause. These may include:
- Feeling a strong urge to urinate immediately after drinking
- Difficulty holding urine
- Feeling sudden urges to urinate which are difficult or impossible to control
- Needing to urinate very frequently
- Needing to wake up and urinate multiple times during the night (nocturia)
- Leaking urine
- Bladder pain when holding urine.
It is important to remember that these symptoms broadly overlap with those of other bladder conditions, and that your own experience with a low capacity bladder is individual – you may not experience every symptom and may experience slightly different symptoms to those specified. For further advice and diagnosis, book an appointment at Sandhurst Urology.
How small capacity bladders are diagnosed
Your doctor will generally request several tests to determine your bladder’s capacity and what is causing it to hold less urine than average. These tests may include:
- Keeping a bladder diary – your doctor may request that you keep track of how frequently you urinate, at what times of the day, your diet, and other factors which impact your bladder function for a period of time. This may give insight into lifestyle factors that impact your bladder’s capacity.
- Cystoscopy and ureteroscopy – a urologist can pass a small camera on a catheter into your bladder and/or ureters to inspect their size and look for blockages or structural concerns.
- Urodynamics testing – Sandhurst Urology provides full-service urodynamics testing in-clinic, including:
- Uroflowmetry – measuring how quickly you can urinate and how much urine you can pass. It involves urinating into a specialized machine which measures these factors and converts them into a graph of your flow rate.
- Cystometry – measuring the pressure inside your bladder and the surrounding region as your bladder fills. It may indicate stiff bladder muscles which prevent your bladder from holding its full capacity.
- Postvoid residual measurement – measuring the amount of fluid left in your bladder after you have emptied it as you normally would. It can be measured using an ultrasound to show the fluid level, or by draining your bladder with a catheter.
- Other imaging tests – your doctor may ask for x-rays, CT scans, or other tests which show how your bladder looks and behaves.
Preventing small capacity bladder
Small bladder capacity that is caused by birth defects or neurological disorders cannot be effectively prevented, but it may be possible to prevent its impacts on your lifestyle. In addition to recommendations made by your medical team, strategies to do this may include:
- Checking your medications – some antidepressants, hormone replacement therapies, and sedatives can impact your bladder’s sensitivity or cause you to urinate more. If your medications cause urinary urge that interrupt daily life, you may wish to speak to your doctor about other options.
- Maintaining pelvic floor strength – if your bladder has reduced capacity due to urinary incontinence, strengthening the pelvic floor muscles may help increase your ability to hold urine.
- Reducing everyday stress – some studies show a relationship between stressful lifestyles and increased need to urinate. Taking time to rest may reduce pressure on both your mind and bladder.
- Avoiding caffeine and alcohol – these chemicals can irritate the bladder and cause it to feel full before it should. Reducing them may improve your bladder capacity.
- Maintaining a healthy weight – higher body weight can reduce the bladder’s functional volume by placing additional pressure on it.
- Avoiding smoking – many harmful chemicals from tobacco are passed out of your body in urine, making the bladder particularly at risk of bladder cancer and resulting reduced capacity. Repeated coughing from smoking may also cause urine leakage.
Treatments for small capacity bladder
Your treatment for a small capacity bladder depends on the cause, and your urologist at Sandhurst Urology will help you determine which is ideal for you. Options may include:
- Medications – your doctor may prescribe anti-muscarinics or betta-3 adrenoceptor agonists to help the bladder muscle relax, letting it hold more urine.
- Behavioural training – with help from a urologist or physiotherapist, many people can train their bladder to hold a higher volume of urine and are able to ‘hang on’ for longer.
- Double-voiding – after urinating, you may wish to wait 10-20 seconds and try again. This helps ensure that your bladder is empty, reducing the need for later trips to the toilet.
- Timed urination – following a daily bathroom schedule, emptying your bladder at specific times whether you feel the need to or not. This can help control urges to urinate and limit the interruption they cause.
- Dietary and lifestyle adjustments – reducing caffeine, alcohol, and other irritants may reduce your need to urinate.
Medical interventions for small capacity bladder
Treatments offered through Sandhurst Urology’s Bendigo clinic include:
- Botox bladder injections – your surgeon injects tiny amounts of Botox into the bladder walls using a cystoscope. Botox forces the bladder muscles to relax, which may allow your bladder to hold more fluid.
- Endoscopic tumour and stone management – if your bladder’s capacity is reduced by bladder tumour or stones, Sandhurst Urology can provide endoscopic removal surgery. This involves treating the cause without making cuts in the skin, or by performing the whole procedure through two or three small incisions.
- Cystoplasty – your urologic surgeon can perform surgery to make your bladder physically larger. This is typically only performed when other treatments have failed, but may be needed for patients who have small bladders due to previous bladder surgery.
- Cystectomy with reconstruction – in rare cases, your surgeon may recommend removing your bladder entirely and rerouting urine to either a bag outside of your body (ostomy bag) or an internal pouch made from your own body tissue (neobladder).
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