I had a great time recently in Toronto sharing preventive pelvic and abdominal health tips with pregnant women. What wasn't fun was what I noticed on the bathroom floor when nature called.
What I saw were urine drops on the seat and on the floor in front of the toilet. This happens a lot: I often have to visit three to four stalls before I find one that doesn't have the remnants of someone who went before me. Now, I do wish that people would wipe off the seat before they leave, but what I really want to talk about are the reasons urine may be on the seat and floor in the first place.
The reasons have to do with the pelvic floor.
Let's look first at the urine on the seat. Many women do not like to sit when using a public washroom and so will hover over the toilet. While this will keep you away from any urine on the seat left behind by the woman who hovered before you, it won't allow your pelvic floor muscles to relax as they need to and will also not allow the bladder to empty completely. When the pelvic floor muscles are not able to relax, the urine has a tendency to spray (hence the drops on the seat). When the bladder is not able to completely empty, over time it will start signalling you to empty before your bladder is full. This means more frequent trips to the toilet.
It is important to sit down and allow your pelvic floor muscles to relax so the bladder can contract and empty. Use seat covers or spread some pieces of toilet paper on the seat. That may be a lot to ask for some, though, and it leads me to my next point.
There are a couple of possibilities why there are drops of urine on the floor just in front of the toilet. One is that many women deal with urge incontinence – the sudden need to void or the inability to make it to the bathroom in time. Women may feel the need to pee and then walk to the washroom. As they get closer the urge grows stronger, and as they enter the stall the bladder may not be able to be stopped. Women frantically try to get their pants down so they can sit, but in many cases urine is already coming out and drops hit the floor before they are seated.
Another possibility is that urine drips out as a woman stands up after emptying – often referred to as posturinary drip. Perhaps the bladder was not completely empty or the sphincter muscle was unable to apply enough pressure to close the urethra.
Urge incontinence can be the result of nerve damage and can also be the result of poor elimination habits. Posturinary dripping may be the result of poor potty posture or weak pelvic floor muscles.
There can be other causes, but regardless of the reason women need to know this is not normal and it is very treatable in most cases. Pelvic floor physiotherapists are the best place to start. They may suggest a bladder diary to determine whether there are foods that irritate the bladder. They will teach you proper elimination habits and help you retrain your bladder to send the appropriate signals at the appropriate time. They can also help with proper potty posture – seated, sternum lifted, elbows on the knees, abdomen and pelvic floor relaxed. Pelvic floor physiotherapists are highly skilled women's health professionals who can help optimize your pelvic floor function and empower you to take control of your bladder, rather than your bladder controlling you.
Kim Vopni is a Vancouver-based certified pre/postnatal fitness consultant, co-founder of Bellies Inc. and owner of Pelvienne Wellness Inc. offering innovative products for a better birth and recovery. You can follow her on Twitter at @FitnessDoula.