How to relax when bladder contracts?

[Mop]

Hello, I was wondering how you deal with urgency symptoms. Did you develop particular technique to lessen the urge in situations where you can't go to the toilet?

I suffer from sudden involuntary contractions of my detrusor sometimes when the bladder is only slightly filled and sometimes when it is fairly full and everything in between. Usually these contractions fade after 20 seconds or so, but sometimes they get so bad that it dribbles in my pants. I had been trying all different sorts of techniques to deal with this, from deep breathing, distraction, moving around, squeezing the pelvic floor. Recently I found that rigorously massaging my butt cheeks close to the anus sometimes helps to relax my bladder (unfortunately only for a short time, so I still have to pee before my bladder is full). I got so used to doing this, that I unconsciously do this in public and people sometimes ask me why I'd have to scratch my butt all the times

Since I am new to the forum, I'd like to give a short summary of my CPPS story, if I can call it so, since I don't suffer from any pain at all, but maybe someone can relate to my experiences. I found this forum quite helpful, since the modern mind and body healing methods are even less known in Germany and there don't seem to be many people who suffer only from frequency and urgency, so it's hard to share my experiences with anyone.

My symptoms started more than two years ago and from what I know today I would relate it to constant heavy lifting at work and stress, that I put myself under. I did physical work all day and after work I continued doing sports, so I probably overworked my body and my pelvis in particular, but I never felt any pain that would make me stop. Today I'm still physically active, but much less than back then.

My only problem is frequent urination due to sudden bladder contractions. The intensity of these can vary quite a lot from day to day or even within a day and unfortunately I cannot relate the intensity to anything in particular like stress, more or less physical activity or so (they can be worst in the most relaxed situation). Rarely I can go half a day without having to pee, sometimes I have to pee every hour. Sometimes I can stay on the toilet for minutes after peeing and there is still some dribbling out.

Sometimes I can lie down and relax to calm my bladder. The only moment when my bladder gets really full is after waking, but as soon as I get up, I can be sure that my bladder muscle contracts, so I guess that certain muscles contract while standing up and trigger my detrusor. I tried to relate it to anything, particular foods, sports (I'm still not sure whether bodyweight training is doing my pelvis good or not), my testosterone deficiency, tensed muscles in my lower back (also without pain)...

Many urologists couldn't help me until I luckily found one who advised me to read "headache in the pelvis". At that point I had been doing Autogenic Training for over a year, with a very slight improvement. Now I also follow the Stanford/Wise-Anderson Protocol, apart from the trigger point treatment, since I couldn't find any. I'm still not sure to what extend it helps me. My urologist says it's basically a mental problem that I have to tackle, but he doesn't give many more advises. It may be that my detrusor muscle is falsely conditioned and I wondered whether it would be helpful to urinate before there is an urge to avoid involuntary contractions, but I fear that this would make the bladder contract when its even less filled.

Now I rather concentrate on getting better at PR and try to feel any tension that I didn't notice before.

[webslave]

I'd like to give a short summary of my CPPS story, if I can call it so, since I don't suffer from any pain at all

You do not have CPPS.

My only problem is frequent urination due to sudden bladder contractions.

That's called "urge incontinence" — a sudden and strong need to urinate. You may also hear it referred to as an unstable or overactive bladder, or detrusor instability. In a properly functioning bladder, the bladder muscle (detrusor) remains relaxed as the bladder gradually fills up

Do you know this, and have you researched urge incontinence?

[ChgoGuy]

Webslave - But can you really call "Urge incontinence" and "Overactive Bladder" the same thing? I tend to get confused all the time by this. They seem to get lumped together as the same, however people with UI tend to leak urine when having the urge, while those with OAB tend to not leak. Am I correct, or am I misinformed? Earlier on, the first Urologist I saw threw UI into a long list of things he thought I had, and yet I have never been unable to hold it no matter how strong the urge was. Of course there is some minor dribbling afterwards that sometimes normally comes with age.

This is what has been perplexing to me. Do I also have OAB with CPPS or not? I have been treating myself as such for 3 yrs, however since I started using the Therawand, if I use it correctly and hit the right areas, it tends to relieve anything resembling OAB until the muscles tense up again or flare up. I was off all week because of the chronic urge. The more I tried to pee, the more I aggravated my bladder. It seems to get aggravated between the sphincter and the urethral orifice, then everything else tends to flare up with it. So what tends to happen then, is that I end up with a week flow and dribbling out of urine, and then the cycle just continues to aggravate things over days. Although I use the Therawand everyday, I tend to be afraid of overworking certain areas, where I fear it's just going to make the flare ups and urination worse. However - If I really deal with the pain of targeting those areas, like a miracle, I loosen up those muscles that well, that over the course of 20-30min afterwards, my bladder allows me to release a fair amount of urine, and the urge/overactivity of the bladder then relieves itself. Last night, after using the wand, I urinated over 600ml after using the wand. Of course I had to urinate a couple of times, but I have not been able to release 600ml of urine in that short of time, in at least 3 yrs. Within 2 hrs I urinated about 100ml total. Last night I actually slept the best I could in weeks. I got up a few times feeling some minor urge, but really didn't pee much. Then I fell back asleep.

Getting back to the perplexing part, because I really don't know the answer. Speaking for myself, does it always have to be OAB causing the urge? Because after using the wand, I feel that the urge is being caused by CPPS and tight pelvic muscles. It's like "what comes first the chicken or the egg ?" I feel that there are people who have OAB, and others that have secondary OAB caused by CPPS. Does this sound about right? Or am I overthinking this?

Funny thing is that I woke up okay today. Now that I sat down to type this, it's causing pain in my urethra and penis. Time to get off the laptop and get moving. Ugghh!

[eltenso]

I am also confused with this. When I started having urinary issues (5 years ago, alas!), an urology resident suggested I could have OAB. I did my research and I found that people with OAB commonly don't have pain, and they tend to have some degree of incontinence. I did have prostatitis-like symptoms (pain in urethra, tip, suprapubic...), and I have never had incontinence whatsoever, but anyway I gave Detrol a try, and it only made my hesitancy worst.
I know I have a tight pelvic floor, because I have been seen by physical therapists (including Tim Sawyer) but, with the exception of 10 days following the Wise's clinic, I have never seen any real improvement in my urinary symptoms after physical therapy or internal work. When I have a burning sensation in the urethra, only inserting the finger does seem to calm that pain/discomfort, but the frequency and hesitancy at night are still there. Now, although there is some component that is pelvic-floor related, I am starting to wonder whether the etiology of my urinary symptoms might be organic.

[webslave]

UI and OAB: the difference comes down to leakage. While urge incontinence is sometimes referred to as "overactive bladder," that condition is slightly different; people with an overactive bladder feel an urge to urinate but don't necessarily leak urine (i.e. they have stronger bladder sphincters). But otherwise they are the same.

If you have no pain ("burning" is a form of pain BTW), you do not have CPPS (chronic pelvic PAIN syndrome), and strictly speaking, you should not be a member of this forum.

The volume of urine passed each time by a normal adult will vary from around 250 - 400mls. If you are passing that much when you go, your bladder is probably ok.

[ChgoGuy]

@Webslave - Thanks for clarifying what I had asked.

[webslave]

@Webslave - Thanks for clarifying what I had asked.

I probably didn't

But please note that UI and OAB are big areas of urology with a lot of research/theories/medication and I am not across this issue to anywhere near the extent I am with CPPS.

If you have OAB and CPPS then you have a multi-factorial case, and while this forum will be useful for the CPPS, not so much with the OAB. The best help you'll get is from other members who also have both conditions. Sorry I could not help more.

[ChgoGuy]

I felt you did help. Either way, you made it clear what at least the differences and similarities are between the 2, if not for me, then somebody else. Your impact is huge and I would hope people listen to you.

As for me, I'm still not sure if I have OAB, or all the pushing of urine out of my bladder at small amounts is irritating the bladder. I tend to get anxious if I can't piss and tend to try and force it out. When I do this, I THINK I am causing my urge issues. I'm not sure if that makes sense at all. Most of the times, the urge I feel is more related to pain or burning from the penis and urethra. Its only after this flares up, everything goes downhill from there. I start making unneeded trips to relieve myself of urine that's probably not there because it becomes a mind game from there.

I could be wrong about the whole thing. Its only a theory. But I have a hard time wrapping my head around the fact that I woke up one morning with an OAB or CPPS that wasn't there the night before. The only time I pissed that much was after consuming a lot of carbonated beverages, or in my case, after anytime taking Pseudeophedrine, which I was taking at the time.If I'm so sensitove to all these drugs, perhaps I am my bladder and prostate worst enemy.

If that makes any damn sense?!?!

[webslave]

I tend to get anxious if I can't piss and tend to try and force it out.

But why do that? Listen, I have a slow stream at age 60 now, and my father before me at my age had been operated on for BHP. I have BHP too, but I don't stress about it. I sit to urinate, and let every last drop come out in its own good time. It's a bit stop-start, but I see it as normal for a man my age and with my genetic heritage. At your age it had started a bit already. I do not get myself all worked up into a frenzy about it, start trying to "force" it out, etc. You could be creating this whole issue out of nothing, just because of your hypervigilant personality.

[ChgoGuy]

How do I argue with that Webslave? LOL!!

Personally, I think some of my problems also stem around sleep deprivation (not by choice), and the fact my mind is going full throttle all the time. I'm in a rush to go nowhere. I'm thinking of giving it a go soon, and go talk to somebody so to figure myself out. I also started taking some Valerian Root to help get sleep.

What if anything do you take for your BPH Webslave? I must admit that I should have taken Quercetin sooner for the pain issues. I heard and read about it like 2 yrs ago, but figured it was just some snake oil or just another useless hyped up product directed at people like us. Its probably one of the most helpful supplement I have taken by far.

[webslave]

I see BPH as a normal part of getting older, so I don't treat it. Most men my age have symptoms (BPH affects about 50% of men between the ages of 51 and 60 and up to 90% of men older than 80). I don't think about it, I don't worry about it, and I'm at peace with getting older. I think more about dying, to be frank. As you age, the prospect of dying begins to crystallize in your head. Your parents die, your friends and relatives start dying, and you see the unmistakable signs of mortality in your own body. It's sobering, and it's something you have to come to terms with as time passes.

I'm glad you are one of the patients helped by quercetin. :)

[ChgoGuy]

I did my my internal work last night before bed. I felt decent afterwards, then dozed off. About an or so later I awoke and couldn't fall back asleep. I could feel something was amiss and not right. Little by little it creeped back up on me, and I've been up the rest of the night. I tried some more internal work to see if I could relieve it. Jumped in a hot tub for awhile and did some deep breathing. Got back out and did some more deep breathing, and must do my stretches before I leave for work.

I truly don't understand sometimes if or what I could possibly be doing wrong. I don't appear to be bothered by anything. Some times I wonder if it's the job. Funny how it happened before returning back to work. I could possibly retire early, but I would lose my health insurance for the wife and I. So I can't do that. I do like my job even though I deal with some of the hassles like people. All I know is I'm putting an awful lot of effort into beating this. Of course I wouldn't completely want to retire. I make good money but I'm not in a great place financially to just risk anything by hanging it up.

When I was younger, I didn't worry about aging or even dying. But now I'm older and see the golden years weren't so kind to either of my parents, and that does sit in the back of my mind, although I think I take better care of myself then they did. Death? I have a love hate relationship with that. I don't fear death. I fear suffering. My only other fear of death is that if I died before my wife, I worry about her. She's been by my side for 35 yrs thru thick and thin. I would just like to get thru this and enjoy the time we have left now that my kids are adults, but I hit this major stumbling block with this shit. The whole death thing can wait. Thanks for listening!!

[Mop]

Webslave, you're probably right,I may not have CPPS, but according to my urologist I don't have a typical case of urge incontinence or OAB either. I think he's talking about CPPS in my case because he suspects the causes to be similar to those in some cases of CPPS. He thinks it's due to an overworked and unconsciously tensed pelvis and stress. Furthermore the common treatments for OAB, like toilet training or drugs to relax the bladder didn't work, so he hopes that treatments like those of CPPS show better success.

But is it that the urge and frequency of CPPS patients is due to aggravated nerves or something else rather than actual contractions of the bladder?

[webslave]

Frequency in CPPS patients is due to nerves and the inflammation they can cause. It will be interesting if you are helped by CPPS-style treatments. I'm not saying they won't work, in fact you already have gained some benefit from relaxation techniques.

You know that you can cause bladder irritation in mammals by stressing them, don't you?

[Mop]

Yes I do, but I don't think stress is the main cause since my bladder can sometimes be calm in the most stressful situations and go off every hour, when I'm totally relaxed. It's still quite a riddle to me.

"burning" is a form of pain BTW

I don't feel any burning either, sometimes there's a feeling of a dull tightness around the perineum, in particular when I practice paradoxical relaxation.

The volume of urine passed each time by a normal adult will vary from around 250 - 400mls. If you are passing that much when you go, your bladder is probably ok.

I pass everything from 200 to 550 ml each time I have a pee but I would't say my bladder is ok. If it was I would pass about the same amount each time and it wouldn't go off unwillingly. I find it hard to clearly distinguish between OAB and UI, because the contractions of the bladder can be light and no urine will be shed, but they can be so strong, that the strongest sphincter doesn't stand a chance, so it doesn't necessarily depend on the state of your muscles.