How the bladder works: symptoms, treatment and prevention explained simply.

The bladder is a vital organ that often only receives attention when problems occur. But did you know that your bladder can store up to half a litre of fluid before you feel the urge to go to the toilet? In this article, you will learn all about the anatomy of the bladder, common complaints and how you can maintain your bladder health - including tips on how to prevent problems such as bladder infections or incontinence.

The anatomy of the bladder

The urinary bladder is an expandable, muscular hollow organ located in the pelvic area that serves as a temporary storage facility for urine before it is excreted via the urethra. It is a central organ of the urinary system which, together with the kidneys, ureters and urethra, regulates urine excretion. In this section, you will find out how much fluid the bladder can hold, how it differs anatomically in men and women and how it fulfils its function.

How does the bladder work?

The bladder works as a highly coordinated system controlled by nerve impulses. It is surrounded by smooth muscle that expands when the bladder fills and contracts to release urine. Neural signals between the bladder and the brain control when urine is released and when it is not.

Important functions of the bladder:

Sphincter muscles: These muscles work as valves that hold back or release urine.

Neural control: The brain receives signals from the bladder to register the urge to urinate and controls the sphincter muscles.

How much fits in a bladder?

The average adult bladder can hold around 400 to 600 millilitres of urine before the urge to urinate occurs. People with larger bladders or better bladder training may be able to hold up to 700 millilitres, while children and older people often have a smaller capacity.

Factors that influence the capacity:

Age: Bladder capacity tends to decrease with increasing age.

Health condition: Conditions such as an overactive bladder or incontinence can affect capacity and control.

Hydration: A good fluid intake can mean that the bladder needs to be emptied more frequently.

Can a bladder rupture?

Although it is extremely rare, a bladder can actually rupture under extreme conditions. This often occurs in situations where there is an injury or the flow of urine is blocked, such as in cases of severe enlargement of the prostate (BPH). The body usually warns you with severe pain or uncontrolled urination before such a scenario occurs.
Bladder ruptures are extremely rare, but are more common in cases of injury or untreated bladder obstruction. In cases of urinary retention, a catheter is often inserted to empty the bladder to prevent overdistension.

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Difference between the bladder in men and women

The bladder itself functions in the same way in both sexes, but the anatomical differences in the urinary tract lead to gender-specific complaints. While women suffer more frequently from bladder infections, men often have problems with urine flow due to their proximity to the prostate.

Is your bladder healthy?

Have you noticed that your urine stream has become weaker or that you have to get up more often at night to urinate? These could be signs of bladder problems or benign prostate hyperplasia (BPH). You can use the International Prostate Symptom Score (IPSS) to assess for yourself how severe your symptoms are.
The IPSS self-test allows you to assess the extent of your symptoms and find out whether you need to see a doctor. Take a few minutes to do the test - it's an important step in keeping an eye on your health. The sooner you recognise possible symptoms, the sooner you can take action.

Carry out a free self-test now

Frequent urination - how often is normal?

Many people wonder how often it is normal to have to go to the toilet. Urinating 4-7 times a day is considered normal, depending on fluid intake and other individual factors. However, frequent urination can be disturbing and may indicate problems such as an overactive bladder, diabetes, or urinary tract infections (UTIs).

Causes:

Excessive fluid intake, especially caffeinated or alcoholic drinks.

Urinary tract infections (common in women)

Overactive bladder due to nerve disorders, bladder irritation or ageing processes.

Solutions:

Avoid bladder irritants such as coffee or alcohol.

Early detection from home: Streamcheck collects valuable data via urine analysis to detect abnormalities at an early stage. Regular analysis helps to recognise uncontrolled urine flow in good time - all without having to visit a doctor.

Bladder training: This involves controlling the urge to urinate and holding back urine for certain periods of time.

Medication: In severe cases, medication can be used to relax the bladder muscles.

Bladder infection

Bladder infection in men

Bladder infection in women

Although bladder infections (cystitis) occur less frequently in men than in women, they are still painful and unpleasant. In men, cystitis often occurs in connection with prostate disease or urethral strictures.

Causes:

Enlarged prostate (BPH), which can block the flow of urine.

Bacterial infections, often caused by sexual activity or urethral stricture.

Urinary retention caused by an obstructed urethra.

Solutions:

Antibiotics for the treatment of bacterial infections.

Regular fluid intake to promote urine flow and prevent infections

For chronic cases: Prostate treatment to improve urinary flow.

Bladder infections are one of the most common urinary tract infections in women, as the shorter urethra makes it easier for bacteria to enter the bladder. Many women experience cystitis at least once in their lifetime and it can lead to recurrent infections.

Causes:

Bacteria (usually E. coli) that enter the urethra from the intestine.

Sexual activity, as it can push bacteria into the urethra.

Inadequate fluid intake and hormonal changes (e.g. during the menopause).

Solutions:

Antibiotics are the common treatment for bacterial infections.

Prevention through hygiene: Women should wipe from front to back after urinating to prevent the spread of bacteria.

Drink plenty of fluids to flush the bladder.

Why does it burn when I urinate?

A burning sensation when urinating is often a sign of an infection or inflammation of the urinary tract. However, it can also be due to sexually transmitted infections (STIs) or irritants in the urine.

Causes:

Urinary tract infections (UTIs), often caused by bacteria.

Sexually transmitted infections, such as chlamydia or gonorrhoea.

Irritants in the urine, such as caffeine, alcohol or certain medications.

Solutions:

Antibiotics if an infection is the cause.

Avoidance of irritants in the diet

If an STI is suspected: see a doctor and receive appropriate treatment.

Prevention and early recognition of symptoms helps enormously to avoid major problems and pain.

Blood in the urine: what to do?

Blood in the urine (haematuria) can be an alarming symptom and often indicates serious problems. Although it is sometimes harmless, e.g. after intense physical activity, it can also indicate kidney problems or bladder cancer.

Causes:

Infections of the urinary tract.

Kidney stones or bladder stones.

In rare cases: Bladder cancer or other serious illnesses.

Solutions:

Medical examination to determine the exact cause.

Imaging procedures such as ultrasound or CT to localise stones or tumours

In the case of infections: Antibiotic therapy

What is a weak bladder?

A weak bladder is often characterised by incontinence or an overactive bladder and mainly affects older people or women who have given birth. People with a weak bladder have difficulty controlling the flow of urine.

Causes:

Pelvic floor muscle weakness, often after pregnancy or due to ageing processes.

Overactive bladder, caused by nerve disorders or irritants.

Solutions:

Pelvic floor exercises (Kegel exercises) to strengthen the muscles.

Bladder training to regain control over the urge to urinate.

Medication to calm the bladder.

The feeling of having to urinate again after urinating

This feeling can indicate an irritable bladder, cystitis or prostate problems in men. Those affected often have the feeling that they cannot empty their bladder completely.

Causes:

Bladder infections that irritate the bladder and cause a feeling of incomplete emptying.

Prostatic hypertrophy (in men), which impedes the flow of urine.

Urinary tract infections or stones.

Solutions:

Drink enough to flush the bladder.

Early detection and monitoring by measuring urine flow.

If prostate problems are suspected: Visit a doctor and have a urological examination.

Antibiotics if an infection is present.

Uncontrolled urine flow

Uncontrolled urinary flow, also known as urinary incontinence, is a common problem that affects many people - especially older adults and postpartum women. It occurs when control of the bladder muscles is lost, leading to involuntary leakage of urine. Urinary incontinence can have a significant impact on daily life and greatly reduce quality of life.

Problem: People who suffer from urinary incontinence lose the ability to fully control the flow of urine. This can occur during physical activity, when coughing or sneezing (stress incontinence) or with a sudden, strong urge to urinate (urge incontinence). In severe cases, incontinence can occur spontaneously and without warning.

Causes:

Weakness of the pelvic floor: Often caused by pregnancy, childbirth or age, in which the pelvic floor muscles that support the bladder are weakened.

Overactive bladder: This condition leads to a sudden, uncontrollable urge to urinate, even when the bladder is not full.

Neurological disorders: Conditions such as Parkinson's disease, strokes or multiple sclerosis can affect the nerves that control the bladder.

Hormonal changes: Particularly after the menopause in women, the lack of oestrogen can affect bladder control.

Solutions:

Pelvic floor exercises: Regular Kegel exercises can strengthen the muscles of the pelvic floor, which helps to control urine flow.

Bladder training: This involves setting fixed times to urinate in order to get the bladder used to a normal emptying rhythm again.

Medication: In some cases, medication can help relax the bladder or strengthen the muscles to improve control

Bladder health: What is good for the bladder?

Bladder health is influenced by many everyday habits that can help prevent bladder problems. In this section, you will find out which measures are useful for promoting a healthy bladder.

One of the easiest ways to promote bladder health is to stay hydrated. Water helps to dilute the urine and ensures that the bladder is emptied regularly, which reduces the risk of infections.

Drink at least 1.5 to 2 litres of water per day.

Caffeine and alcohol should only be consumed in moderation as they can irritate the bladder.

Regular fluid intake flushes bacteria out of the urinary tract and helps to prevent urinary tract infections. Older people in particular should make sure they drink enough, as the feeling of thirst decreases with age and the risk of bladder problems increases.

Preventive medical check-up

Regular check-ups are essential in order to recognise bladder problems at an early stage. Urine samples are usually analysed to detect signs of infection, blood in the urine or other irregularities.

Streamcheck offers a modern solution that allows you to monitor your bladder health from home. With Streamcheck, you can regularly measure important parameters such as urine flow and urine volume and recognise abnormalities at an early stage. This innovative method of self-monitoring helps to identify potential problems before they become more serious and offers a practical alternative to traditional check-ups.

Bladder-friendly diet

Certain foods can strengthen the bladder and prevent discomfort. Antioxidant-rich foods such as cranberries and fibre-rich foods promote bladder health and contribute to general digestion, which reduces pressure on the bladder.

Cranberries: Rich in antioxidants, help fight bacteria and reduce the risk of infection.

Fibre: Wholemeal products, vegetables and fruit contribute to better digestion and can reduce bladder pressure.

Avoid: Highly acidic foods such as citrus fruits and tomatoes should be consumed in moderation as they can irritate the bladder. Processed foods and products containing sugar, such as fruit yoghurts or fruit juices, should also be avoided as they contain substances that promote inflammation. Emulsifiers in ready-made products, such as E433 and E466, are also suspected of promoting inflammation of the mucous membranes.

Anti-inflammatory foods: Vegetables, fruit and healthy fats such as olive oil or linseed oil should be regularly included in the diet.

Healthy fats: Fatty sea fish such as salmon, herring and mackerel provide valuable omega-3 fatty acids, which can reduce inflammation in the body.

Probiotics and prebiotics: Foods such as kefir, sauerkraut or fermented products such as kimchi help to promote healthy gut flora, which strengthens the immune system and indirectly contributes to bladder health, especially after antibiotic treatments.

Regular emptying of the bladder

Emptying the bladder regularly is a simple way to prevent bladder infections and keep the bladder healthy. Holding back urine for long periods can lead to infections or overstretching of the bladder.

Recommendation: Go to the toilet about every 3 to 4 hours, even if the urge to urinate is not very strong.

Complete emptying: Make sure you empty your bladder completely to minimise the risk of infection.

Regular emptying helps to flush bacteria out of the bladder and prevent infections.

Exercise and bladder strengthening

Regular exercise strengthens the pelvic floor muscles, which are crucial for bladder control. Strong muscles can prevent incontinence and promote overall bladder health. Light strength training or daily walking can also help to support the bladder and improve bladder control. Regular exercise not only helps the bladder, but also contributes to overall health and well-being.

Kegel exercises

These exercises specifically strengthen the pelvic floor muscles and are particularly effective for people who suffer from incontinence.

Make sure that you don't tighten your abdominal, buttock or thigh muscles, but only the pelvic floor muscles. Breathe calmly and evenly.
Kegel exercises are particularly effective for people suffering from urinary incontinence and can significantly improve bladder control in the long term.

1 Recognise the right muscles: To activate the pelvic floor muscles, tense the muscles that stop the flow of urine. This is the pelvic floor.

2nd exercise position: You can perform the exercise sitting, standing or lying down.

3. tense up: Tense the pelvic floor muscles for 3-5 seconds.

4. relax: Then let the muscles relax for 3-5 seconds.

5. repeat: Perform this cycle 10-15 times in a row. Repeat the exercise about 3 times a day.

Bladder training

Bladder training is a method that aims to control the urge to urinate by gradually extending the time between visits to the toilet. People with an overactive bladder or incontinence in particular benefit from this technique.

The aim is to improve bladder control through planned toilet visits and reduce uncontrolled urge episodes. Start with short intervals and slowly lengthen them until a stable rhythm develops.

Bladder training can significantly improve quality of life by helping those affected to better control their bladder.

The most important information about the bladder at a glance

Here are the most frequently asked questions and answers about the bladder to give you a quick overview of its function, common problems and possible treatment approaches.

How much urine can a healthy bladder store?

A healthy bladder can store around 400 to 600 millilitres of urine before the urge to urinate sets in. The exact capacity can vary from person to person, depending on age, state of health and drinking habits.

What causes frequent urination?

Frequent urination can be caused by various factors, including urinary tract infections (UTIs), overactive bladder, excessive fluid intake and diabetes. Bladder irritants such as caffeine and alcohol can also increase the urge to urinate.

How can I prevent bladder inflammation?

Bladder infections can be prevented by drinking regularly, emptying the bladder completely and avoiding foods that irritate the bladder. Hygiene measures such as urinating after sexual intercourse and wiping properly (from front to back) also help to prevent infections.

What is an overactive bladder?

An overactive bladder is characterised by a frequent, sudden urge to urinate that is difficult to control. Causes can include nerve disorders, bladder infections or certain medications. Treatments include bladder training, medication, and in some cases surgery.

Feature	Women	Men
Urethra	Shorter (approx. 3-4 cm)	Longer (approx. 20 cm), crosses the prostate
Location of the bladder	In front of the uterus, deeper in the pelvis	Above the prostate
Susceptibility to infections	Higher, as the shorter urethra offers bacteria a shorter route	Lower, but higher risk of prostate-related problems