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What is Double Voiding?

Double trouble, double vision, double-or-nothing…double voiding?

You likely recognize the first three common sayings, but what is double voiding? 

Let’s examine double voiding, and how it can help women suffering from certain pelvic disorders.

Definition of Double Voiding

Double voiding is a technique used to help you learn to empty your bladder more completely. In simple terms, double voiding means urinating, then waiting a few minutes and trying again.

Double voiding is one of the treatments often suggested for women suffering from urinary incontinence, among other pelvic conditions.1

The Importance of Bladder Health 

To better understand double voiding, it’s important to understand your bladder and how it works, because completely emptying your bladder is a key part of bladder health. 

Your bladder is the organ in your pelvis that stores urine after it moves through your kidney. The role of your bladder is to store that urine and then help you move the urine out of your body. 

A healthy bladder should be able to store enough urine that you can participate in everyday activities — from working, to exercising, to simply sitting and reading — as well as to allow you to sleep at night. 

For the bladder to work properly, your nerve control system between your brain and bladder tells your body when you need to pee. It stores the urine until you get to the bathroom and then it empties when appropriate. 

The bladder has a sphincter muscle that works in conjunction with your important pelvic floor muscles to relax while the bladder contracts. Working together, this system allows urine to flow and the bladder to empty.2

What’s Wrong With My Bladder?

There are a number of conditions that can impact your bladder. Some of the more common pelvic disorders include the following:3

  • Urinary incontinence: this is when you can’t control your bladder, and pee leaks out before you can get to the bathroom.
  • Overactive bladder: this is when you pee more often than is typical, and often includes bladder leakage too.
  • Interstitial cystitis or bladder pain syndrome: this long-term condition causes pain in your bladder and frequent or sudden urges to pee.

Other disorders include bladder stones and bladder cancer.

In other instances, your bladder may simply not be fully emptying. This may be caused by behaviors, such as when you rush and don’t empty your bladder, or when you go to the bathroom too often and pass only a small amount of urine — which can actually reduce your bladder’s muscle pressure and flow rate.

In other instances, medical conditions like constipation, vaginal prolapse, or childbirth may impact your ability to fully empty your bladder.2

Why It’s Important to Empty Your Bladder

While going to the bathroom too often may cause issues, it’s equally important to empty your bladder fully when you do go to the toilet. 

Here’s why fully emptying your bladder every three to four hours is important:2

  • It reduces the likelihood of developing urinary tract infections and cystitis.
  • It protects your kidneys from damage.
  • A bladder that doesn’t empty can go into retention, which causes the bladder muscle to stretch and be damaged. That can impact the ability of your bladder to contract and further make it difficult to fully empty.
  • It could lead to complications like urinary tract infections, kidney stones, or bowel dysfunction, since bowel and bladder health go hand in hand.

Here’s an example of the benefits of emptying your bladder. One study showed that people who used the double voiding technique had a lower incidence of bacteria in their urine than those who did not.4

Why Would I Try Double Voiding?

Your doctor may suggest you try double voiding as a way to fully empty your bladder.  

One instance is if you’re suffering from overflow incontinence. This is a form of leakage that happens when your bladder is too full and you leak or dribble pee without meaning to. It may happen because you can’t empty your bladder as often as you need to, you have difficulty emptying, or you have a bladder obstruction or other problem that causes your bladder to get too full and overflow.5

Another example is urinary retention, a condition in which you can’t empty all the urine from your bladder. This condition could be related to other health problems, like a cystocele or bladder prolapse in women. Urinary retention takes different forms, from acute — a sudden inability to urinate; or it can be chronic — a gradual inability to empty the bladder.6

You may know you need to practice double voiding if you’re noticing that you need to go pee shortly after you just went to the bathroom; if you’re suffering from urinary incontinence; or if you have a feeling that you haven’t fully emptied your bladder.2

How To: Double Voiding Technique 

Here are the steps to practice double voiding:2

  1. Sit comfortably on the toilet and lean forward slightly.
  2. Rest your hands on your knees or thighs, as this will optimize the position of your bladder for peeing.
  3. Urinate as you normally do, emptying your bladder as much as possible.
  4. Stay on the toilet and wait anywhere from 20 to 30 seconds.
  5. Lean slightly further forward and try urinating again; or if possible, rock side to side as another way to better empty your bladder. 
  6. You can also try standing up and walking around for 10 seconds before returning to the toilet.

Remember that you should never strain when you’re peeing as this can negatively impact your pelvic floor muscles.

What Can I Do For Bladder Health?

Good bladder habits go hand in hand with good pelvic health. There are some changes to lifestyle you can make that will promote overall pelvic health, like quitting smoking and maintaining a healthy weight. 

Here are other tips for improving bladder health.

Maintain Good Bowel Function

Bowel issues like constipation and irritable bowel syndrome could cause bladder problems. Avoid constipation by eating fiber-rich food, and drinking plenty of water. You might think that cutting back on water will help with bladder problems, but good bowel function helps your bladder to function better, and water intake helps avoid constipation.2

Don’t Hold It In!

Don’t wait to go to the bathroom by holding in your pee. This adds stress to your bladder muscles and may increase the chance you’ll contract a urinary tract infection. Don’t rush to pee by hovering over the toilet, either. Take time for your bladder to be completely empty when you are on the toilet. 2

Perform Pelvic Floor Muscle Exercises

One key lifestyle modification is to perform pelvic floor muscles exercises — known commonly as “Kegels” — on a regular basis. These exercises will strengthen your pelvic floor, the hammock-like structure of muscles and ligaments that hold your pelvic organs in place and also help your bladder and rectum contract and relax on demand. That makes the pelvic floor a key partner in bodily functions like peeing and pooping. 

To perform Kegels, imagine that you’re trying to stop your urine flow. To do that, tighten or contract the muscles you would use to stop urinating. Hold for a count of 3 seconds, and then fully relax for 3 seconds. Aim to perform 3 sets of 10 Kegels per day.1 

It’s also suggested that you alternate positions for the 3 sessions — perform them once sitting, once standing, and once lying down. Using all three positions makes the muscles strongest.7

Why Kegels Are Important

Why should you do Kegels? Research has proven that pelvic floor exercises will prevent your pelvic muscles from getting weak, which can lead to a number of pelvic conditions. Strong pelvic floor muscles can also give you better control over your bladder and bowels. In fact, they can be used as treatment and prevention. Women of any age can and should perform these important exercises.

You can also use a tool to help you do Kegels properly, like the clinically proven Gynesis Urinary Incontinence Shorts.

See A Doctor 

It’s important to see your doctor if you are concerned enough to attempt the double voiding technique. That’s because you could have an underlying condition, including a urinary tract infection, or another pelvic disorder, that’s causing issues.  Use our Physician Finder to find a doctor near you with expertise in women’s health for diagnosis and guidance if double voiding is necessary. If you’re suffering from a condition like urinary incontinence, an effective treatment plan can help you remain active and healthy.