Is It Normal for Your Lower Abdomen to Swell When You Need to Urinate?

Is it normal for the lower abdomen to bulge when feeling the urge to urinate?

I recently noticed that my lower abdomen appears significantly different before and after urination.
When I feel the urge to urinate, my lower abdomen bulges out, particularly noticeable when lying flat, and it feels like a firm, ball-like mass below my navel.
After urination, this sensation disappears.
I visited an internal medicine clinic, and the doctor performed an ultrasound while I had the urge to urinate.
He noted that my bladder was quite distended and scanned my lower abdomen, only seeing the bladder.
He then asked me to use the restroom and return for another scan.
Afterward, he mentioned that there was no residual urine in my bladder and that everything seemed fine.
Should I seek further evaluation?

Zhi Zhi, 20~29 year old female. Ask Date: 2016/07/28

Dr. Xu Peiqi reply Family Medicine

Hello, thank you for your inquiry.
If the ultrasound has been performed and both pre- and post-void assessments confirm that the bladder is distended but the residual urine is normal, there is actually no need for concern.
It is advisable to avoid holding in urine.
The noticeable distension of the bladder before urination may be due to a lean body type with less fat, which makes the bladder more visible when it is full.
It could also be related to weaker abdominal muscles, making the bladder's distension more apparent.
However, it is important to be cautious about abdominal hernias; if the bladder distension is accompanied by pain and the symptoms do not improve after urination, it is essential to seek medical attention promptly.
Thank you once again for your message.

Reply Date: 2016/07/28

More Info

It is not uncommon for individuals to experience a sensation of fullness or swelling in the lower abdomen when they have a full bladder and the urge to urinate. This phenomenon occurs because the bladder, which is a muscular sac, expands as it fills with urine. When the bladder is full, it can create a noticeable bulge in the lower abdomen, especially when lying down. This is particularly true if the bladder is significantly distended, as it can push against surrounding structures in the abdomen, leading to the sensation of a firm or "ball-like" mass.

In your case, the ultrasound examination conducted by your doctor confirmed that your bladder was indeed distended when you had the urge to urinate, but there was no residual urine left after you emptied your bladder. This is a positive sign, indicating that your bladder is functioning properly in terms of emptying completely. The absence of residual urine suggests that there are no significant obstructions or dysfunctions in the urinary tract that would prevent complete voiding.

However, it is essential to consider a few factors regarding your symptoms and the need for further evaluation:
1. Frequency and Urgency: If you are experiencing frequent urges to urinate or a sense of urgency that disrupts your daily activities or sleep, it may be worth discussing with your healthcare provider. Conditions such as overactive bladder or urinary tract infections can lead to increased urinary frequency and urgency.

2. Pain or Discomfort: If you experience pain, discomfort, or any unusual sensations in your lower abdomen or during urination, this could indicate an underlying issue that may require further investigation. Conditions such as bladder infections, interstitial cystitis, or prostatitis (in males) can cause similar symptoms.

3. Changes in Urination Patterns: Any significant changes in your urination patterns, such as increased frequency, changes in urine color or odor, or difficulty starting or stopping urination, should be evaluated by a healthcare professional.

4. Follow-Up: Since your ultrasound indicated that your bladder emptied completely and there were no residual issues, it may not be necessary to pursue further testing immediately. However, if your symptoms persist or worsen, or if you develop new symptoms, it would be prudent to follow up with your healthcare provider for additional evaluation.

In conclusion, while it is normal to feel a sense of fullness in the lower abdomen when the bladder is full, it is essential to monitor your symptoms. If you have any concerns or if your symptoms change, do not hesitate to reach out to your healthcare provider for further assessment. They may recommend additional tests or referrals to a specialist, such as a urologist, if necessary. Maintaining good hydration, practicing healthy bladder habits, and being aware of your body's signals can also contribute to urinary health.

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