Feeling Like You Have to Pee Right After You Pee? Female Causes of Vesical Tenesmus

Have you ever felt the need to pee immediately after using the bathroom? You're not alone. This uncomfortable and frustrating sensation, when it occurs frequently, is known as vesical tenesmus (a persistent urge to pee, often feeling like the bladder hasn’t fully emptied).

For women, this condition can stem from various causes, such as urinary tract infections, bladder irritation, or pelvic floor issues. While occasional urges might not be a cause for alarm, persistent discomfort indicates an underlying condition that needs medical attention.

In this article, we’ll discuss the common causes of vesical tenesmus in women and effective ways to manage your symptoms and improve your bladder health.

Taking a Closer Look at Vesical Tenesmus

Vesical tenesmus may affect more women than men, primarily due to women's shorter urethras, which make bladder infections more common, and female-specific anatomical changes that can occur from pregnancy and childbirth affecting pelvic support.

This condition, which makes you feel like you constantly need to pee even after just voiding, is often accompanied by additional symptoms, such as needing to push to pee, urinary incontinence, and frequent urination (frequency).

How can vesical tenesmus impact your life?

Struggling with the constant urge to pee can affect not only your bladder health but also your overall quality of life.

• Mental health: Feeling like you constantly need to pee can be very distressing and can have a significant impact on your mental well-being.

• Social interactions: You may avoid social events due to worries about finding a nearby bathroom or experiencing discomfort.

• Activity levels: You might be discouraged from working out or playing sports as physical activity can often trigger or worsen symptoms like urgency or leakage for some individuals.

• Sleep disturbances: The constant urge to pee can keep you up at night (nocturia), disturbing your sleep and resulting in daytime fatigue.

• Intimate relationships: If you feel embarrassed or uncomfortable due to your vesical tenesmus, it may start to affect your relationship with your intimate partner.

Possible Causes

The reasons for vesical tenesmus vary, but some of the most common causes include:

Bladder stones

If your bladder doesn’t fully empty after you urinate (urinary retention), the minerals in the remaining urine crystallise and turn into bladder stones over time. These bladder stones can irritate the bladder lining and cause inflammation or muscle spasms, triggering a constant urge to urinate.

Urinary tract infection

UTIs are a very common cause of acute urinary symptoms. Most UTIs are readily treatable by a healthcare professional. They are caused by bacteria entering the urinary system. The bacteria inflames and irritates the bladder lining, triggering sensitive nerves that make you feel like you constantly need to pee.

Overactive bladder

OAB involves urinary urgency ( a sudden, compelling need to pee that is difficult to defer), often with frequency and nighttime urination. While the urge component is strong, the specific sensation of needing to void again immediately after finishing (vesical tenesmus) is often more related to inflammation, irritation, or incomplete bladder emptying, although some people with OAB may experience it.

Interstitial cystitis

Also known as painful bladder syndrome, interstitial cystitis is characterised by bladder pain that worsens as the bladder fills and persists temporarily after emptying, urinary frequency and urgency. Painful urination(dysuria), pain during sex can also occur. Since most people with interstitial cystitis have bladder hypersensitivity or inflammation, a near-constant urge to pee is a common symptom.

Bladder outlet obstruction

A bladder obstruction, such as a bladder stone, tumour, significant pelvic organ prolapse, scar tissue (urethral stricture), prevents the bladder from emptying fully, leading to urinary retention and potentially a persistent feeling of needing to urinate due to the residual urine.

Vaginitis/ Urethritis

Vaginitis is a vaginal infection, typically caused by bacteria whereas urethritis is inflammation of the urethra, sometimes associated with STIs or irritants. These conditions can sometimes irritate the nearby bladder neck or urethra creating a persistent urge to urinate or discomfort during/ after urination.

How is Vesical Tenesmus Diagnosed?

Your healthcare provider will analyse your symptoms and may perform tests to determine the underlying cause of vesical tenesmus. This might include:

• Talking with you about your symptoms. You may also be asked to keep a bladder diary to record how often you pee and how often you feel the urge to pee.

• Discussing your medical history. By talking about your medical history, your GP may be able to draw links to potential underlying causes.

• Performing physical examinations, including an abdominal exam to check for tenderness.

• Potentially ordering urine tests, blood analysis, and ultrasounds in more complex cases. Further specialist tests like cystoscopy or urodynamics might be needed in some cases.

Treatment Options

Once your doctor identifies the likely cause of your vesical tenesmus, they will recommend a tailored treatment plan. Common treatment options include:

Treating the underlying condition

If your doctor determines that your vesical tenesmus is caused by a medical condition, such as a urinary tract infection or constipation, you'll be treated for the underlying condition. Depending on the exact cause, you may be prescribed antibiotics, laxatives, or other specific medications.

Treating the inflammation/irritation

In many instances, inflammation or irritation is a key factor in the feeling of needing to pee constantly. If this is the case for you, your doctor will address this based on the cause. For example, specific medications for interstitial cystitis aim to soothe the bladder lining, while treatments for vaginitis target the infection.

Treating the muscles

Sometimes, vesical tenesmus is associated with involuntary muscle spasms (like in OAB). If applicable, your doctor may prescribe smooth muscle relaxers, antispasmodics, or anticholinergics. Pelvic floor physiotherapy focusing on relaxation techniques may be helpful if pelvic floor muscle overactivity is suspected..

In some cases, electric nerve stimulation and botulinum toxin injections into the bladder muscle may also alleviate symptoms in refractory OAB.

Managing cancer symptoms

If your vesical tenesmus is caused by bladder cancer or another type of cancer, treatment will focus on the cancer itself. While cancer treatments like chemotherapy or radiotherapy may worsen symptoms temporarily, strong pain relievers or muscle relaxants can provide some symptomatic relief alongside specific cancer therapies.

Ways to Improve Your Overall Bladder Health

If you want to maintain a healthy bladder and potentially reduce the risk or severity of urinary issues like vesical tenesmus, consider the following tips:

• Avoid potential bladder irritants: If you notice a link, reduce your intake or consider completely eliminating irritants like artificial sweeteners, alcohol, caffeine, acidic foods, citrus fruits, carbonated drinks, and highly processed foods from your diet. Keeping a food and symptom diary can help identify personal triggers.

• Perform pelvic floor exercises (if appropriate): If appropriate for your condition (e.g. weakness rather than over-tightness) and under guidance, strengthen your pelvic floor muscles by doing Kegel exercises and squats. Consulting a healthcare professional or pelvic floor physiotherapist is recommended to ensure correct technique and appropriateness, as sometimes relaxation is more beneficial.

• Eat a wholesome diet: Try to include natural foods like berries, potatoes, broccoli, kale, and other leafy greens in your diet. Ensure adequate fibre intake to prevent constipation.

• Drink enough fluids throughout the day: Aim to drink adequate fluids, typically 1.5-2 litres spread throughout the day (mainly water), unless advised otherwise by your doctor. Avoid drinking large volumes at once or close to bedtime.

• Manage chronic conditions: Go for regular checkups and manage conditions like diabetes effectively, as poorly controlled chronic illnesses can impact bladder health.

FAQs

Is it normal to feel like I need to pee directly after peeing?

No, it's generally not normal to feel like you need to pee right after you've peed. In most cases, it's a sign of an underlying condition that requires medical assessment t.

Is vesical tenesmus related to stress and anxiety?

Yes. Not only can persistent bladder symptoms like vesical tenesmus trigger anxiety, but stress and anxiety can also worsen symptoms like urgency and frequency in some people. This is why it's often helpful to take the time to relax and prioritise your mental health through techniques like mindfulness, deep breathing, by spending time with friends, reading a good book, or having a long bath.

What is rectal tenesmus caused by?

Rectal tenesmus (the constant or recurrent need to pass faeces, often with little result) is often linked to bowel conditions, infections, colorectal cancer, irritable bowel syndrome(IBS), haemorrhoids, or rectal abscesses, among other causes. As the causes are so broad, it is best to speak to a doctor and get a personalised assessment to find the cause in each individual.

What are the different types of urinary incontinence?

• Stress incontinence: Leaking when sneezing, laughing, coughing or lifting.

• Urge incontinence: A sudden, strong urge to urinate followed by involuntary leakage.

• Mixed incontinence: A combination of stress and urge incontinence.

• Overflow incontinence: Urine leakage due to incomplete bladder emptying (urinary retention).

• Functional incontinence: Caused by physical or cognitive barriers (e.g. mobility issues, dementia) to reach the bathroom in time.

Is cranberry juice good for my bladder?

While evidence is mixed and if present tends to favour high-dose capsules rather than juice for prevention of UTIs, some studies suggest cranberry may help prevent some bacteria from sticking to the bladder walls, potentially helping to reduce the risk of UTIs in certain individuals. It is not considered a treatment for active UTIs and excessive sugar in juice can sometimes be a bladder irritant.

Final Thoughts

The constant urge to pee shortly after voiding can take a toll on your physical health, social life, and mental wellbeing. If this is something you've been struggling with for a while, it's time to make an appointment with your GP to discuss your symptoms and start looking into diagnosis treatment options.

At Jude, we’re dedicated to empowering women with knowledge about health issues such as urinary incontinence and frequent urination. Our online blog, which features articles like this one, provides practical advice and key information. We also offer a range of specialised incontinence products, including liners, pads, and leak-proof undies.

Take control of your bladder health so you can enjoy an active and fulfilled life!