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Underactive bladder- finding it difficult to empty my bladder

By Pelvic Floor Health
on July 06, 2019

I am 25 years old. The last 2-3 years I’ve had some bladder issues. When I go to the toilet, the pee often starts very slow and then almost stops and then begins again.


Sometimes I’m not feeling that I empty my bladder - especially when I’ve been holding it for a while. Sometimes it’s almost normal. I don’t have a problem with holding on the pee, I don’t leak or have to rush to the bathroom. No problems with jumping, sneezing, laughing either. My doctor did some testing for infection which came out negative. I often have lower back pain and a small scoliosis. I have always been very active. Is there any thing I can do to improve this issue.

Pelvic Floor Answers

Urinary retention can have some of the same underlying issues as bladder weakness and building up pelvic floor strength to support and blood flow to the pelvic floor organs, and improve bladder control can be helpful.

There can be many reasons for bladder retention such as a hereditary issue (other women in your family may have the same problem) the shape of the urethra or a partial bladder prolapse all of which can make it difficult to properly empty the bladder.
Heavy lifting, weights training and standing still a lot, can affect the pelvic floor muscles and working to improve these can have a positive impact on back pain also.

Using Smart Balls can be a good first step to see if the issues can be resolved quite simply and quickly
Increasing your intake of water to ensure your system is well hydrated and ensuring your bladder is sufficiently full before emptying also assists with bladder training. This would mean waiting until you feel the urge to urinate then waiting 5-10 minutes longer and then going.

Smart Balls are easy to use and can help you identify your pelvic floor muscles to help you release them fully when going to the toilet.

I would recommend trialling the SmartBalls - initially the Smart Ball Uno for 6-8 weeks along with increasing your fluid (water) intake.

If you do not get any improvement from this then I would recommend making an appointment with a pelvic floor therapist for an assessment to see- they can offer some electric stimulation therapy and may be able to identify if you have a prolapsed bladder. This can occur as a result of pregnancy-childbirth and heavy lifting

They may then recommend seeking further more specialist help if you have a prolapsed bladder or an obstruction or require oestrogen replacement therapy

If you decide to go ahead and try the Smart Balls there are step by step instructions on how to use them. If after using them for 6-8 weeks you do not notice any improvement in your ability to empty your bladder then please get back in touch and we can assist you with the next steps.

If you notice some improvement, then we suggest continuing with the Smart Balls and possibly upgrading to the Smart Balls Due that offer a stronger pelvic floor workout.

Ask a Question. Treatment for a mild prolapse issue

By Pelvic Floor Health
on June 12, 2019

For mild prolapse issues we find the Smart Balls are around 90% more popular with women than the Natratone so you may wish to trial these as an alternative. 
Smart Balls are more easily used as part of your daily routine hence their popularity. They are very effective at resolving bladder weakness issues. 

Read more »

Ask a Question. Smart Balls or Natratone?

By Pelvic Floor Health
on November 17, 2017

Which one should I use, Smart Balls or Natratone?


I have recently (8 weeks ago) given birth to my first child. He was a large baby and I had an extended period of pushing during my labour. I have just visited my GP after experiencing a sagging feeling in my vagina. She diagnosed a pelvic organ prolapse (bladder prolapse) where the front wall of my vagina is bulging and sagging down. I am not experiencing any incontinence at this stage but I am unable to 'hold on' for long when I really need to urinate. I am wondering what would be the better option to purchase to help with strengthening my pelvic floor, the NatraTone or SmartBalls?

Pelvic Floor Answers

We do recommend Natratone for women who have mild to moderate prolapse, you can later on if you choose, use the SmartBall Uno for maintenance, however the Natratone is a good long term option and we recommend you continue either to use the device or continue the correct exercises for 3-4 months at least (rather than the minimum of 6 weeks) to help strengthen your pelvic and core muscles and reduce the impact of the prolapse.
The Natratone is easy to use and you can use it daily rather than 3x per week if you choose.
You will be able to reuse the Natratone throughout your life as the medical grade plastic is long lasting

Ask a Question. Grade 2 Bladder Prolapse - Will Smart Balls help me?

By Pelvic Floor Health
on July 14, 2017

Will SmartBalls help my Grade 2 Bladder Prolapse?


I have a grade 2 bladder prolapse can the balls help for this problem?

Pelvic Floor Answers

I would recommend the Natratone as the better option to help strengthen your pelvic floor muscles and to help reduce the impact of your Grade 2 Prolapse

While not likely to reverse your prolapse, many women with prolapse find improvement and greater bladder control from stronger pelvic floor muscles and if they do require surgery can have quicker recovery times with better blood flow and muscle tone from the exercises using the Natratone.


Ask a Question. Can a woman with a prolapse use the Duo Smart Balls?

By Pelvic Floor Health
on December 15, 2016

Can I use the Duo SmartBalls if I have a prolapse?


I bought Smartballs Duo and still have them unopened in exactly the same condition they were sent to me. I read through the descriptions again and see that women with prolapsed a uterus should get the single "Uno". Am I still ok to use the two balls?
Also, if so, I have very strong muscles according to my physio so wondering if I chose the right Smart Ball set? much appreciate your help.

Pelvic Floor Answers

We are increasingly recommending that all women start with a single ball and then progress on to the double balls as this is much easier and success encourages women to keep using the balls to get benefit.
You are welcome to try the double balls and can then purchase the SmartBalls Uno if you need go back a few steps and start with the Uno. It will depend on the type and extent of your prolapse as to how easy it will be to use the Duo balls.
The main issue for women who have not used SmartBalls before and who have a prolapse is that they find it difficult to insert the double balls.
Unfortunately due to health and safety reasons we are not able to accept back even unopened SmartBalls so I recommend using them if you can.


Ask a Question. When will I know I am ready for the next level Smart Ball?

By Pelvic Floor Health
on August 30, 2016

Do you think I should try the next level up of the Smartball? If not now, when will I know when I'm ready for that next level?


I just have a daughter is almost 15 months old - during the 30hr labour my urethra was crushed between her head and my pelvis and I then had a third degree episiotomy.
So my pelvic floor got quite a hammering. I saw a hospital physio who tested my muscles and got me doing more pelvic floor exercises.

I've also been using the Smartball Uno (the beginner one) for about 1 hour a day, doing pelvic floor exercises regularly, and doing pilates as much as I can (which is only once a week sometimes) but I still leak or at least feel compromised during high impact exercise when it involves splitting the legs!!

I'm assuming that I will get back to where I was prior to being pregnant? Some women say that's just what childbirth does but I don't want to settle for that. I feel like I'm doing a lot. My physio said not to keep the ball in all day so I usually do it for an hour or so at a time when I'm walking. So...
Do you think I should be keeping the Smartball in all day?
Do you think I should try the next level up of the Smartball? If not now, when will I know when I'm ready for that next level?

Sorry for so many questions, just got a bit down on it today at the gym when I thought I would be okay. Thanks in advance.

Pelvic Floor Answers

Thank you for your enquiry and great to hear that you are so committed to recovering your pelvic floor strength. I cannot say for sure that you will be able to return to your pre-birth state, however I do think there are still options for you to improve.

My first suggestion would be to increase the amount of time you are wearing the SmartBall for as a single ball for one hour per day is not enough time do make a difference. I do NOT recommend using the double.
SmartBalls at all at this stage as they are double the weight and would be too much of a strain on your pelvic floor muscles.

Perhaps you could speak with your physio- who definitely has the specific skills and training- and ask if you can increase the amount of time you wear the single Smartball for by 30 minutes to 1 hour each week and gradually increasing the time you can wear them for, aiming ultimately to wear them for 5 to 10 hours -but not putting strain on your muscles. It is the amount of time daily plus the long term use that makes SmartBalls effective.

We have another product- called Natratone-that we recommend over SmartBalls for women who have had significant trauma and or prolapse.
This is a device that is used actively for short period of time, so actual active exercises and has been developed by women's health physios. It works a greater set of core muscles and is very effective.

Some women choose to continue to use the SmartBalls as well. I would recommend if you are in a position to purchase it that you try the Natratone and use it for a longer period that the recommended minimum of 6 weeks. You can check out the Natratone information and FAQ's on the website.


Ask a Question. At risk of prolapse can you please advise what I should use?

By Pelvic Floor Health
on August 04, 2016

Can you give me some advice on which of your products would be best suited for me please?


I was wanting a bit of help in deciding which option would be best for me. I have been told that the walls of my vagina are starting to fall in and are very floppy. I have had three children and my first birth suffered a lot of trauma to the vagina. I was also told that I may be at risk of developing a prolapsed uterus. Can you give me some advice on which of your products would be best suited for me please.

Pelvic Floor Answers

If you are at risk of a prolapse I would recommend the Natratone. It works a greater group of muscles than the SmartBalls and is very good for toning and strengthening you pelvic floor and core muscles.
I would also recommend you use it more frequently than the minimum of 3x per week and for several months rather than the minimum of 6 weeks.
You can follow the Natratone programme daily if you wish and long term.
The Natratone device comes with a DVD or you can view the online video on how to use, I recommend watching this first before starting the exercises.

Using the Natratone you will learn to identify and correctly engage your pelvic floor muscles and can continue the exercises without using the Natratone device. While it will not fix-undo your prolapse,the improved strength and support of the pelvic girdle will help prevent further deterioration and you are likely to notice some improvements.

Ask a Question. What commitment is required to properly use the Natratone?

By Pelvic Floor Health
on July 29, 2016

I want to understand what the Natratone exercises do or don't do and the commitment required on my part


How much space would I need to do the Natratone exercises (we have a small house and I gather privacy might be useful!) - i.e. are they sitting, standing, combination?
With prolapse, would I continue to do them every day/every second day for the rest of my life - how likely using Natratone is it that I'd only do exercises for 3 months and then not need them anymore? Just trying to be sure I understand what the exercises do or don't do and the commitment on my part. And what if I could do them once a day, but every day? Would I still be likely to receive enough benefits for it to be worthwhile?

Pelvic Floor Answers

The exercises start with 2 weeks on the floor. it can be helpful to have access to watch the video while doing them. You could wear a long skirt or have a blanket over your lower body or even wear pants. Then there are 2 weeks sitting and 2 weeks standing using the Natratoner.
The Natratone programme teaches you how to do the exercises both with the device inserted and then the same exercises without the device. For all women and especially for women with prolapse, pelvic floor exercises are a lifelong necessity to prevent bladder weakness.
Natratone helps you to focus and identify the correct muscles and will provide greater support for the prolapse, preventing it from deteriorating.
The minimum recommendation is 5 minutes 2x a day 3 days per week for at least 6 weeks and likely to be 12 weeks for a prolapse. Every day once per day would definitely provide benefits, the repetition is important. Long term you may keep up the exercises without the Natratoner. The reality for most women is we do lapse, and at any stage you can resume using the device.
We cannot guarantee that your prolapse will disappear, but your outcomes are likely to be greatly improved.
Hope that answers your queries and feel free to ask any more.

Ask a Question. Bladder prolapse is making me want to go to the bathroom constantly

By Pelvic Floor Health
on July 24, 2016

I have a bladder prolapse, it is in the 'front' of the wall, felt most when I lean forward and when it is bad I feel like I am constantly wanting the bathroom.


I have been referred to your website by a friend.
I am 31, small built, 45kg 160cm, and had a baby 2 years ago. I have a small prolapse...apparently not really enough for the gynecologist to do more than mention it in passing. But I feel it at least weekly, some weeks almost constantly. I gather it is a bladder prolapse, as it is in the 'front' of the wall, felt most when I lean forward and when it is bad I also sometimes feel like I am constantly wanting the bathroom.
The joys of children, huh! I had a long, difficult labour. My condition is such that it is highly unlikely anything will be done medically, and to be honest I don't think I trust them to do it anyway. It is never painful, just an uncomfortable pressure.
I have been doing pelvic floor exercises since before my son was born, and currently would do them at least 2-3 times a day...this maintains the prolapse some weeks fairly well, while other weeks it is just not enough (I really notice if I forget to do them for a couple of days though!).
I am a student, so really need to be sure whatever I purchase is going to be the best option for me.
 Could you please help me work out whether Smart Balls or Natratone would be helpful and worth the investment?
 I don't have much spare time, so would tend towards the smart balls as they don't require as much time commitment on my part, but noticed your website recommended Natratone more for prolapse.


Pelvic Floor Answers

Thank you for your email. We do recommend Natratone for a prolapse as it works a greater grouping of core muscles and also improves the brain-pelvic floor muscle connection to ensure you are activating the correct muscles as you exercise.
The exercises using the Natratone require 5 minutes, twice a day (allow 4 hours at least between your first and second set of exercises )at least 3 times a week, however we recommend getting in to a daily routine and continuing either with or without the Natratone device for at least 3 months and for women with prolapse you can keep going. So if you are able to make time for this.
Natratone is designed to last, so while you are making a bit of an investment your can keep using it for years.

Some women with prolapse find that they are not able to comfortably wear SmartBalls because of the pressure on the vagina. If you are getting quite an intense or regular feeling of the pressure it could be that SmartBalls wont work for you. Unfortunately they cannot be returned, so the Natratone is less of a risk and also the most suitable product for you in this instance.

Ask a Question. I have a prolapse, will the SmartBall help me regain bladder control?

By Pelvic Floor Health
on July 01, 2016

I have difficulty with bladder control and I have a slight prolapse. Will wearing the smart ball will still help me regain bladder control?


I have just recently bought the smartball uno.
I find once inserted that I don't feel very much - it seems to stay in place very well. This is not because my muscles are strong as I have difficulty with bladder control!
I do however have a slight prolapse and I wonder if the vagina wall pressing against the device is keeping it in place.

Do you think that wearing the smart ball will still help me regain bladder control?

Pelvic Floor Answers

It is perfectly normal not to really feel the Uno as we do not have many nerve endings in the upper part of the vagina. A prolapse is more likely to either push the Uno out or make it uncomfortable to wear the Uno so it sounds like you are doing well to have the Uno staying in place.
We recommend you keep using the SmartBall and following the instructions for use.
As you do have a prolapse we would recommend a minimum period of regular -daily or every second day for at least 12 weeks.
Whilst the SmartBalls wont make your prolapse go away, the improved muscle tone from using them is very likely to improve your bladder control and prevent your prolapse from deteriorating further. Toning the pelvic girdle helps to support the walls of the vagina and resist the prolapse.
You will need to persevere as there is no quick fix, and we recommend continuing on a regular maintenance programme long term.

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