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Urinary Urgency Syndrome: Causes, Factors, and How Physical Therapy Can Help

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Overactive bladder syndrome (OAB) is a condition that affects many people regardless of age. It often manifests as a sudden, intense, and irresistible urge to urinate. It may be associated with frequent urination both during the day and at night. For some people, these symptoms become an obstacle in their daily lives, causing anxiety and stress, and may affect their social and occupational functioning.

What is urinary urgency syndrome?

Urinary urgency syndrome is defined as an unpredictable, sudden urge to urinate, which often results in a person having to go to the bathroom as soon as they feel the urge. “Many clients come to us with the problem that they feel like they constantly need to go to the bathroom, but at the same time they don’t know why this is happening, or they’re embarrassed to talk about this problem,” explains Katarína Hanuliaková, a physical therapist and owner of the IntimFyzio family physical therapy center. This syndrome can also affect younger women and men, although its prevalence increases with age.

How does urinary urgency syndrome develop?

The causes of urinary urgency syndrome can vary, and physical and psychological factors often overlap:

  1. Physiphysiological Causes: Changes in the tone of the pelvic floor muscles or in the tension of the smooth muscle of the bladder can contribute to the bladder’s inability to properly control its filling and emptying. “ If the pelvic floor muscles are weakened or chronically overworked, this can lead to frequent urges to urinate or even incontinence,” adds Katka Hanuliaková.

  2. Hormonal changes: Hormonal changes, such as a decrease in estrogen in menopausal women, can affect pelvic floor tone and alter bladder sensitivity, contributing to symptoms of urinary urgency.

  3. Neurological Factors: Certain neurological disorders, such as multiple sclerosis or Parkinson’s disease, can affect the nerve pathways between the brain and the bladder, which can lead to poor bladder control.

  4. Psychological and Emotional Causes: Stress and anxiety have a significant impact on our nervous system. Long-termstress can also manifest as increased tension in the pelvic floor, which can lead to increased bladder sensitivity and the urge to urinate.

  5. Improper toileting habits: Urinary urgency syndrome can also be triggered by improper habits developed in childhood or by poor voiding routines during more stressful periods of life. This syndrome is often developed by mothers on maternity leave who have little time for themselves and have gotten into the habit of using the restroom “just in case, before the baby wakes up,” even when there is no physiological need yet.

The Connection to the Mind and Emotions

““Although it is a physical problem, urinary urgency syndrome has very strong psychological and emotional connections,” notes Katka Hanuliaková. “People who experience long-term stress, tension, or anxiety may find that these emotions are also transferred to the pelvic floor muscles. This mechanism is natural for the body, but prolonged tension can lead to chronic symptoms.”

Feelings of shame or embarrassment regarding this topic can further exacerbate psychological distress, which can lead to withdrawal, avoidance of social situations, and a deterioration in overall mental health. It is precisely one’s mental state and various emotional blocks that often play a key role in how intensely and frequently a person experiences these symptoms.

How can physical therapy help?

Pelvic floor physical therapy is one of the effective methods for managing the symptoms of urinary urgency syndrome. “Properly guided physical therapy can help restore strength, coordination, and relaxation of the pelvic floor muscles, which can significantly improve bladder control,” explains physical therapist Katka Hanuliaková. The holistic approach we take at IntimFyzio to any health issue our clients may have includes an initial examination and diagnosis, pelvic floor treatment ifindicated , individually tailored exercises and relaxation techniques that help improve the connection between the nervous system and the muscles. If we feel that a client’s urinary urgency syndrome has a psychosomatic origin, we can also arrange a session with a psychotherapist who will address the emotional aspects of the problem.

Key Approaches in Physical Therapy:

  • Pelvic Floor Strengthening Exercises: These exercises help strengthen the muscles that support the bladder and ensure its proper functioning.

  • Pelvic Floor Muscle Relaxation: These techniques teach you how to properly control and relax your pelvic floor muscles so that they are not in an abnormal state of tension.

  • Breathing and Stress Management: Proper diaphragmatic breathing and effective stress management can help relieve tension in the pelvic floor and reduce the urge to urinate.

Final Recommendation

If you’re struggling with symptoms of urinary urgency, don’t hesitate to seek professional help. “Urinary urgency syndrome isn’t something you should have to live with without help. Physical therapy can be an effective tool to help you regain control over your body and emotions and improve your quality of life,” says Katka Hanuliaková.

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The body does not need to be fixed. It needs to be understood.

I am a woman, wife, mother and physiotherapist. Over the years of practice, I have realised that health does not come only from eliminating symptoms or solving a specific problem. Real change comes when a person begins to better understand themselves, their body, and the way they live their life.

It was this idea that led me to create the space you know today as ToBe – a place where different areas of expertise, perspectives, and approaches to health are interconnected. A place that does not see a person only through a diagnosis or individual symptoms, but as a unique whole.

My professional journey began in physiotherapy and the musculoskeletal system. Over time, clients and their stories gradually led me deeper – from working with the body through the pelvic floor to understanding the meaning of emotions, the psyche, and the functioning of the nervous system. Today, I see the body as the bearer of a person’s story, and therapy as a space where we can get to know that story, understand it, and support its natural process of change.

How I work

Years of practice have taught me to slow down. To listen more. To place less emphasis on performance, results, or quick change.

In therapy, I strive to create a safe space where clients can become more aware of their bodies, their needs, and the connections between what they are experiencing and what is happening on a physical level. I don’t focus only on symptoms; I also look for their possible causes and the context in which they arise.

Over the years, I have become increasingly aware of how closely the body, mind, and nervous system are connected. This is why I naturally integrate a psychosomatic perspective and the principles of nervous system regulation into my work – gently, clearly, and always with respect for where each client is in their own process.

I believe the body has a remarkable capacity for healing and renewal. Sometimes it doesn’t need more pressure — it needs understanding, a sense of safety, and the right conditions to begin functioning in a different way.

What I can help you with

In my practice, I specialise mainly in:

  • urogynecological physiotherapy
  • pelvic floor dysfunction
  • incontinence
  • painful conditions after childbirth
  • preparation for childbirth and postpartum recovery
  • painful menstruation
  • pain during sexual intercourse
  • functional disorders of the musculoskeletal system
  • chronic pain without an organic cause
  • unintegrated scars
  • psychosomatic connections of health problems
  • regulation of the nervous system

Methods and approaches I use

In my work, I connect physiotherapy with knowledge from psychosomatics, work with the nervous system, and a holistic therapeutic approach. I mainly use:

  • urogynecological physiotherapy
  • pelvic floor therapy
  • diagnosis and therapy of functional disorders of the musculoskeletal system
  • visceral manipulation
  • osteopathic principles
  • craniosacral therapy
  • psychosomatic approach in physiotherapy
  • principles of nervous system regulation
  • knowledge from Somatic Experiencing® training

In therapy, I combine professional knowledge with a sensitive perception of the person and their story. My goal is not only to relieve the problem, but to support the client in better understanding themselves and their body.

ToBe – the concept

ToBe grew naturally out of the original IntimFyzio centre. Over time, I increasingly felt the need to bring different areas of expertise together and create a place where a person does not have to be divided into separate parts.

Today, ToBe is a multidisciplinary space where physiotherapy, psychology, psychotherapy, women’s health, traditional Chinese medicine, work with the nervous system, and other approaches come together – united by a common idea: to see a person in their entirety and create the conditions for health, growth, and a deeper connection with oneself.

Education and professional development

I studied physiotherapy at the Faculty of Medicine of Comenius University in Bratislava, and completed my master’s degree at the University of Brighton in the United Kingdom.

I have completed a specialisation in functional and structural disorders of the musculoskeletal system at the Slovak Medical University in Bratislava. I hold a licence for independent medical practice and am a member of the Slovak Chamber of Physiotherapists.

Training that has significantly shaped my therapeutic approach

  • Somatic Experiencing® (currently in training, Lilian Troost)
  • Psychosomatic approach in physiotherapy (CKP Edu, Prague)
  • Visceral manipulation and osteopathic approach (Inge Schuermans, MSc)
  • Birth trauma in physiotherapy and self-regulation tools in client practice (Mgr. Radka Tomášková)
  • Holistic approach to scar and pelvic floor therapy (PhDr. Michaela Prokešová, PhD.)
  • Traditional care for women and mothers (Angelina Miranda Martinez)
  • Osteopathic approach in pregnancy and gynaecological dysfunctions (Inge Schuermans, Jory Paul)
  • Ludmila Mojžišová method (Mgr. Jana Jedličková)
  • Physiotherapy of pelvic floor dysfunction and urinary incontinence (Prof. Magdaléna Hágovská, Mgr. Zuzana Woleková)
  • Craniosacral therapy (Mgr. Helena Toušková, Upledger Institute)
  • Certified DNS Therapist Diploma (Prof. Pavel Kolář)
  • Diagnosis and Therapy of Functional Disorders of the Musculoskeletal System (Eva Janíková)
  • Stott Pilates (Jitka Kadish)

I believe health is not a goal to be achieved. It is a relationship we build with ourselves, our bodies, and our lives – and it is a journey I love to accompany my clients on.