i just peed 10 minutes ago but when i breath out and and my stomach go

i just peed 10 minutes ago but when i breath out and and my stomach goes flat urine sensation comes but when i take miraben everything goes to normal

Reading File

Finding Sources

Searching PubMed

overactive bladder mirabegron mechanism treatment

Reading File

Here is a clear explanation of what is happening to you and why mirabegron (Mirabel) works:

What You Are Experiencing: Overactive Bladder (OAB)

Your symptom in plain terms: You feel a sudden, strong urge to urinate even though your bladder was recently emptied. The trigger for you is exhaling - when your diaphragm moves up and your abdomen flattens, it briefly increases pressure on the bladder, which triggers an involuntary bladder muscle contraction.

The Underlying Mechanism

Your bladder has a muscle called the detrusor muscle. Normally, it stays relaxed while filling and only contracts when you consciously decide to urinate. In OAB, the detrusor contracts involuntarily and prematurely - this is called detrusor overactivity.

When you breathe out:

Your diaphragm rises
Your abdominal wall flattens
This slightly increases pressure inside your abdomen
That pressure transmits to the bladder
In a sensitive/overactive bladder, this is enough to trigger an unwanted urgency signal

This is why it feels like you need to go even though you just emptied your bladder 10 minutes ago.

Why Mirabegron (Mirabel) Fixes It

According to Lippincott Illustrated Reviews: Pharmacology and Katzung's Basic and Clinical Pharmacology:

Mirabegron is a selective beta-3 adrenergic receptor agonist
Beta-3 receptors sit on the detrusor muscle of the bladder
When mirabegron activates these receptors, the detrusor relaxes
A relaxed detrusor muscle has greater storage capacity and is much less likely to contract involuntarily
Result: urgency, frequency, and that sudden "I must go NOW" feeling are all reduced

Unlike older OAB drugs (anticholinergics like oxybutynin), mirabegron does not cause dry mouth, constipation, or confusion - making it a well-tolerated choice, especially for long-term use (Hinman's Atlas of Urologic Surgery).

What is Triggering You Specifically

The breathing-related trigger you describe is a recognized phenomenon. Physical maneuvers that briefly increase intra-abdominal pressure (coughing, sneezing, laughing, straining, even deep exhalation) can provoke urgency in people with OAB because the detrusor is hypersensitive to any pressure change.

What You Can Do Beyond Medication

Since you are already on mirabegron and it helps, a few additional strategies can make a difference:

Strategy	How it Helps
Bladder training - gradually extend the time between voids	Retrains the detrusor to tolerate fuller volumes
Pelvic floor exercises (Kegels) - tighten pelvic floor when urgency hits	Suppresses the involuntary detrusor contraction
Fluid management - avoid caffeine, alcohol, carbonated drinks	These irritate the bladder lining and worsen urgency
Timed voiding - urinate on a schedule, not just when you feel the urge	Breaks the habit of responding to every small urge

When to Revisit Your Doctor

If mirabegron stops working well, or if you also have:

Pain with urination
Blood in urine
Incomplete bladder emptying

...it is worth getting a urology review, as those symptoms may point to other causes (UTI, bladder stones, or a neurological issue).

You are on the right medication for this condition, and the breathing trigger you identified is consistent with OAB and detrusor overactivity - a well-understood urological condition.

How do i correct it without taking medication

Finding Sources

Searching PubMed

overactive bladder behavioral therapy pelvic floor

Reading File

Loading Image

Great news - the evidence from Campbell Walsh Wein Urology (the most authoritative urology textbook) is clear: behavioral therapy is equal to or better than medication for OAB, with 60-80% reduction in urgency episodes. Here is everything you need:

Correcting OAB Without Medication

The three pillars are: Urge Suppression, Pelvic Floor Training, and Bladder Retraining. Do all three together for best results.

PILLAR 1: Urge Suppression (Most Important - Start Here)

This is the key skill you need for your specific trigger (breathing out / stomach going flat). The urge is a wave - it starts, peaks, then naturally dies down. Your job is to ride it out rather than run to the toilet.

When the urge hits:

Stop and stay still - do NOT rush to the toilet. Running actually worsens the urge.
Squeeze your pelvic floor muscles quickly 3-5 times - rapid squeezes, not one long hold. This reflexively relaxes the detrusor (the bladder muscle).
Relax the rest of your body and take slow, deep breaths - consciously slow your breathing.
Distract your mind - count backwards from 100 by 7s, make a mental to-do list, think of something absorbing. This works because urgency has a strong mental component.
Tell yourself: "I am in control. The urge will pass." - self-talk actually helps, this is evidence-based.
Once the urge subsides, walk calmly and slowly to the bathroom - do not rush.

This diagram from Campbell Walsh Wein Urology shows exactly how the urge wave works and what to do at each stage:

Urge wave suppression and bladder training guide

PILLAR 2: Pelvic Floor Muscle Training (Kegel Exercises)

The pelvic floor muscles, when trained, can actively suppress involuntary bladder contractions. This is the core rehabilitation of OAB.

How to do Kegels correctly:

Find the right muscle - imagine you are stopping the flow of urine mid-stream. That squeezing is the pelvic floor.
Do NOT squeeze your buttocks or stomach - only the pelvic floor.

Two types of exercises to do daily:

Type	How	Reps
Quick flicks	Squeeze fast and release immediately	10-15 reps
Slow holds	Squeeze and hold for 5-10 seconds, then fully relax	10 reps

Do 3 sets per day (morning, afternoon, evening). Results take 6-12 weeks of consistent practice.

PILLAR 3: Bladder Retraining (Stretches Your Bladder's Capacity)

Your bladder has "learned" to feel full when it is not. Retraining reverses this.

The schedule:

Week 1-2: When you feel an urge, suppress it and delay voiding by just 5 minutes before going.
Week 3-4: Extend the delay to 10-15 minutes.
Week 5+: Keep extending by 15-20 minutes each week.
End goal: Voiding every 3-4 hours during the day (not every 30-60 minutes).

The key rule: void on a schedule, not on demand. You decide when to go, not your bladder.

PILLAR 4: Lifestyle Changes That Make a Big Difference

Change	Why It Helps
Cut caffeine (tea, coffee, cola)	Caffeine directly irritates the bladder lining and worsens urgency
Cut alcohol	Diuretic + irritant effect
Reduce fizzy drinks	Carbonation irritates the bladder
Drink the right amount - about 1.5-2L water/day	Too little concentrates urine (more irritating); too much fills the bladder faster
Avoid drinking large amounts at once	Spread fluid intake evenly through the day
Stop drinking 2 hours before bed	Reduces nocturia (night-time urgency)
Lose weight if overweight	Excess abdominal weight increases bladder pressure - directly relevant to your breathing trigger
Treat constipation	A full bowel presses on the bladder

For Your Specific Trigger (Breathing Out)

Since your urgency is triggered by exhaling and your stomach going flat, this is a pressure-sensitivity issue. Two specific tips:

Practice diaphragmatic breathing - train yourself to breathe from your belly rather than holding tension in your core. This reduces the sharp pressure changes that trigger your bladder.
At the moment of exhale-triggered urge: immediately do 3-5 rapid pelvic floor squeezes. This is your personal "rescue move."

How Long Does This Take?

Clinical trials in Campbell Walsh Wein Urology show 60-80% reduction in urgency episodes with consistent behavioral training, sometimes performing better than medication alone. Expect:

Some improvement in 2-4 weeks
Significant improvement in 6-12 weeks
Full benefit in 3-6 months

Do not stop mirabegron abruptly - discuss with your doctor as you improve, and they can gradually wean it once your bladder is retrained. The behavioral changes are permanent; the medication is a bridge.

How to find right muscle

Finding Sources

Searching Images

pelvic floor muscle anatomy diagram male

This composite educational graphic features diagnostic transperineal ultrasound images and a schematic diagram illustrating male pelvic floor dynamics. Panels A and B present sagittal ultrasound views in relaxed and contracted states, respectively, with superimposed anatomical markers. Key landmarks identified include the bladder, pubic symphysis (PS), urethra-vesical junction (P1), ano-rectal junction (P2), bulb of the penis (P3), and mid-urethra (P4). Panel C is a comparative line diagram that overlays the relaxed (dashed lines) and contracted (solid lines) positions of these structures relative to the pubic symphysis. Displacement vectors (arrows) demonstrate the cranial and ventral movement of the pelvic floor landmarks during voluntary contraction. The content is designed to teach pelvic floor functional anatomy and the calculation of landmark displacement, which is clinically relevant for assessing pelvic floor muscle function and treating conditions like urinary incontinence or pelvic floor dysfunction in males.

This multi-panel figure illustrates surgical techniques and intraoperative findings for in situ pelvic floor reconstruction following perineal surgery. Panels (a) and (b) are anatomical diagrams showing the schema for levator ani muscle closure in male and female patients, respectively. The male diagram highlights the relationship between the levator ani and the prostate, showing the placement of sutures to bridge the pelvic defect. Panel (c) is a clinical photograph of the perineal surgical site, with metal retractors exposing a deep pelvic wound where sutures are applied to the levator ani muscle. Panels (d) and (e) provide laparoscopic views of the pelvic cavity. Panel (d) shows the pelvic floor prior to closure, with arrows identifying the unsutured levator ani muscle and a visible intra-abdominal drainage tube. Panel (e) depicts the same surgical field after levator ani closure, showing the reconstructed pelvic floor, the drainage tube in situ, and surgical instruments used for manipulation. The content is designed for surgical education regarding pelvic floor integrity and hernia prevention post-resection.

This composite educational image illustrates the pelvic floor and anal canal anatomy and its clinical relevance in rectal cancer staging. Panel (a) is an anatomical diagram depicting the coronal view of the anal canal, highlighting the levator ani, puborectalis muscle, external sphincter, and internal sphincter, with a dashed line marking the intersphincteric plane. Panel (b) is a coronal T2-weighted MRI showing a cT3a rectal tumor in a male patient. An arrow indicates irregular wall thickening with minimal (±1 mm) perirectal extension invading the right internal anal sphincter. Panel (c) is a coronal T2-weighted MRI of a female patient with a cT4b rectal tumor. The tumor (outlined by a dashed line) shows extensive infiltration, invading both internal sphincters and extending into the external sphincter, levator ani, and puborectalis muscles on the left side. Muscles and sphincters appear characteristically hypointense on T2 imaging, while the tumor presents as an intermediate-signal mass disrupting normal anatomical boundaries, essential for determining surgical management such as abdominoperineal resection.

This clinical anatomical photograph displays a lateral cadaveric dissection of the human male pelvic floor muscles, divided into two panels (A and B). The imaging demonstrates the complex spatial relationships and intermuscular connections between the superficial and deep perineal layers. Panel A shows the superficial transverse perineal (STP) muscle originating near the lateral tendon (white star) and extending inferomedially to connect with the external anal sphincter (EAS, black arrow) and anteriorly with the bulbospongiosus (BS, white arrow). The BS and EAS are also linked (black asterisk). The levator ani (LA) is shown originating from the pubis bone and tendinous arch. Panel B, following lateral reflection of the STP, reveals the LA's bifurcation into anterior (white arrowhead) and posterior (black arrowhead) muscle bundles relative to the EAS. Key educational markers indicate the connection between the LA and BS (white asterisk), the blending point of the LA and EAS (white circle), and the connection between the STP and LA (black triangle). The anococcygeal ligament (ACL) is visible posteriorly, anchoring the EAS to the coccyx. This visual resource is intended for advanced medical education in surgical anatomy and pelvic floor functional pathology.

Finding Sources

Loading Image

Here are 3 reliable ways to find the right muscle, then confirm you have it:

Method 1: The "Stop the Stream" Test (Easiest)

Next time you urinate:

Start peeing normally
Mid-stream, try to stop the flow completely
The muscle you just squeezed to stop it - that is your pelvic floor

Important: Only do this to identify the muscle, not as a regular exercise. Doing it repeatedly while urinating can interfere with normal bladder function.

Method 2: The "Lift and Squeeze" Feel

When you are NOT urinating (sitting, lying down):

Sit comfortably or lie on your back with knees bent
Imagine you are trying to stop yourself passing gas (wind)
You will feel a lifting, squeezing sensation deep inside your lower pelvis - between your sit bones
For men: the base of your penis and scrotum will lift slightly upward - you may be able to feel this with your hand on the inner thigh area

That internal lift = pelvic floor contraction.

Method 3: The Mirror/Hand Test (Confirms You Have It Right)

For men:

Sit or stand and look at the base of your penis
When you squeeze the pelvic floor correctly, the penis will pull slightly inward and upward (like a small lift)
Your buttocks, thighs, and stomach should not move

How to Know You Have the WRONG Muscle

A very common mistake is squeezing the wrong muscles. Check for these errors:

Wrong muscle being used	Sign
Buttocks	Your bottom lifts off the seat
Thighs	Thighs press together or rotate inward
Abdomen	Your belly pushes outward or tightens
Holding your breath	You stop breathing while squeezing

If any of these happen, relax completely and start over. The pelvic floor works independently - nothing else should move.

The Ultrasound View (What Happens Inside)

This ultrasound image from a clinical study shows what happens when the pelvic floor contracts correctly in a male - the urethra, bladder junction, and surrounding structures lift upward toward the pubic bone (the solid lines show contracted position vs dashed lines for relaxed):

Male pelvic floor ultrasound showing contraction - structures lift upward toward pubic symphysis

That upward lift is exactly what suppresses the unwanted bladder contraction.

Once You Find It - How to Practice

Exercise	What to do	Goal
Quick flick	Squeeze fast, release immediately	10-15 times
Slow hold	Squeeze and hold for 5 seconds, then fully relax for 5 seconds	10 times
Full relax	After each set, consciously let the muscle go completely limp	Always

Do this 3 times a day. The "full relax" is just as important as the squeeze - an overtight pelvic floor can also cause problems.

Tip: The easiest position to start is lying on your back with knees bent. Once you get the feel, practice sitting and standing too, since that is when you actually need it during urgency.

This is a shared conversation. Sign in to Orris to start your own chat.