Bladder training is an important form of behavior therapy that can be effective in treating urinary incontinence.
The goals are to increase the amount of time between emptying your bladder and the amount of fluids your bladder can hold.
It also can diminish leakage and the sense of urgency associated with the problem. Bladder training requires following a fixed voiding schedule.
Keeping a VOIDING DIARY is very important. This helps your health care provider determine the correct place to start the training and to monitor your progress throughout your program.
Bladder Retraining Instructions
- Empty your bladder as soon as you get up in the morning. This act starts your retraining schedule.
- Go to the bathroom at the specific regular times. This time is chosen by you based on how long you can hold your urine without a sensation of urgency. This may be as short at 1hour at the beginning.
- Wait until your next scheduled time before you urinate again. Be sure to empty your bladder even if you feel no urge to urinate.
- Follow the schedule during waking hours only.
- When you feel the urge to urinate before the next designated time, use “urge suppression” techniques or try relaxation techniques like deep breathing (discussed below)
- When you have accomplished your initial goal, gradually increase the time between emptying your bladder by 15-minute intervals.
- Try to increase your interval each week — however, you will be the best judge of how quickly you can advance to the next step.
- Don’t be discouraged by setbacks. You may find you have good days and bad days. As you continue bladder retraining, you will start to notice more and more good days, so keep practicing.
Urge Suppression Techniques
The following steps can help reduce the urge to urinate and will improve bladder control.
Stop, stand very still and do not move. Sit down if possible. Breathe and stay calm. Do not panic. Anxiety only makes the urge more severe.
Contract pelvic floor muscles quickly and strongly 5 -10 times. This sends a signal to the bladder to stop the feeling of urgency. Try not to contract abdominal muscles at the same time. Remember that when the pelvic floor muscles contract, the bladder muscle must relax. As the bladder muscle is relaxed, it is less likely to leak urine.
Take a deep breath and let it out. Try to make the urge go away by using relaxation and visualization techniques. For example imagine a dry desert.
When the urge has gone away, walk normally to the bathroom. If you urinate frequently, you will develop the habit and will also feel the urge more frequently. The ultimate goal is to allow at least two to four hours between urination episodes.
If feeling the urge to urinate at night, try the stop, squeeze and relax technique to go back to sleep. Try to lie still. Perform 10 quick and strong pelvic floor muscle contractions without contracting abdominal muscles. Then try to go right back to sleep. It is normal to get up one time per night to urinate. If awakened after a few hours, you can decide to get up to urinate. The goal is no more than once per night of sleep.
Michelle Strovski, Maple Ridge Urology, Serving Maple Ridge, Coquitlam, Mission, Abbotsford, Langley, and Vancouver.