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BLADDER TRAINING

What is the bladder training?

The bladder training is removing the bad habits and learning new habits, giving the control back to you, instead of letting your bladder control you and your life. Research has demonstrated many women think the bladder training reduces the frequency, urgency and urge incontinence.

How do I achieve bladder control?

  1. 1. The programs for bladder control help you increase the times between urinations; they help you increase the volume the bladder can withhold and they help you control de urge symptoms when the bladder contracts unnecessarily. The bladder retraining is to help you regain control over the bladder.
  2. 2. Part of the bladder training program consists on understanding the messages the bladdern is sending, which messages you should listen to and which ones can be ignored. A bladder training program should also help you to recognize when the bladder is full and when it’s not.
  3. 3. Your bladder may take many weeks, month or even years to acquire the bad habits; therefore, you will not regain control immediately. It will take time, commitment and patience to retrain your bladder towards the good habits. You should feel encouraged because most people observe an improvement within 2 weeks, although it may take 3 months or more to regain control of your bladder.

How to improve the frequency (pollakiuria)?

  1. 1. How often do you go to the bathroom every day? If you go at intervals less than 2 – 3 hours, you’ll need to increase the time between urination. For example, if you go every hour, set the next limit for an hour and 15 minutes. If you have the urge need to go before that time has passed, try some of the ideas from the next section to control that feeling and make the bladder wait.
  2. 2. If you can hold the time suggested, and are able to do that for 3 to 4 days straight, increase the time again. Gradually increase the time between urinations until you’re able to go every 2 – 3 hours during the day.
  3. 3. Try to decrease the number of times you go to the bathroom “just in case”. For example, ask yourself if you really need to go every time you leave home – if you just went 20 minutes ago; maybe you don’t need to. A normal bladder can comfortably hold 400 ml, the equivalent of 2 full cups.

How to overcome the urgency and urge incontinence?
Try to practice all these ideas to control de urgency and make the bladder wait. Verify which ideas work best for you and use them as needed.

  1. 1. Contract the muscles of the pelvic floor as strong as possible and hold as much as you can. Keep doing this until you feel the urge disappears or is under control. Contracting the muscles of the pelvic floor helps contract the urethra (duct coming from the bladder), keeps it closed and prevents incontinence.
  2. 2. Rapidly contract the muscles of the pelvic floor and strong as you can, relax them after that. Repeat this several times in a row. Some women may notice several contractions in a row works better than trying to hold a contraction for a longer period.
  3. 3. Make firm pressure in the perineal region; you can do this when crossing your legs or sitting over a firm surface. This also sends the message to the bladder, through the nerves, that the exit of the bladder is closed; therefore having to wait to empty it.
  4. 4. Distract your mind as much as you can. For example, some people start counting backwards, but any form of mental distraction or relaxation is good.
  5. 5. Change positions if this lowers the urge sensation. Some people notice that leaning forward helps a little bit.
  6. 6. Stand still when you suddenly feel a strong need to urinate and control the urgency. You will not be able to hold, be under control and run to the bathroom, all at the same time.
  7. 7. Try not to jump or move up and downward in the same place. The movement is transmitted to the bladder, making the problem more serious.

 

How effective is the bladder training?

The bladder training (and training of the muscles of the pelvic floor, when appropriate) helps one in every 2 to 3 women with urge incontinence. Remember that when you have successfully retrained your bladder towards the good habits, you must practice these habits for the rest of your life.

Additional advice to help with bladder control: Sometimes there are other changes you can do that will help you improve bladder control.

If you’re overweight, have problems that make you cough often (example, asthma, bronchitis) or suffer from constipation, you should discuss this with your physician, physiotherapist or continence advisor, given that all these conditions can worsen urinary loss. Some medications make bladder control a little harder, so you should check this with your physician if any of these situations worry you.

Drink fluids in normal amounts, at least 6 to 8 glasses (1000 to 1500 ml) of fluid per day, unless it’s indicated in a different way by your physician. If you drink very little, urine will be more concentrated. This irritates the bladder, giving it the need to be emptied more often even with little volume. The lack of fluids can also lead to urinary infections.

Avoid drinking all fluids at once; space fluid intake during the day. If you take too much at once, you can experiment the need to go to the bathroom with urgency, in a short period of time.

Some drinks seem to irritate the bladder, making you go to the bathroom more often. Usually, these drinks are alcoholic beverages and the ones with caffeine, such as: coffee, tea, soft drinks and energetic beverages; reduce caffeinated drinks to 1 or 2 per day.

Avoid taking fluids two hours before going to sleep because this increases the possibilities of waking up during the night to go to the bathroom.