Bladder Training

Bladder training can be effective in the treatment of urge incontinence, mixed incontinence, urgency-frequency syndrome, and stress incontinence. Studies have shown that bladder training can reduce urinary incontinence episodes by 50% in 60-70% of women. Better yet, it has no side effects. It consists of a combination of strategies to control urgency and bladder volumes through a program of scheduled urinations with gradually increasing intervals. Bladder training can give women a way to reclaim their bladder control. Another way to think of bladder training is “potty training for adults”.

The first step is to keep a 24 hour record of your frequency of urination, fluid intake, uncontrollable urine leakage episodes, activity during the uncontrollable urine leakage episodes, and whether a sudden urge to urinate was present during the uncontrollable urine leakage episode. This is done by keeping a bladder diary. Click her for a copy of a bladder diary we recommend.

If you completed a bladder diary for your first physician office visit, your physician should be able to establish a baseline urination frequency (time interval between urinations) to begin bladder retraining. If you have not seen a physician as yet, determine the shortest time interval between urinations and begin bladder retraining at this time interval. For example, if your bladder diary shows that you go to the bathroom every hour or less, your scheduled voiding interval should begin at 30 minutes. If your bladder diary indicates more than one hour between urinations, your scheduled voiding interval should begin at 60 minutes.

Once you establish your initial voiding schedule with the help of your bladder diary, follow these instructions

·Void every morning as soon as you wake up and every evening just before going to sleep

·Void every time your baseline voiding schedule indicates whether you need to or not. This prevents the bladder from overfilling which can lead to uncontrollable urine leakage associated with a sudden urge to urinate, or a cough, laugh, or sneeze.

·Make every effort to put off urinating between your scheduled voiding even if you have a strong urge to urinate.

In order for you to do this, you can try some mind games to postpone urination

oMind games to postpone urination

oCount back from 100 by 7’s

oBalance the check book

oPerform a series of quick pelvic floor contractions and relaxations

oSelf-talk or meditation

·You only need to follow the schedule while you are awake because scheduled urinations during sleeping hours is unnecessary.

·If you absolutely have to interrupt your schedule, get back on track with the next scheduled void as soon as possible.

·Keep a daily record of your urination and leakage episodes using a bladder diary so that you can track your progress. The wonderful thing about a bladder diary is that it provides feedback as to how well you are doing. As you gain control over your bladder you may notice a decrease in the number of uncontrollable urine leakage episodes recorded on the bladder diary. You may also notice a decrease in the frequency of urination from baseline as you increase the time interval between urinations.

·When the initial voiding schedule gets easy for you increase the interval between urinations.

Remember – Do not increase your daily fluid intake beyond 6 to 8 8 ounce glasses per day because excessive fluid intake will increase the frequency of urination and limit the effectiveness of bladder retraining

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