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BLADDER TRAINING

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 can also diminish the sense of urgency and/or leakage associated with the problem.

Bladder training requires that a fixed voiding schedule be established, whether or not the urge to urinate is present. If urge occurs before the assigned interval, urge suppression techniques (such as relaxation and Kegel exercises) should be used. As success is achieved the interval is lengthened in 15 to 30 minute increments until it is possible to remain comfortable for 3 or 4 hours. This goal can be individualized to suit each woman's needs and desires.

Keeping a diary of your bladder activity 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

  1. Empty your bladder as soon as you get up in the morning. This act starts your retraining schedule.
  2. Go to the bathroom at the specific times you and your health care provider have discussed. Wait the full amount of time before you urinate again AND when it is your scheduled time. Be sure to empty your bladder even if you feel no urge to urinate. Follow the schedule during waking hours ONLY. During the nighttime go to the bathroom only if you awaken and find it necessary.
  3. A helpful hint: When the urge to urinate is felt before the next designated time, use "urge suppression" techniques or try relaxation techniques like deep breathing. Focus on relaxing all other muscles. If possible, sit down until the sensation passes. If the urge is suppressed, adhere to the schedule. If you cannot suppress the urge, wait 5 minutes then slowly make your way to the bathroom-then re-establish the schedule. Repeat this process every time an urge is felt. 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, but you will be the best judge of how quickly you can advance to the next step. Increase the time between each urination until you reach a 3-4 hour voiding interval.
  4. It should take between 6 to 12 weeks to accomplish your ultimate goal. Don't be discouraged by set-backs. 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.
  5. You will hasten your success by doing your pelvic muscles exercises faithfully every day. Your diaries will help you see your progress and identify your problem times.
  6. The UCSF Women's Continence Center is here to help and support you. Be sure to keep your regularly schedule visits. If you need more help, medication and other treatments are available and may be useful.

GOOD LUCK!

 

 

 

Questions or comments about this Web site may be sent to
coe@obgyn.ucsf.edu. Last updated: 09/15/2009

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