Bladder training

Bladder training is a way of teaching your bladder to regain control by suppressing the unwanted contractions and allowing it to hold larger amounts of urine. It helps the bladder to become less overactive. Bladder training is about restoring normal sensation in the bladder, so that patients go to the toilet less frequently and pass larger volumes.

If your bladder contracts with little or no warning it can give you an urgent need to pass urine. This gives you little or no time to get to the toilet. Uncontrolled bladder contractions are not dangerous but are a common cause of frequent voiding, a feeling of urgency and leakage of urine.

For most people the cause of an overactive bladder is unknown. There could be a neurological cause for the problem (relating to the brain or spinal nerves) but this is uncommon. Stress can make the problem worse and the type of fluids you drink can also influence your symptoms. It can occur at any age.

The bladder acts as a storage tank, which expands on filling, like a balloon. A normal bladder in a healthy adult can comfortably hold a pint (500mls) of urine. You need to aim for 300 – 400 mls. You can use a jug to measure your urine.

The bladder should be emptied three to four hourly. This also depends on how much you drink and your bladder capacity.

Instead of bladder controlling you, you need to learn how to control your bladder. Instead of rushing to the toilet as soon as you get the urge to pass urine it is important to try to learn to ‘hold on’. Don’t go straight away. Try to increase the time you hang on for, start with few minutes first, and then gradually increase this. For example if you find you are going to the toilet every half an hour, try holding on for another 10 minutes for a week, then by 15 minutes for a week and then 30 minutes etc. Eventually your bladder capacity will increase and you should be able to hold on for 3-4 hours between toilet visits.

To begin with progress may seem small but, provided you persevere, you should see a great improvement. You will need to continue the treatment for at least three months or longer, by which time you should be regaining control of your bladder and the improvement will be long lasting.

There are different techniques for this. Here are some suggestions:

1. Sit straight on a hard seat.
2. Distract yourself by: counting down from 100, try doing a crossword or word search, read a book, reciting the alphabet or wait for the next break on television.
3. Try holding on to something, like a rolled up towel on a chair, sitting on the edge of a bath tub, hopping from one foot to another, crossings legs or standing on tiptoes.
4. Contract your pelvic floor muscle. Contracting these muscles may help to suppress both urgency and incontinence.

You will find it useful to keep a diary of when you go to the toilet at the start of bladder training and then again a few months later. Some patients may get the urge when doing particular activities, like before going out, getting out of the car, putting keys in the door, returning home, undressing or running the tap.

In order to stop this urge try squeezing your pelvic floor muscle and taking more time to get out of car or back into the house.