Bladder Training

Bladder Training
(Also described as bladder retraining, bladder drill or bladder re-education)

1. Keep a chart (sometimes called a Bladder Diary)

Chart your trips to the toilet and the volume of urine passed for a minimum of three days, covering work and leisure days. You will need to buy an inexpensive plastic jug if you don’t have one and, when at home, pass urine into this each time you visit the toilet. Write down on a piece of paper or on a chart if you have been given one, the times day and night, and the volume of urine in the jug. Empty the jug and rinse it with cold water after use every time.

Keep the jug for this purpose only. Once you have completed your first chart store the jug in a safe place as you may be asked to repeat this procedure to compare and assess your improvement. If you are going out or if you work, the clinic will not expect you to take your jug, but please keep a note of each time you pass urine. When you arrive home, put the time and a tick on the chart each time you passed urine while away from home.

Also record on your chart the volumes and type of fluids you drink on these days.

2. Increase your fluids

Many people seem to entirely rely on tea and coffee for their fluid intake. Experience has shown that this does not help with bladder training, as the caffeine in these drinks (and many others) makes the body produce urine quickly and makes the bladder muscle squeeze more powerfully than usual, causing urgency (the sudden need to reach the toilet quickly).

Try varying your fluids to include water, fruit juices, lemon or orange barley water or milk drinks. Be careful about the sugar content of some drinks if you want to keep your sugar intake under control. Unless advised otherwise by your doctor, try to drink 8 to 10 beakers or glasses of fluid a day, gradually throughout the day and evening, having a drink every 1 to 2 hours. It may be necessary to drink more in hot weather. Your urine should be pale straw colour most of the time and you are aiming to pass good volumes when you need to go.

3. Pelvic Floor Muscle Exercises (PFME’s)

The nurse or physiotherapist will teach you to carry out a programme of PFME’s. This will strengthen the supporting muscles and encourage the bladder itself to relax. Also, by tightening the pelvic floor muscles when you feel the sudden need to pass urine, you can help this urgent feeling go away, helping the bladder to stretch and hold on for longer.

4. Bladder Training

You are going to increase the time between visits to the toilet by ‘holding on’ to your urine for longer. When you feel the sudden desire to pass urine, sit down on a hard chair, tighten the pelvic floor muscles and breathe deeply. Concentrate on sending messages to the bladder to try to help the urgent sensation to go away. Once this feeling has passed, carry on with what you were doing. Try to extend the time between visits to the toilet. You are aiming eventually to pass urine every 2 to 3 hours during the day.

It may take several weeks to retrain the bladder so do not give up. The extent of the improvement depends on your commitment. Sometimes the doctor may prescribe some tablets to help with the retraining, but the biggest effort must come from you carrying out the bladder retraining technique as described here and the pelvic floor muscle exercises.

Once back to a normal pattern of passing urine, remember to continue with a good fluid intake and the pelvic floor muscle exercises.

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