Bladder Training

Incontinence: What is it?

The lack of voluntary control of urine or stool

3 main types of urinary incontinence

• Urge incontinence: The need to urinate comes on so fast you cannot get to a toilet in time.
• Stress Incontinence:  When urine leaks because of sudden pressure on your lower stomach muscles. For example: laughing, coughing, sneezing, or while exercising
• Mixed incontinence:  Combination of both stress and urge incontinence

Why we recommend bladder training for you:

There is strong evidence that the use of bladder training helps men and women successfully manage stress and urge incontinence.  This is good news—your bladder can be trained, similarly to training your quadriceps or biceps, because it is controlled by muscles.

To first start the training, it is important to complete a bladder diary.  This is usually done in our practice before you have a urodynamic test performed, and allows you to have something to measure against when you start the training. The bladder diary allows you to note things such as the amount of fluids you are consuming, how many times you are urinating, and how many times you are leaking.  It also helps you determine if you are leaking when your abdominal pressure increases (i.e. such as with coughing, sneezing, laughing, or with exercise), as well as if your diet is playing a role in your incontinence.

The goal of bladder training is to help you:

• Lengthen the amount of time between bathroom trips.
• Increase the amount of urine your bladder can hold.
• Improve your control over the urge to urinate.

Three bladder training methods are listed below. Your provider may recommend 1 or more of these methods to help control your incontinence.

Pelvic floor muscle exercises: Also known as Kegel exercises, these help strengthen the muscles directly and indirectly involved with urination. By strengthening these muscles you will be able to better control when you have to go.

Delayed urination: Some people who have urge incontinence can learn to put off urination when they feel the urge. You start by trying to hold your urine for 5 minutes every time you feel an urge to urinate. When it’s easy to wait 5 minutes, you try to increase the time to 10 minutes until you’re urinating every 3 to 4 hours. When you feel the urge to urinate before your time is up, you can try relaxation techniques. Breathe slowly and deeply. Concentrate on your breathing until the urge goes away.  This goes hand in hand with scheduling bathroom trips.

• Scheduled bathroom trips: Some people control their incontinence by going to the bathroom on a schedule. Once you’ve determined how frequently you use the bathroom, you add 15 minutes to that time. Let’s say you go to the bathroom ever hour. During retraining, you will aim to go every hour and fifteen minutes. Even if you don’t have to go, you still want to make the trip to the bathroom. This trains the brain and body. After a set number of days, gradually increase the amount of time between bathroom breaks.

Keep in mind that bladder training can take 3 to 12 weeks. During your training program, your doctor may have you keep track of the number of urine leaks you have each day. This will help you and your doctor see if bladder training is helping. Don’t be discouraged if you don’t have immediate results or if you still experience some incontinence.

Things that are irritating your bladder (and you should limit):

• Alcohol
• Caffeine (sodas, coffee, tea, etc)
• Foods high in acid (such as tomato or grapefruit)
• Citrus Beverages
• Chocolate
• Spicy foods can irritate your bladder.
• Obesity
• Reduce amount of fluids consumed at bedtime- Go to the bathroom as soon as you go to bed and as soon as you wake up in the morning

Other recommendations to control incontinence:

• Medications: e. Oxybutynin, Myrbetriq
• Pelvic Floor Physical Therapy
• Medical Devices: Interstim or Urgent PC (for urge incontinence)
• Surgery