Bladder retraining

With this condition, the bladder contracts before it is full, often resulting in little or no warning for you to get to the toilet in time.

If you have an overactive bladder, you may feel very little warning of the need to pass urine (this is called urgency) and you may need to pass urine very often, (this is called frequency). Some people have difficulty in making it to the toilet on time because their bladder gives them little warning, which may result in leaking urine (this is called urge incontinence).

You may also find that you wake during the night to pass urine (this is called Nocturia).

An overactive bladder can happen at any age and is a very common type of bladder problem. The cause of the condition is not known.

Firstly, you must understand that your bladder contractions are abnormal.

Secondly, you should do a strict bladder drill with the chart provided.

Thirdly, you may also be given tablets to help stop the contractions.

The aim of bladder retraining is to restore continence, by retraining the bladder to an improved or normal pattern of emptying, so that the bladder tolerates being stretched as it fills. This should reduce the frequency and the urgent desire to pass urine and end incontinence episodes.

You will pass urine by the clock. To begin with you will go to the toilet every hour. When you have been successful at remaining dry, the time between passing urine will be increased by 15 to 30 minutes.

Day 1

• Start each day at 8:00am by emptying your bladder normally
• Then start going to the toilet every hour
• Once you have managed an hourly bladder drill without leaking move to 11/2 hourly, then 2 hourly and so on
• It will get progressively more difficult as you move from 2 to 2 and a half, and 3 hours
• Over a period of a few weeks your symptoms should improve

• Although tablets help, don’t forget that the bladder drill is far more important than the tablets
• When you feel the bladder contract concentrate on sending messages from the brain telling the bladder not to contract
• By sitting on a hard seat, this puts pressure on the muscles and works in the same way as crossing your legs did when you were younger
• Do 5 quick squeezes of your pelvic floor muscles, this sends a message to your bladder which helps to calm it down
• Count backwards from 50, or do something similar to distract you from the urge to pass urine
• Don’t worry about getting up at night, this will sort itself out once you have managed the daytime drill
• Don’t despair if it doesn’t work quite as quickly as you hoped
• Bladder retraining requires great willpower and determination

Your doctor may prescribe tablets which help to reduce the over active contractions of your bladder. There are several drugs which can help.

Aim to drink 1 to 2 litres of fluid per day, but you should avoid drinks such as tea, coffee, fizzy drinks and alcohol, as they can irritate your bladder and make you pass urine more often.

Never cut down on your fluid intake to avoid the symptoms of any bladder problems

Gynaecology Outpatient Clinic

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