The aim is to slowly stretch the bladder over time so that it can hold larger and larger amounts of urine. In time, the bladder muscle should become less overactive and you should become more in control of your bladder. This means that more time can go by between feeling the desire to pass urine, and having to get to a toilet. Leaks of urine should become less likely. A doctor, nurse, or continence advisor will explain how to do bladder training. The advice may include some of the following techniques:
You will need to keep a diary. Make a note in the diary of the times you pass urine, and the amount (volume) that you pass each time. Also make a note of any times that you leak urine (are incontinent). Your doctor or nurse may have some purpose made diary charts to give you. Keep an old measuring jug by the toilet so that you can measure the amount of urine you pass each time you go to the toilet.
When you first start the diary, go to the toilet as you normally would for 2-3 days. This is to get an initial idea of how often you go to the toilet and how much urine you normally pass each time. If you have an overactive bladder you may be going to the toilet once every hour or so, and passing less than 100-200 ml at a time. This will be recorded in the diary.
After 2-3 days, the aim is to then hold on for as long as possible before you go to the toilet. This may seem difficult at first. if you normally go to the toilet every hour, it may seem quite a struggle to last one hour and five minutes between toilet trips. When trying to hold-on, try distracting yourself.
- Sitting straight on a hard seat may help.
- Try counting backwards from 100.
- Try doing some pelvic floor exercises.
With time, this should become easier as the bladder gets used to holding larger amounts of urine. The idea is to gradually increase the time between going to the toilet and to train your bladder to stretch more easily. It may take several weeks, but the aim is to pass urine only 5-6 times in 24 hours (about every 3-4 hours). Also, each time you pass urine you should pass much more than your initial diary readings. On average, people without an overactive bladder normally pass between 250-350 ml each time they go to the toilet. After several months of training you may find that you just get the normal feelings of needing the toilet, which you can easily deal with for a reasonable time until it is convenient to go.
Whilst doing bladder training, you may only need to fill in the diary for a 24-hour period once every week or so. This way you can record your progress over the months of the training period.
Bladder training can be difficult, but it gets easier with time and perseverance. Bladder training works best if combined with advice and support from a continence advisor, nurse, or doctor. Make sure to drink a normal amount of fluids when you do bladder training.