Bladder Retraining

The goal of bladder retraining is to return you to a more normal and convenient pattern of urinating to restore continence and urinary control.

People who experience urinary urgency, frequency, excessive nighttime urinating and urinary leakage can show improvement with this retraining technique. Bladder retraining helps restore your bladder capacity to normal. The program includes education about bladder function, urge control, record keeping, and following a schedule of urinating (voluntarily emptying your bladder). The success of the program depends on your effort to consistently keep a specific schedule and to have follow-up appointments with your health care provider.

Timed Voiding

• Working with your provider, choose an appropriate length of time between voids. Start with a time interval that you can manage successfully (even if this means voiding as often as every 30 minutes).
• Each morning upon arising, go to the toilet and completely empty your bladder. Your voiding schedule will begin upon getting out of bed and end at bedtime.
• Your voiding schedule is every _______ minutes/hours. Follow this interval as closely as possible. The important part of the retraining is that you practice telling your bladder when to empty and when to hold.
• Go to the toilet at the scheduled time even if you do not feel the need to urinate. The amount you urinate is not important. It is important to relax and not strain while voiding.
• If you feel the need to urinate before the scheduled time, use urge delay techniques.

Progressing the Program

• The guiding principle of the bladder drill is to increase the time between voiding episodes gradually with the goal to be able to urinate every 3-4 hours.
• When you can manage the above schedule comfortably for 1 week, increase the time interval by 30 minutes. For example, progress from voiding every 60 minutes (7 am, 8 am, 9 am) to voiding every 90 minutes (7:30 am, 9 am, 10:30 am).

Tips for Controlling the Urge to Urinate

• Never rush to the toilet. Stop, sit down if possible, or remain still. When you remain still it is easier to control the urge.
• Perform some quick pelvic floor contractions to suppress the urge.
• Concentrate on decreasing the urge by taking slow deep breaths.
• Mental distraction techniques including visualization of your favorite vacation spot, counting backwards, deep breathing or positive self-thoughts, for example, “I can control my bladder” will help control the urge.
• Pressure to the perineal area helps control the urge. Place your hand or a rolled up towel against the outside of your underwear and apply firm pressure.

Tips for Success

• Avoid foods and beverages that irritate your bladder. See the handout How Diet Can Affect Your Bladder for a bladder irritant list.
• Stay hydrated while limiting excessive fluid intake. Drink around 4-6 glasses of water each day. Follow a fluid intake schedule as outlined by your provider.
• Maintain regular bowel habits. If you are constipated, add fiber to your diet.

Dealing with Problems and Set Backs

Setbacks are not uncommon if you have been ill with a cold or flu, are tired, cannot completely concentrate on the program, feel nervous or tense, are sensitive to cold weather or the sound of running water, or are about to start your menstrual period.

If all of the above techniques fail and you still have an overwhelming urge to go, you may use the toilet.

The urge feeling needs to be suppressed on a consistent basis; be patient and stick with the program. Before you begin, decide what type of strategy will work for you and use it faithfully.

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