Bladder training (sometimes called 'bladder drill')
The aim is to slowly stretch the bladder so that it can hold larger and larger volumes 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 elapse between feeling the desire to pass urine and having to get to a toilet. Leaks of urine are then less likely. A doctor, nurse, or continence advisor will explain how to do bladder training. The advice may be something like the following.
You will need to keep a diary. On the diary make a note of the times you pass urine, and the amount (volume) that you pass each time. Also make a note of the times you leak urine (are incontinent). Your doctor or nurse may have some pre-printed diary-charts for this purpose 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 usual for 2-3 days at first. This is to get a baseline 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 every hour or so, and only passing less than 100-200 ml each time. This will be recorded on the diary.
After the 2-3 days of finding your 'baseline', the aim is then to 'hold on' for as long as possible before you go to the toilet. This will seem difficult at first. For example, it 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. For example:
- Sitting straight on a hard seat may help.
- Try counting backwards from 100.
- Try doing some pelvic floor exercises (see below).
With time it should become easier as the bladder becomes used to holding larger amounts of urine. The idea is to gradually extend the time between toilet trips 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 baseline diary readings. (On average, people without an overactive bladder normally pass 250-350 ml each time they go to the toilet.) After several months you may find that you just get the normal feelings of needing the toilet which you can easily put off for a reasonable time until it is convenient to go.
Whilst doing bladder training, perhaps fill in the diary for a 24 hour period every week or so. This will record your progress over the months of the training period. Bladder training can be difficult, but becomes easier with time and perseverance. It works best if combined with advice and support from a continence advisor, nurse, or doctor. Make sure you drink normal amount of fluids when you do bladder training (see above).
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Where to next?
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Understanding urine and the bladder
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How common is stress incontinence?
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What are the treatment options for stress incontinence?
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Doing the exercises for stress incontinence
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Other ways of exercising pelvic floor muscles
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Some general lifestyle measures to help with stress incontinence
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Urge incontinence
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How common is urge incontinence?
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What are the treatments for urge incontinence?
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Bladder training (sometimes called 'bladder drill')
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Medication for urge incontinence
sarah jayne, 10 months
i have an appointment with a urologist to start doing 'bladder drills' - does any other patients feel like the bladder training worked? be grateful for any information.
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