Bladder Retraining

Bladder training can be effective in the treatment of urge incontinence, mixed incontinence and urgency-frequency syndromes. It consists of a combination of strategies to control urgency and a program of scheduled urination with gradually increasing intervals. Bladder training can give women a way to reclaim control over bladder function. Another way to think of it is "potty training for adults."

Bladder Diary
The first step is to keep a record of your baseline bladder control. That's done by keeping a bladder diary. A diary will establish your baseline fluid intake; number of leakage episodes; and urinary frequency (amount of time between trips to the bathroom).

Next, decide on your initial scheduled voiding interval. If your bladder diary shows that you go to the bathroom every hour or less, your scheduled voiding interval will start at 30 minutes. If your bladder diary indicates more than one hour between your bathroom breaks, then your first interval will be one hour.

Once you establish your initial voiding schedule, the medical team at Atlantic Urogynecology Associates recommends that patients do the following:

  • Void every morning as soon as you wake up and every evening just before going to sleep
  • Void every time your schedule says you should - regardless of whether you think you need to
  • Make every effort to put off urinating - even if you have a very strong urge to do so - until your scheduled time comes up
  • You only need to follow the schedule while you are awake. No scheduled urination is necessary during sleeping hours
  • If you absolutely have to interrupt your schedule, get back on track (with the next scheduled void) as soon as possible
  • Keep a daily record of your urination and leakage episodes, so that you can track your progress
  • When the initial schedule gets easy for you, increase your interval by 30 minutes
  • Stay on a given interval for at least one week before increasing
  • Aim for a goal of minimal to no accidents and a voiding schedule of between two to four hours. Getting there should take you anywhere from four to 12 weeks
  • You may find it easier to be successful with your bladder training if you go on the "bladder diet" at the same time

If you feel as though you are about to have an accident before your scheduled time to urinate, focus on something else to make the urge go away. Some ideas: count backwards from 100 by sevens; sit down or lie down; get on the phone with a friend; perform several strong Kegel exercises.