bladder retraining as a treatment for urinary incontinence

by Diane K. Newman, RNC, MSN, CRNP, FAAN

Some treatments for urinary incontinence require only self-care in the form of behavioral therapy including bladder retraining.

Bladder retraining teaches a person to restore a normal pattern of voiding and normal bladder function. Bladder training teaches you to adopt longer time intervals between voiding. The goal is for you to be voiding no more than every 4 hours. To help you get to 4 hours, you need to distract yourself by concentrating on relaxing. Learning to relax will lessen the strong urge sensation and allow you to wait longer to toilet. You will then stop the bad habit of frequent voiding, improve your ability to stop urinary incontinence and cut down on urinary urgency.

Research has indicated that 75% of women with stress and urge urinary incontinence who followed a bladder retraining program had at least a 50% reduction in the number of urinary incontinence episodes.

Suggestions that may help you control the urge to urinate

1. Concentrate on another body sensation like slow, deep breathing. Sit down, relax and take five deep breaths. Try to concentrate on the air moving in and out of your lungs, your chest moving in and out and not on your bladder sensation.
   
2. Distract yourself by playing mind games—counting backwards from 100 by 7's, for example.
   
3. Time how long you are able to keep the urge away. Try waiting 1 to 2 minutes and then go to the bathroom whether you feel you have to go or not. If you delay voiding, the next urge sensation will be very strong, and you will have a more difficult time controlling it. Next time try to delay the urge even longer maybe 3 to 4 minutes. Practice these relaxation techniques at home when you are near the bathroom so you do not worry about being incontinent.
   
4. When the urge sensation is less, you should wait a few minutes, walk, unhurried, do not run, to the bathroom to void.
   
5. Empty your bladder immediately before going to sleep to reduce the chances of awakening to urinate.

References

Newman, DK. Managing and Treating Urinary Incontinence. Health Professions Pr. 2002.

Posted December 2003
Last updated July 2009

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