Bladder retraining for incontinence

What is bladder retraining?

The purpose of bladder retraining is to gradually extend the intervals between voiding to reduce the frequency, improve the ability to ‘hold on’ and reduce or even eradicate leaks. Leakage issues can lead to poor habits which can unintentionally make things worse, such as going to the toilet ‘just in case’ and reducing fluid intake.

Going to the toilet before your bladder is full programs it to hold less and want to void more. Similarly, although reducing fluid intake reduces urine production, it increases its concentration, which can irritate the bladder intensifying the urge to void frequently. In other words, it can lead to going to the toilet a lot, but passing only small amounts of urine. By gradually introducing good habits, the bladder can adopt a more usual function.

What’s normal?

According to the Continence Foundation of Australia a healthy bladder holds 300 – 400mls (1½ to 2 cups) during the day and up to 800ml (4 cups) overnight. Most people will void 5 to 8 times a day. A full bladder may wake you (no more than once in the night if you’re under the age of 65 or twice if you’re aged over) but you should still have plenty of time to get to the toilet.

Awareness that you need to void typically starts when the bladder is holding 200-300 ml, but a healthy bladder can put if off and ‘hold on’ for a reasonable period until it’s appropriate to go to the toilet (e.g. a car trip, meeting, game or class). And of course, a healthy functioning bladder doesn’t leak.

Healthy bladder habits

To help re-establish good habits, here’s what you should be aiming for:

Drinking plenty of water

• 1.5 – 2 litres (6 to 8 cups) across the day to ensure constant hydration
• Limit fizzy drinks (especially those with artificial sweeteners), caffeine and alcohol which can all irritate the bladder

Eat well

• A healthy diet, high in fibre and low in sugar will help avoid constipation which in turn, prevents the straining that can contribute to a weakened pelvic floor muscle and reduced control
• Maintain a healthy body weight (BMI) as excess body weight puts additional pressure on the pelvic floor muscle

Exercise

• There is no downside to physical activity; it helps keep weight off, the bowel regular and the endorphins (feel-good hormones) flowing
• The pelvic floor muscle should also be exercised regularly for good bladder control. Instructions can be found in the TENA Exercise Zone

Good toilet habits

• Urinate only when the bladder is full
• Open bowels when the urge is felt – don’t keep putting it off as it can lead to constipation

Retraining

Speak to your GP about the suitability of bladder training for you, as it is best done under the supervision of a healthcare professional.The process involves completing a Bladder Diary, noting fluid intake and output as well as the degree of ‘urge’ experienced and any leakage.

As an example, the Queensland Government has a good template with instructions, but your doctor may prefer a different version. The objective is to gradually extend the amount of urine your bladder can comfortably hold, increasing control and the time between voids. You can read more about Bladder Retraining on the Continence Foundation of Australia website and the New Zealand site, Continence NZ.

Measuring urine output

The simplest way for men to do this is to purchase a large, inexpensive, plastic measuring jug to keep in the bathroom and urinate directly into it. Once you’ve noted the amount passed, simply pour the urine into the toilet and wash the jug, so it’s ready for the next time.

Managing incontinence

While retraining, you may want the security of an absorbent product to manage any leaks. TENA has a range of products designed specifically for men that rapidly absorb and lock away fluid, keeping you dry and odour free.

Take advantage of our Product Finder Tool, and Free Samples find the product that best suits you.

Sources:
https://www.ucsfhealth.org/education/bladder_training/
https://www.continence.org.au/pages/bladder-training.html
https://jeanhailes.org.au/health-a-z/bladder-bowel/bladder-incontinence
https://www.continence.org.au/pages/about-your-bladder.html
https://www.health.qld.gov.au/__data/assets/pdf_file/0020/431183/consumer-bladder-diary.pdf

Asaleo Care makes no warranties or representations regarding the completeness or accuracy of the information. This information should be used only as a guide and should not be relied upon as a substitute for professional, medical or other health professional advice.