What’s bladder training? And should you try it?

You do push-ups to strengthen your arms and walk laps for stronger legs. Guess what? A leaky bladder is a muscle that can benefit from a training plan, too.  
  
Bladder training is a program that is often recommended to the one-quarter to one-third of women and men who suffer from a leaky or overactive bladder. The idea is to put yourself on a bathroom schedule, with the goal of stopping those “uh-oh” moments in a few weeks’ time.   
  
The program gradually stretches your bladder so it can hold more urine, making the time needed between bathroom visits longer. It also includes behavioral treatment to give you more control over the urge to urinate.  

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Research shows that bladder training improves urinary incontinence symptoms in 57 to 87% of the people who try it, according to a report in the American Journal of Nursing. It works for both women and men. And, according to the American Association of Family Physicians, bladder training can help people who have been diagnosed with different forms of urinary incontinence, including urge incontinence (a nearly uncontrollable urge to “go”) and stress incontinence (when you leak if you sneeze, cough, or laugh).   

Even better, bladder training could help you avoid the need for incontinence medications, which often come with annoying side effects, such as dry mouth and constipation.   
  
Here’s how it works: 

Step 1: Start a bladder journal 

Jot down the times you go to the bathroom, as well as any accidental leaks and strong urges to go. It’s also a good idea to make a note of what you were doing when the leak happened. Any calendar or notebook will do, but you can also download the printable bladder journal from the National Institute of Diabetes and Digestive and Kidney Diseases.  
  
After two or three days, look back over your journal and find the shortest period of time between bathroom trips. Add 15 minutes to that time and use that as your beginning point.  
  
Let’s say your journal reads that you go to the bathroom about every 45 minutes. As you begin your training, aim to go every hour. 

Step 2: Begin your scheduled trips

Empty your bladder first thing in the morning. As the day goes on, head to the bathroom at your scheduled intervals (see Step 1).  

Here’s the tricky part: Even if you don’t feel a need to go, head to the bathroom anyway and try to urinate. Remember, your goal is to train your body and brain to adapt to this new schedule.  

After you go to bed, only get up to go if you need to. Resume the training in the morning.  

Step 3: Distract and conquer 

If you feel the urge to go between visits, try to hold off for five minutes. During this time, focus on something else. Try reading a book or magazine. Do math problems or a crossword puzzle. Or breathe slowly and deeply as you relax your body. Imagine the urge becoming less and less.  

You can also try Kegel exercises to help stop the sensation. To do them, quickly relax and contract your pelvic floor muscles (see Bonus Move below).  

If the urge goes away, wait and use the bathroom at your next scheduled time. If the urge is too strong, calmly and slowly head to the bathroom.  

Take advantage of your HMSA Well-Being Lifestyle Resources. Hawaii–based health coaches are available to help you create a plan and offer support as you work toward your goals. Learn more about Health Coaches and other Lifestyle Resources here.

Step 4: Add more time

Once you can go for a full day on your schedule without leaking, increase the time between bathroom visits by 10 to 15 minutes. Add another 15 minutes once you’ve mastered your new schedule.   

Keep going until you can wait three to four hours between bathroom trips. Use your bladder journal to track your improvement.   

Most importantly, be patient. Gaining control of urges to urinate can take three to 12 weeks, and it’s normal to have some leaks along the way. 

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Bonus Move: Kegel Exercises   

Kegel exercises are squeeze-and-release moves that you can do anywhere, anytime. They help strengthen the pelvic floor muscles that support your bladder and urethra (the tube that carries urine from your bladder to the outside of your body).  

In a review of 31 well-designed Kegel studies, researchers from the University of Montreal concluded that pelvic floor muscle training “can cure or improve symptoms of stress urinary incontinence and all other types of urinary incontinence.”

To do Kegels:  

1. Start with an empty bladder.   
2. Identify the pelvic-floor muscles by tightening and relaxing the same muscles you’d use to hold in urine.  
3. While sitting or lying down, tighten your pelvic floor muscles. Hold the “squeeze” as you count to five. Then fully relax and count to five. Repeat 10 times. Gradually increase the squeeze and relax periods to 10 seconds each.   
4. Do this routine three times a day.  

Sources: 

What is bladder training: National Library of Medicine 
Research on bladder training for incontinence symptoms: American Journal of Nursing 
Research on nonsurgical treatment for urinary incontinence: American Family Physician 
Bladder training steps: University of California San Francisco 
Lifestyle changes as treatment: National Library of Medicine 
Review of Kegel studies: University of Montreal 

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