Bladder Retraining

Bladder retraining is a therapy used by the Urology Division as well as the Women’s Center for Continence and Sexual Health at Premier Medical Group.

What is bladder retraining?

The bladder is responsible for storing urine before the urine leaves the body. Bladders are susceptible to conditions like bladder stones and cystitis, making bladder health important. Because proper functioning of the bladder is essential for the body to be able to remove urine and be able to store more urine as the kidneys produce it, you should pay attention to how often you urinate to be sure your bladder is healthy. Frequent urination can be a sign of a urinary tract infection, diabetes, or an enlarged prostate, so frequent urination should not be ignored. 

Normal bladders send signals to your brain and urinary system when there is enough urine to trigger a response from you to urinate. However, people with overactive bladders or urinary incontinence have a hard time managing the urge to urinate and may lack control over their bladder. Bladder retraining is a therapy that helps people regain control over their bladder and the urge to urinate. With bladder retraining, people can better regulate the frequency of urination and retrain their urinary system to send signals only when you actually have to urinate. 

What is the goal of bladder retraining?

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Bladder retraining aims to help your bladder learn to retain more urine before signaling to your body to urinate. The goal is to establish a routine schedule of urination to teach the body to go at set times. While urinating often is not always a bad or unhealthy occurrence for the body, facing the urge to urinate too frequently can send you to the bathroom at inconvenient times and make every urge feel more urgent than it likely is. 

Urinating too often can disrupt other systems in the body beyond the urinary tract system, and bladder retraining is a simple solution to making sure your body stays regulated. In addition, your quality of life can improve when you are not thinking as much about the next time you will need to go to the bathroom or having to plan trips around the bathroom. Bladder retraining is an approachable technique that can show maintainable results that make a big difference in your everyday life. 

Who should use bladder retraining?

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A normal, healthy bladder has a capacity of about 2 cups of urine. Given the bladder’s capacity, doctors recommend going to the bathroom roughly every 3 hours to make sure the bladder has a chance to empty and not retain urine for too long. People with healthy bladders urinate roughly 6 to 7 times within 24 hours though this number can vary based on a person’s daily routine and other conditions or medications that may reduce or increase the number. 

Bladder retraining can be an effective therapy for many people of all different ages, genders, and demographics who are urinating more than what should be needed. The therapy is most beneficial for those with bladder issues like urinary incontinence, urinary urgency, or overactive bladder. Not everyone with these conditions will respond in the same way to bladder retraining; however, bladder retraining does work to resolve bladder issues for many people. 

How does bladder retraining work?

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Bladder retraining typically consists of a combination of methods that target strengthening the muscles used in the urinary tract system and mentally adjusting to teach your brain and body to follow a new urination schedule. Each program is different depending on the person, but the therapy typically takes several weeks to months for results to show. Your individual therapy plan will be the most effective with consistency and good tracking measures to see how you progress. Your doctor will help you assess your needs and determine the best combination of bladder retraining therapies to try. 

Main bladder retraining techniques include:

    1. Delaying urination: This technique works by trying to hold off on urinating after you feel the urge to. When beginning the retraining process, start by waiting 5 minutes after you feel the urge to go to the bathroom. Over time, you can increase the amount of minutes to 10 or more, working your way up to being able to wait a span of 3 or 4 hours between bathroom visits. It can be difficult to distract yourself when the urge hits, so try breathing and relaxation techniques to help you extend the time. 
    2. Scheduling bathroom visits: In combination with delaying urination, scheduling bathroom visits helps you keep track of how often you urinate and try to plan out bathroom visits. You can use a bathroom log or diary to help you see the times you most often need to go to the bathroom, which will help you plan your schedule. To best keep to the schedule, you should go to the bathroom at the scheduled time even absent the urge to go. 
  • Kegel exercises: Kegel exercises aim to strengthen the muscles of the urinary tract system. Strengthening the muscles that help you start and stop urination improves the efficacy of your pelvic floor, which supports your bladder. To start Kegel exercises, squeeze your muscles as if you are trying to stop urinating for 5 seconds then release and squeeze again in intervals. Try to work up to 10-second intervals in 3 sets of 10 squeeze and relax contractions in a day. 

In addition to bladder retraining, your doctor may also recommend other options to try alongside bladder retraining. These options include:

  • Maintaining a healthy weight: Keeping in a healthy weight range can help your bladder function better and allows you to strengthen muscles to control urges. 
  • Diet: Some foods can irritate the bladder, so your doctor may recommend adopting a diet that avoids bladder triggers. Foods to avoid include acidic fruits, processed foods, raw onions, caffeine, alcohol, and spicy foods. 
  • Medicine: Medications like anticholinergics and mirabegron work to relax your bladder muscles and manage your brain’s signals to the bladder to help reduce urination frequency. 

What are the benefits of bladder retraining?

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There are many benefits to bladder retraining. While the main advantage to training your bladder is to establish a regular urination schedule for yourself, the fringe benefits of the training are also great reasons to try bladder retraining. With bladder retraining, you can correct bad habits like going to the bathroom each time you come across a convenient bathroom, increase the time between bathroom visits, and lessen the chances or occurrences of accidental urination. 

Retraining your bladder can eliminate conditions like overactive bladder and can reduce your risk of bladder infections. Also, regaining control of how frequently you urinate can make people experience less anxiety about urination and feeling like you need to be close to a bathroom. Bladder retraining improves your quality of life physically and mentally, making the treatment option promising for people who struggle with their urinary incontinence and who cannot control their urges to urinate. 

Should you see a doctor for bladder retraining?

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Even though you can participate in bladder retraining without the assistance of a medical professional, you should see a doctor when you notice irregularities in your urination. These irregularities could be signs of a urinary tract condition that needs medical attention to diagnose and treat. In addition, it is best to consult your primary care physician before starting a bladder retraining program to ensure this therapy will not interfere with other treatments you may be receiving. 

Your doctor can help you understand the root of your frequent or irregular urinations and inform you of what healthy bladder function looks like. Attending regular doctor visits can help you keep accountable to your bladder retraining program. For example, your doctor may ask that you keep a diary of your urination habits to track the success of the retraining and look for patterns that may help tailor the program to your body. Together with your doctor, you can diagnose your bladder issues and create a functional plan to help you regain control over your bladder.

Are there any risks to bladder retraining?

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Early on in bladder retraining, there are some risks to the program. The risks are generally not dangerous to your health or wellbeing but can impact your daily life. For example, as you work to establish a new urination schedule, you are at a higher likelihood of experiencing more urinary accidents that could cause embarrassment or discouragement. Another possible risk of bladder retraining is that your efforts will not work and that you still cannot effectively control your bladder. The therapy requires consistency and dedication, which can test a person’s patience and willingness to stick with the process. 

On the reverse side, you risk becoming bladder incontinent or developing other bladder conditions as a result of not attempting to train your bladder. Bladder retraining is often the first form of treatment used to resolve bladder issues before resorting to more medically involved and potentially invasive treatments. While there is the risk the retraining treatment will not work, bladder retraining poses a minimal risk to your health and is often successful for those who try it.