How to Retrain your Bladder

How to Retrain your Bladder

Bladder retraining is a helpful process for anyone dealing with OAB, urinary frequency, urge incontinence and even urinary hesitancy.

How Your Bladder Works

Your bladder is meant to store the urine produced by your kidneys. The amount of urine you produce depends on what you eat and drink and also how much you sweat. Urine is constantly being produced and gradually fills up your bladder until it is time to empty.

The walls of the bladder have a series of mucosal folds call rugae that allow for expansion of the bladder. The muscular layer of the wall of the vagina is called the detrusor muscle which is made up of smooth muscle fibres that contract to empty and relax to allow the bladder to fill.

The Vagina Coach, Kim Vopni

The bladder can hold 300-400 mls of urine (which is about 1.5-2 cups) and it is normal to void every 3-4 hours or 5-9 times per day. As the bladder fills, there are messages sent to the brain and once it reaches a certain point, the brain will start to suggest it is getting close to time to empty.

What Is an Overactive Bladder?

If the bladder contracts without warning you may get a sudden, often urgent need, to empty. This is more accurately called Urinary Urgency or if there is a release of the bladder, Urinary Incontinence.

Overactive Bladder or OAB is characterized by the bladder contracting even when it is not full and can be from a disruption of the nerve signals. People who ‘pee all the time’ often believe they have OAB but it is more accurately urinary frequency and this is often a result of behavior patterns. The bladder is often trained to signal more often because of lifestyle habits that we have. Bladder Training is often the first recommended plan for treatment.

How Is It Diagnosed?

When seeking help for OAB it is important to find the root cause and rule out certain things to arrive at an accurate diagnosis. A medical history is the first step followed by a physical exam. Urines tests, Bladder Scans and a Cystoscopy or Urodynamic Testing may be ordered. Working with a pelvic floor physical therapist is ideal if you have one in your area.  They can help determine contributing factors and may suggest a bladder diary.  A bladder diary is a helpful tool to identify possible bladder irritants or behaviors that may be contributing to the problem.

The Vagina Coach, Kim Vopni

How Do You Use A Bladder Diary?

A bladder diary is a form you use to track what goes in and what comes out. It is best to do it over 3-4 days to start to notice patterns. You will record all of your food and drink each as well as when you void. You will want to track the time, if you felt any urgency, the volume that comes out and what you were doing at the time.

With 3-4 days of data, you can see if there are any foods/drinks that contribute to symptoms or if you notice that a certain time of day or an activity brings on symptoms.

Download your Free Bladder Diary Now and get started!

What Are the Most Common Bladder Irritants?

Coffee/Tea/Caffeine I Alcohol I Carbonated drinks I Some citrus fruits I Tomato-based foods I Chocolate I Some spicy foods I Artificial Sweeteners I Preservatives in processed foods

The Vagina Coach, Kim Vopni

How Do I Retrain My Bladder?

Bladder Retraining is the recommended first step along with seeing a pelvic floor physiotherapist. It is recommended to use a bladder diary while you work on retraining your bladder to monitor progress. Bladder retraining is easier to do while at home so perhaps start on a Friday evening at home, so you have the weekend to self-monitor and start adapting.

Using the information from the first time the bladder diary was used, it is advisable to eliminate any bladder irritants and focus on consuming at least 2 litres of water per day, throughout the day. You can also look to see what your typical interval is between bathroom visits. Is it 20 mins? 45 mins? 1.5 hours?

You will then work on delaying the urge to pee based on timed toileting. Remember that a full bladder will empty every 3-4 hours and will be about 2.5-3 cups of urine. Knowing this, if you get an urge to void before 3 hours has passed you can use some specific techniques to help calm the urge and not respond.

First thing is to talk to your bladder. You can do this out loud or in your head. Tell your bladder that YOU are in control. Acknowledge that you played a role in creating the increased signaling but that you are working to resolve that. Tell your bladder that you know it isn’t full because you just voided 30 mins, 1 hour or 2 hours ago and have not had a huge volume of liquid intake or bladder irritants.

If the signal continues, try doing some calf raises. Rise up on your toes and then rest back down on your heels – repeat. Alternatively, you can try curling your toes. You can do either of these distraction measures while you are talking to your bladder.

It is even more powerful to do this in front of the toilet because seeing a toilet can often increase the urge.

The Vagina Coach, Kim Vopni

Another distraction method is to do some kegels. Again, you can do kegels while curling your toes, while doing calf raises and/or while talking to your bladder.

Once the signal or urge subsides, you can get back to doing what you were doing or walk away from the toilet without voiding. Early on, it may seem impossible to delay the void and some may even experience a complete loss of their bladder contents but remember, it is a process and you can try again the next time.

Delayed voiding is one technique. You can also try timed voiding where you set a schedule (for instance every 3 hours) and try and stick to that.

Are There Other Treatments?

If bladder retraining is not working and the doctor has determined it is truly OAB, you can investigate other options such as medication, Botox, nerve stimulation, and PNS (Percutaneous Tibial Nerve Stimulation) which helps connect your nervous system to your bladder through the use of a small electrode placed by your ankle. This electrode sends pulses to the tibial nerve.

Who Should I See for Help?

Having a health care team or village is ideal. A pelvic floor physiotherapist is a great first step and they can help determine if the need is medical or if there is any organ prolapse that may be a contributing factor. If it is recommended that you see a medical provider, you will typically start with your family doctor who may refer you for PTNS or Botox. They may also refer you to a urologist for additional testing.

Having a list of questions prepared ahead of time is helpful during medical visits. Remember to always use your BRAIN and ask questions about what is offered to you – what are the Benefits? What are the Risks? What are the Alternatives? What is my Intuition telling me? What if I do Nothing?

It is also important to ask yourself about your symptoms

  • Do my symptoms prevent me from or make me stop doing the things I enjoy?
  • Am I afraid to be too far from a bathroom?
  • Do I plan my day around my bladder?
  • Have my symptoms changed my relationships with friends or family?
  • Do my symptoms interfere with my sleep?

Bladder retraining is a helpful process for anyone dealing with OAB, urinary frequency, urge incontinence and even urinary hesitancy.

Download your Free Bladder Diary Now and get started!

You may be interested in learning more in my Free Webinar6 Steps To Showing Your Bladder Who’s Boss.