ABOUT BLADDER TRAINING
The aim of bladder training is to help you gain better control over your bladder. This will allow you to:
- reduce the constant need to go to the toilet (frequency)
- put off going to the toilet until your bladder is full
- increase the volume of urine you pass when you do go to the toilet.
What are normal bladder habits?
A healthy bladder can hold one and a half to two cups (300-400mls) of urine (wee) during the day and about four cups (800mls) at night. It is normal to pass urine five or six times a day if you drink between 6-8 glasses of fluid. It is usual to empty your bladder when you get out of bed in the morning, three times during the day, and before you go to bed at night. As we age this pattern may change, as older people tend to make more urine at night.
A bladder training program
We recommend working with a continence nurse specialist or men's women's and pelvic health physotherapist to design a bladder training program to suit your individual needs. Bladder training programs may take up to three months, with weekly or fortnighly appointments to monitor your progress and measure your improvement.
At the start of a bladder training program, you will be asked to keep a bladder diary. Every time you pass urine, you record the date, time and how much urine you pass. You will also need to record the amount of fluid that you consume each day. This will need to be done for a few days to see how much your bladder holds and how often you need to empty it. You should also include comments about leaking or other symptoms such as burning or pain.
How do I measure my urine?
To measure the amount of urine you pass, put a container (like an ice cream container) in the toilet bowl. Sit on the toilet and pass urine into the container. When you have finished, measure the urine by tipping it into a measuring jug. For men, you may prefer to stand and pass urine directly into the measuring jug. You should write the measurement from the jug in your bladder diary, then tip the urine into the toilet and flush.
You can also use absorbent pads to work out how much urine you leak over one or two days. This is done by using a dry pad that has been weighed in a plastic bag. When you change the wet pad you put it back in the plastic bag and weigh it. If you take away the weight of the dry pad from the weight of the wet pad you can work out how much urine you have leaked. One millilitre (ml) of urine weighs one gram.
For example:
- Wet pad: 350 grams
- Dry pad: 150 grams
- Weight difference: 200 grams
- Amount leaked: 200 mls
What will I learn?
Your continence professional will teach you how to use your pelvic floor muscles. These muscles support your bladder and urethra (urine tube) and help to hold back the strong urge to pass urine. This will help you put off going to the toilet, or hold it in until you reach a toilet.
Over time, you should notice you don't need to go to the toilet all the time, being able to stop yourself from going and passing more urine when you do go. You will also learn about diet and lifestyle modifications, including how to manage constipation (and straining), which can cause bladder control problems.
Bladder training takes time, so don't worry if it feels like things are not improving right away. The important thing is to keep trying, make note of the things that make a difference, and stay positive.
SEEK HELP
For further information, contact the National Continence Helpline on 1800 33 00 66. The National Continence Helpline is staffed by continence nurse specialists who offer free and confidential information, advice and support. They also provide a wide range of continence-related resources and referrals to local services.