Three quick points about training my brain to knock off its pressure to have me urinate. First, my problem may be different from yours. For example, I have an inherited kidney defect that causes me to rely on Amiloride, a specialized diuretic designed to preserve/reclaim potassium. The diuretic speeds removal of water (and wastes) from my body. As a result, my brain has been trained to respond earlier and more often to stimuli that suggest my bladder needs relief. Second, perhaps I made a mistake in using the word "exercising," suggesting a regimen that we haven't yet developed fully. Third, I was a victim of benign prostatic hypertrophy (BPH) that stole a lot of the space in my bladder and encouraged my brain to take that into account; a golf-ball sized hunk of prostate flesh was removed by a transurethral resection of the prostate (TURP) several years ago. That said, here's the other advice from my nephrologist.

First and foremost, I am much more conscious about hydrating my system regularly and more often than in recent years. By over-consuming water somewhat, my brain is expected to learn that I need more water in my organs and that my bladder should tolerate more pressure than my urine has been developing there. This helped us understand why rolling over in bed at night -- in effect, simply irrigating bladder lining on one side that has been "drying out" from lying horizontal for a couple of hours -- wakes me up and sends me to the bathroom. The challenge here is to find a position in bed that I can maintain for longer periods.

I should try to drink each day at least 8 cups of water between arising in the morning and 3-4pm (we have dinner about 6pm and retire about 11pm). Routinizing the schedule here might train my brain to expect hydration at fixed times, so changing the schedule every day is being tested for effects. We're looking for a way to slowly increase water consumption over a couple of months in order to increase my capacity for maintaining better hydration without resorting to urination.

I also should try to consciously reject bladder signals to urinate when they are triggered by an environmental experience. So far that has meant "holding" my urine when thoughts of drinking water, washing hands, taking a shower, doing the dishes, or getting my feet wet triggered an impulse to urinate. It remains to be seen whether routinizing my daily exercise, conducting it longer, changing motions, and changing start times and duration might have an effect. Martin

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