Control frequent urges with bladder training

With an overactive bladder, you may become accustomed to urinating frequently or going at the slightest urge. Sometimes, you may go to the bathroom even if you don’t have the urge to urinate because you want to avoid a possible accident. In time, your bladder begins sending “full” messages to your brain even when it’s not full, and you feel compelled to go.

Typically, a person urinates 5 to 6 times a day, with the bladder holding as much as 2 cups of urine. In the case of an overactive bladder, you may go to the bathroom more than 8 to 10 times daily — and more than twice a night — each time urinating only a small amount.

Bladder training involves teaching your bladder new habits by urinating on a set schedule. This makes it possible for you to gain control over frequent urges and allows your bladder enough time to fill up properly.

Bladder training can be helpful for men and women who have urge and other types of incontinence. It may also involve double voiding — urinating, then waiting a few minutes and trying again. This exercise can help you empty your bladder more completely to avoid overflow incontinence.

A bladder training program may be used alone or in combination with other therapies. It usually involves the following basic steps:

• Identify your pattern — For a few days, record in a bladder diary every time you urinate. For example, you may find that you tend to urinate every hour on the hour. Your health care provider can use the information in your diary to help you establish a schedule for bladder training.
• Set bathroom intervals — After you’ve discovered how much time typically passes between bathroom breaks, your health care provider may suggest that you extend that interval by 15 minutes. So, if you determine that your usual interval is one hour, you work to extend that interval to an hour and 15 minutes.
• Stick to your schedule — Once you’ve established a daytime schedule — you probably won’t need to follow a schedule at night — do your best to stick to it. Begin your schedule by urinating immediately after you wake up in the morning. After that, if an urge arises but it’s not time for you to go, try as hard as you can to wait it out. If you feel that you’re going to have an accident, go to the bathroom but then return to your preset schedule. Urges typically build to a peak and then gradually diminish. Responding immediately to an urge by rushing to the bathroom only serves to increase your sense of urgency, and it may invite an accident. Instead, stop and take a deep breath.
• Manage urges — When you have an urge, relax and try to think of something other than going to the bathroom. Play a mind game such as recalling the last three books you’ve read or the movies you’ve been meaning to watch. It may help to do five to 10 quick, strong pelvic floor muscle contractions to help alleviate the urge and maintain control. If you feel an urge to go at your scheduled time, stop and wait until the urge recedes, then proceed to the bathroom.
• Increase your intervals — Your goal is to gradually lengthen the time between trips to the bathroom until you reach intervals of two to four hours. You might do this by extending the time between bathroom trips by an additional 15 minutes each week until you reach your desired goal.

Don’t be discouraged if you don’t succeed the first few times. Keep practicing, and your ability to maintain control is likely to improve.

Looking for more discussions like this one? Check out the Women's Health and Kidney & Bladder groups.

Find other ways to conquer bladder and bowel issues by picking up a copy of Mayo Clinic on Incontinence.