People with an overactive or weak bladder are often forced by an increased urge to urinate to go to the toilet immediately or lose droplets of urine before reaching the toilet. Bladder training – also called urotherapy – can then help at least partially regain control of their bladder.
Through training, the bladder can learn to stretch more and store more urine. Bladder training also includes various behavioral approaches as well as a concrete drinking and toilet plan.
First step: Diary
The basis for bladder training is a diary. In such a diary you can write down. It is very important to have everything registered, this will be like a small database.
-how often you go to the bathroom,
-how much urine goes out and
-how much fluid you drink throughout the day.
It is also important to provide information on medication and on situations in which urine has been lost unintentionally. The records can help in a conversation with the attending physician and provide important information about the cause of the symptoms.
The toilet plan: Regularity counts
Regular rhythm: In order to get the bladder used to a rhythm, it is important to go to the toilet at regular intervals. A toilet plan can be helpful here. As part of a bladder training program, it is often recommended that the intervals between toilet visits are as even as possible after getting up in the morning after emptying the bladder and immediately after getting up and, if necessary, again after breakfast.
Avoid preventive toilet visits: If you go to the toilet at too short intervals as a preventive measure, the symptoms of an overactive bladder could possibly worsen. The bladder can be “trained” by this behavior to urinate even with a small filling.
Do not urinate immediately: Even if the urge to urinate is very strong, it usually lasts only a few minutes, then the bladder calms down again. You can practice not emptying the bladder immediately when it appears. It can also be helpful to go to the toilet calmly and slowly – and not to run.
Extend the time between toilet visits: It can be helpful to try to extend the intervals between toilet visits, but slowly and without stress. A toilet plan can also help here. For example, you can say that in the first few days you want to try to hold out for 5 minutes before going to the toilet and maintain this rhythm for about half a week.
Later, the period of 5 minutes can be extended to 10, 15 and finally 20 minutes, during which one manages to endure the urge to urinate.
Using the training at night costs a lot of energy. During the day, it is more likely to be successful. Over time the training can be extended to the night.
Techniques for distraction
If you try not to immediately give in to the urge to urinate and prolong the time between toilet calls, some techniques are helpful to distract yourself:
-When the bladder appears, it helps you to relax and distract yourself with positive ideas. You can imagine it in your mind, for example: “In 5 minutes I will go to the toilet until then I will think of something else”.
-It can be helpful to sit on a chair and bend your upper body forward from your hips as if you want to tie your shoelaces. You can hold this position until the urge subsides. The pressure conditions in the abdominal cavity change due to the forward bent posture and the urethra tilts so that the urge to urinate decreases.
-It also helps to tense the pelvic floor while sitting with a straight back and to pull it up inwards.
The drinking plan: Drink regularly and enough
Many people with a weak bladder drink too little because they are afraid of not reaching the toilet in time. But regularity not only helps with emptying the bladder, it also helps with filling it. For this reason, bladder training combines a toilet plan with a drinking plan in which you record when and how much you drink. In many cases, a timer that reminds you of the agreed times with an acoustic signal has proven helpful.
If the water content of the urine is too low, the highly concentrated components of the urine can attack the bladder mucosa. This irritates the mucosa in the long run and the symptoms can worsen.
Drink with or before each meal. It is advisable to drink 1 to 2 glasses of non-carbonated water before each meal. Juices are possible in between, coffee and black tea in small quantities during the day.
In order to disturb the sleep as little as possible, it can help to drink less or nothing at all from about two hours before bedtime.
Coffee, black or green tea and alcoholic drinks have a diuretic effect. But kidney and blister teas or stinging nettle tea also increase urine production. It is helpful to avoid these drinks completely before going to bed.
It can also be helpful to avoid diuretic drinks before social activities, where you spend a lot of time on the road.
Don’t be discouraged by setbacks
You should also try to keep a record of any setbacks, because this is the only way to record successes and to have an overview of possible setbacks.
It is also good to know that setbacks are quite normal. Especially in times of great exhaustion or mental stress, this can happen.
Also, a urinary tract inflammation, a cold or wet, windy weather can be the reason.
Bladder training is not suitable for all forms of bladder weakness. It is therefore good to discuss individually with your doctor whether such training can be useful for you personally.