Bladder Training How To Use Your Pelvic Floor Muscles

What is bladder training?

Bladder training is a way of treating problems of urinary urgency and frequency.

What is the aim of bladder training?

The aim of bladder training is to ‘train’ the bladder to hold on. Over time you can gradually restore a more normal bladder emptying pattern by trying to ignore some of the signals from the bladder and by holding on for longer between visits to the toilet.

Some words it is helpful to know:

Urgency is the really strong need to pass urine which if ignored, could cause a leak (urge incontinence).

Frequency is the need to empty the bladder with only a short time between visits to the toilet.

When is it important to tighten the pelvic floor muscles?

It is really important to try and tighten these muscles in anticipation of any situation where you feel that you may leak:

Getting out of bed
Getting closer to the toilet door
In a toilet queue
When running a tap
Getting up from a chair
Finding your door key when coming home
Lifting heavy items

How can bladder training help the bladder to function
more normally?

The bladder functions best when it is given good volumes to hold. The more you go, the more you will have to go as your bladder gets used to holding less and less urine. If you always respond immediately to the bladder’s signals or go ‘just in case’, your bladder can start to control how you manage your daily activities. Use of ‘delaying tactics’ can be helpful.

What delaying tactics can I use?

The following tactics may be helpful in delaying the urge to pass urine and in improving bladder control:

Try to ‘switch the bladder off’ by tightening the muscles of the pelvic floor just a little. Try and maintain this low level tightening for a full 20 seconds. This is the most important delaying tactic.

You can also try:

Standing still
Standing on tip toes/ hopping from foot to foot
Sitting on the hard arm of a chair/ on the corner of a wall
Crossing your legs
Adding a firm pressure by pressing your hands between your legs
Mental distraction. Try the 8 times table!
Toe scrunching – curl your toes under

Building up time intervals between passing urine is not always easy. Check your watch when you pass urine and set yourself a realistic time to work towards. Remember the average time interval between passing urine is 3 to 4 hours depending on how much you are drinking. Try not to go to the toilet ‘just in case’. If you try to improve the holding time of the bladder in the day you will inevitably improve your ability to hold on at night. What delaying tactics can I use? How can bladder training help the bladder to function more normally?

Do make sure you are sitting comfortably to pass urine in order that the bladder can empty fully.

Which drinks can irritate the bladder?

Tea, coffee and cola may irritate the bladder. These are stimulant drinks which will make the bladder fill quickly and can aggravate urge symptoms. Be cautious with citrus juices, fizzy drinks, diet drinks, alcohol and tomatoes. All of these could cause problems for the bladder. Some soap products can irritate the vaginal tissues and increase feelings of urgency.

What should I drink?

Water, herbal teas, squash and diluted juices are preferable to caffeine based drinks. Decaffeinated tea and coffee may also cause urgency and rapid bladder filling for some people, so plainer drinks are best.

How much should I drink?

It is advisable to have around eight drinks a day. That is roughly three pints or one and a half litres of fluid. Excessive fluid intake may in itself cause frequency but restricting fluids can make the urine concentrated and this too can irritate the bladder. It is a fine balance.

Expect setbacks if the weather is cold and rainy or when you are stressed or unwell. Some women can experience more symptoms around the time of their period.

Your physiotherapist will be able to talk you through all aspects of this leaflet and guide you on a pelvic floor exercise program when you attend the department for an appointment.

What should I do if I have further questions?

Should you have any concerns, please call your named physiotherapist, or leave a message for the Pelvic Obstetric and Gynaecological Physiotherapy Team.