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Bladder training

When you have trouble controlling your bladder, you never know when you're going to feel the sudden, uncontrollable urge to go. You can get to the point where you are planning your entire life around a bathroom being available. The fear of leaking while shopping or out with friends can even be embarrassing enough to make you stay at home.

Bladder control problems are something most people are reluctant to talk about, even with their GPs. However, having that discussion can help you find a solution to the problem and get you back out into the world again.

Often the first treatment that doctors recommend for bladder control problems is bladder retraining. This is a type of behavioural therapy that helps you regain control over urination. It gradually teaches you to hold in urine for longer and longer periods of time to prevent emergencies and leaks.

Your GP may refer you to specialist to start a programme of bladder retraining. Depending on where you live you may be referred to:

  • A continence advisor (a specialist nurse at an NHS continence service.)
  • A urogynaecologist - a medical specialist who specialises in problems with the urinary system in women
  • A physiotherapist trained in using physical methods to promote healing and muscle strengthening
  • A specially trained practice nurse at your GP surgery

Is bladder training right for me?

The decision to try bladder training depends on what's causing the problem. Bladder control training is typically used to treat urinary incontinence, the involuntary loss of urine. Women are more likely than men to have incontinence, with 32 percent of UK women affected, compared to 13 percent of men. Women are especially affected after childbirth and menopause. There are different types of urinary incontinence, including:

  • Stress incontinence: You may leak urine after sudden pressure on your abdomen caused by a cough, sneeze or laughter.
  • Urge incontinence: A sudden, strong urge to go to the toilet because your bladder contracts even when it's not full. You may not always be able to reach the toilet in time.
  • Mixed incontinence: A combination of stress and urge incontinence.
  • Overflow incontinence: A problem emptying the bladder completely that leads to a constant dribble of urine that may not even be noticed.

Bladder retraining may also be used to treat bed-wetting in children.

The bladder retraining technique

Keep a diary. Before you begin bladder control training, your GP may ask you to keep a bathroom diary. In it, you can write down every time you have the urge to go, as well as when you leak. Using your diary as a guide, you can use the following techniques to help you gain more control over urination.

Plan toilet visits. Work out how often you're going to the toilet based on your diary entries. Then add about 15 minutes to that time. For example, if you're going to the bathroom every hour, plan bathroom visits at every hour and 15 minutes. Use the toilet at each scheduled visit, regardless of whether you actually feel the urge to go. Gradually increase the amount of time between bathroom visits.

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