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BLADDER TRAINING

The aim of bladder training is to help you gain better bladder control. This is done by training your bladder to hold more urine, without leaks or the pressing need to pass urine, so you can get to the toilet in time.


WHEN IS A BLADDER TRAINING PROGRAM USED?

If you are reading this leaflet, you may have some problems with bladder control. You might go to the toilet often and find it hard to hold on until you get there. At times you may leak urine on the way to the toilet. If you visit your doctor or a continence advisor they could start you on a bladder training program to help with better bladder control. If you do nothing about it, it may get worse.

Poor bladder control may be due to health problems such as stroke, enlarged prostate gland, or Parkinson’s disease, or just due to poor bladder habits over a long time. For some people the cause is not known.


WHAT ARE NORMAL BLADDER HABITS?

It is normal to pass urine five or six times a day (a 24 hour period) if you drink about one and a half to two litres (5 to 7 glasses) over the day. It is usual to empty your bladder when you get out of bed in the morning, three times through the day, and before you go to bed at night. As people age this pattern may change. Older people make more urine at night so they have to pass urine more often through the night than they do in the day.

A healthy bladder can hold about one and a half to two cups of urine (300 to 400mls) when up and about in the day and about four cups (800mls) during the night, before you need to pass urine.


THE BLADDER TRAINING PROGRAM

Your doctor or continence advisor will ask you to fill out a bladder chart. To do this, every time you pass urine you write down the date and the time and how much urine you passed. You will need to do this for a few days to find out how much your bladder holds and how often you need to empty it.

The bladder chart may look like this:

TimeAmount PassedComments
5:00am250 ml
7.30am70 ml
9.15am160 ml

In the comments, you can write down any leaks you have had (such as “leaked a bit on the way to the toilet”) or other problems (such as “burning” or “pain”).

To measure the amount of urine you pass, put a container (like an ice cream container) in the toilet bowl. Now sit on the toilet and relax, with your feet on the floor. Pass urine into the container. When you have finished, measure the urine by tipping it into a measuring jug. Men may want to stand and pass urine directly into a measuring jug.

Absorbent pads might be used to work out how much urine you leak over one or two days. This is done by giving you dry pads that have been weighed in a plastic bag. When you change the wet pad you put it back in the plastic bag and weigh it. If you take away the weight of the dry pad from the weight of the wet pad, you can see how much you have leaked because each millilitre of urine weighs one gram.

Like this:

Wet pad 400 grams
Dry pad150 grams
Weight difference250 grams
Amount leaked250 mls


WHO WILL HELP WITH YOUR BLADDER TRAINING PROGRAM AND HOW LONG WILL IT TAKE?

A continence advisor or physiotherapist can get the best results for you by designing a program that suits your needs.

These health professionals may be in private practice or may be contacted through community health services and public hospitals where the service is free. The National Continence Helpline (Freecall 1800 33 00 66) will help if you are not sure how to find one in your area.

Most programs take about three months and you may have meetings with your continence advisor every week or every two weeks. They will teach you ways to hold more urine in your bladder.


SOME HELPFUL THINGS YOU WILL LEARN FROM THE PROGRAM

The continence advisor will teach you how to use your pelvic floor muscles. These muscles support your bladder and urethra (the tube that carries urine from the bladder to the outside) and help to hold back the strong urge to pass urine. This will let you hold it in till you reach the toilet.

Over time, you will learn how to drink more, until you can drink between one and a half to two litres (5 to 7 cups) each 24 hours. This way your bladder will slowly learn to stretch to hold more urine. To help keep track of how much you drink each day, you will need to know how much your cup or mug holds. Cups can hold from 120 to 180mls whereas mugs can hold 280 to 300mls or more.

You will also learn how constipation and straining to pass a bowel motion can stretch your pelvic floor muscles and cause poor bladder control. To avoid constipation, you need to eat at least two pieces of fruit and five serves of vegetables each day and eat high fibre bread as well. Fizzy drinks or those with caffeine (chocolate, cola, tea and coffee) can upset the bladder and make it harder for you to hold on. You will learn which drinks to choose so your bladder will not be upset.


WILL THERE BE SET-BACKS?

Do not be worried by small day to day changes in your bladder control – these are normal. Anyone on a bladder training program can have setbacks, when symptoms may seem worse again. This may happen when:

If this does happen, do not lose heart. Stay positive and keep trying.


SEEK HELP

You are not alone. Poor bladder control can be cured or managed better with the right treatment. If you do nothing it might get worse.

Call Expert Advisors on the National Continence Helpline for free:

On FREE CALL* 1800 33 00 66 (8 am to 8 pm Monday to Friday), or

Visit this website: www.bladderbowel.gov.au

The Helpline can arrange for an interpreter through the Telephone Interpreter Service (TIS). Please ring 13 14 50 Monday to Friday and ask for the Helpline.

Bladder training can help bladder control.

* Calls from mobile telephones are charged at applicable rates.



Logo  NATIONAL CONTINENCE HELPLINE 1800 33 00 66  |  www.bladderbowel.gov.au  |  October 2010