This article discusses bladder training, including its uses, benefits, and effectiveness. It also details side effects and other treatment approaches.
Bladder training uses muscle-strengthening and relaxation exercises to help treat the following conditions:
- Stress incontinence: This is when urine leaks because the bladder is under pressure, such as due to:
- coughing
- laughing
- physical activity
- lifting
- Urge or urgency incontinence: Urge incontinence is when the urge to urinate comes on quickly, without giving you enough time to reach a bathroom. It’s possible to have stress and urge incontinence at the same time, which is known as mixed incontinence.
- Urinary frequency: Urinary frequency refers to when you pass urine more than eight times during the day.
- Catheterization: If you have recently had a urinary catheter, bladder training may help improve bladder health and function.
Read more about urinary incontinence, including its types.
Bladder training may:
- increase the amount of urine the bladder can hold
- increase the amount of time between needing the bathroom
- increase the amount of urine you can pass each time
- improve management of urges to urinate
- reduce leaks or wetting
- resolve habits that can contribute to incontinence, such as going to the bathroom when you don’t need to, “just in case”
Usually, bladder training involves working with your primary care doctor, a pelvic floor therapist, a urologist, or both to create a tailored treatment plan.
Your treatment plan may include one or more approaches, such as:
Preparation
Your medical team may ask you to go to the bathroom as you usually would, and record information such as:
- the time you go to the bathroom, and how often
- when and how often you experience leaking or wetting
- what, when, and how much you are drinking any liquids
- how much urine you pass, such as by using a plastic jug
Pelvic floor physical therapy
Pelvic floor physical therapy helps
- the abdomen
- the glutes
- your posture
Your therapist will teach you proper techniques to identify and strengthen the muscles. This can be done with aids such as:
- biofeedback therapy, which uses sensors that light up or sound out when the right muscles are engaged
- electrical stimulation, which uses electricity to stimulate the muscle contraction for you
- weights or cones, which can be inserted into the vagina to help with muscle contractions
They will also let you know how often to do these exercises. If you have questions about your treatment or exercises, talk with your medical team.
One example of a pelvic floor exercise is kegels.
Kegel exercises
Kegel exercises help strengthen the muscles responsible for stopping urine flow.
They can be performed by:
- contracting the muscles, as if you were stopping the stream of urine or holding back a bowel movement
- trying not to squeeze any other muscles
- holding for a few seconds, then fully relaxing the muscles
- repeating the exercises for up to 10–15 repetitions
Avoid doing kegels while actually urinating, which could increase the risk of an infection.
If you have a vagina, gently insert a finger inside while trying kegels. Otherwise, you can gently insert your finger into your anus. You should be able to feel the squeeze on your finger if you are performing kegels effectively.
Read more about kegel exercises.
Delayed urination
One bladder training approach is “holding on” or delaying going to the bathroom when you first feel the urge to urinate.
This should be done gradually. For example, if you typically get the urge to go to the bathroom every 30 minutes, try waiting an extra 5–10 minutes each time for 1 week. Then, try increasing this time by 5 minutes each week afterward.
Over time, your bladder may gradually stretch and comfortably hold more urine for longer.
Ways to help manage your urges can include:
- sitting up straight on a firm seat
- staying still
- performing pelvic floor exercises
- walking at a steady pace to the bathroom
- distracting yourself with an engaging task, such as:
- puzzles
- thinking of names beginning with each letter of the alphabet
- reading
Bladder training can
According to the American Academy of Family Physicians, you may begin to see improvements within 3–12 weeks of bladder training.
It is typical to experience leaks or not see immediate results during this time.
Bladder retraining is generally safe. However, you may experience a temporary increase in leaks or wetting while starting bladder training.
Another potential concern is that the treatment may not be effective for you. Talk with your medical team if you do not see improvements from bladder training.
Other ways to help manage or improve incontinence alongside bladder training may include:
- limiting caffeine and alcohol intake
- staying hydrated, even if you are concerned about leaks
- avoiding drinking more than 300 milliliters or about 1.25 cups of cranberry juice a day
- avoiding foods that may irritate the bladder, such as spicy or acidic foods
- avoiding hovering over the toilet, as this doesn’t allow the bladder to empty properly
- contacting your doctor if:
- you experience urinary tract infection (UTI) symptoms
- you pass bloody or pink-colored urine
- you have questions about your symptoms or your treatment doesn’t seem to be helping
Learn more about the symptoms of UTIs.
Other options for incontinence can include maintaining a moderate body weight and using incontinence products, such as absorbent underwear pads.
If other treatments haven’t helped, your doctor may recommend approaches such as:
- antimuscarinics or anticholinergics, oral medications that may help reduce urges, such as:
- darifenacin (Enablex, Novartis)
- tolterodine (Detrol)
- oxybutynin (Ditropan)
- mirabegron (Myrbetriq), which can help the bladder muscles relax and store urine
- botulinum toxin (Botox) injections in the bladder, which can stop the bladder muscles from over-contracting
- nerve stimulation therapy, whereby impulses stimulate the nerves and help reduce bladder overactivity
Bladder training uses pelvic floor physical therapy and urge management approaches to improve incontinence.
It works by strengthening the muscles that help hold urine, control urine flow, and increase bladder capacity. Examples of bladder training techniques include kegel exercises and gradually trying to hold your urine for slightly longer.
It can take several weeks for many people to see improvement from bladder training. In the meantime, you may experience an increase in urine leaks.
Contact your medical team with questions about bladder training or your treatment plan.