Bladder training🚾: What, why, how + when is it inappropriate ⚠️

Bladder training. What, why, how and when.
Bladder training. What, why, how and when.

Bladder training. What, why, how and when.

We at iPeeWell have prepared a comprehensive article about what bladder training is, why to use it, how to do it and even when to avoid it. iPeeWell is a manufacturer of personal home uroflowmetry device, which is used by people with urinary problems to monitor the progress or worsening of their voiding problems. Key benefits our device brings are convenience, comfort, hygiene, accuracy and cost-effectiveness. Join our expanding group of satisfied customers.
Bladder training is a technique used to help improve control over the bladder and reduce the frequency of urination. The goal of bladder training is to increase the amount of time between urinations, so that the patient can gradually regain control over their bladder function.

Table of Contents

Videos about bladder training

Steps in bladder training

The exact approach to bladder training may vary depending on the patient’s individual needs and the underlying cause of their urinary symptoms. Bladder training may be recommended for patients with overactive bladder syndrome, urge incontinence, small bladder capacity or other urinary tract disorders that affect bladder function[1][2][3][4][5][6][7][8]. There are several steps, which are individually combined to suit patient’s problem by a doctor. They are:

  • Keeping a bladder diary: Patients are asked to keep a diary of their fluid intake and urination habits, including urgency, frequency, volume, and any instances of incontinence. This information can help healthcare providers identify patterns and develop a personalized bladder training plan. You can print the voiding diary (see documents menu), or you can use the iPeeWell Uroflow app for a mobile device and enter data into it. Before going to the urologist, you print out diaries where most of the necessary data is already marked and calculated.[10]
  • Scheduled voiding: Patients are instructed to urinate at scheduled times, such as every hour or every two hours, regardless of whether they feel the urge to go. The goal is to gradually increase the amount of time between scheduled voids, so that the patient can train their bladder to hold urine for longer periods of time.[11]
  • Delayed voiding: Patients are instructed to delay urination when they feel the urge to go, gradually increasing the amount of time they can hold their urine before going to the bathroom.[12]
  • Kegel exercises: Patients may be instructed to perform Kegel exercises, which involve contracting and relaxing the pelvic floor muscles. These exercises can help strengthen the muscles that prevent incontinence.[13]
  • Gradual increase in time between voids: As the patient progresses through bladder training, the amount of time between scheduled voids is gradually increased, until they are able to hold their urine for longer periods of time without experiencing discomfort or incontinence.[12]

Factors influencing bladder training

The success of bladder training depends on several factors, including the patient’s motivation, the severity of their symptoms, and their ability to adhere to the training regimen. Patients may experience some discomfort or incontinence during the initial phases of bladder training, but with consistent practice and monitoring, they can gradually regain control over their bladder function and improve their quality of life.

Warning about bladder training

It’s important to discuss any urinary symptoms with a healthcare provider to determine the underlying cause and develop an appropriate treatment plan. Bladder training may be recommended as part of a comprehensive treatment approach for certain urinary tract disorders, but it may not be appropriate for all patients.[9]

When is bladder training inappropriate?

While bladder training can be an effective technique for improving bladder control and reducing the frequency of urination, it may not be appropriate for all patients, especially those with certain medical conditions. Some medical conditions that may make bladder training inappropriate include:

  • Urinary retention: Patients with urinary retention may not be able to fully empty their bladder during voiding, which interferes with bladder training.
  • Severe urinary incontinence: Patients with severe urinary incontinence may not be able to control their bladder function enough to effectively participate in bladder training.
  • Bladder obstruction: Patients with a bladder obstruction, such as a tumor or scar tissue, may require surgical intervention before bladder training can be effective.
  • Certain neurological conditions: Patients with certain neurological conditions, such as multiple sclerosis, dementia or Parkinson’s disease, may have difficulty with bladder training due to nerve damage.[14][15]
  • Certain medications: Patients taking certain medications, such as muscle relaxants or sedatives, may not be able to effectively participate in bladder training due to the effects of the medication on bladder and nerve function.[16]
  • Advanced age: Patients who are advanced in age may have difficulty with bladder training due to changes in the urinary tract, nerves and pelvic muscles. Many elderly people also have a barrier to seek help.[17]
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It’s important to note that the appropriateness of bladder training will depend on the individual patient and their specific medical condition. It’s important to discuss any concerns[17] or questions with a healthcare provider to determine the most appropriate treatment plan. In some cases, a combination of treatments may be more effective than bladder training alone. For example, patients with urinary retention may require medication or surgery to address the underlying cause of the retention before bladder training can be effective. Patients with severe urinary incontinence may benefit from a combination of bladder training and other techniques, such as pelvic floor exercises or medication.

Conclusion

In summary, while bladder training can be an effective technique for improving bladder control and reducing the frequency of urination, it may not be appropriate for all patients. Patients with certain medical conditions may require alternative or additional treatments to effectively manage their urinary symptoms. It’s important to work closely with a healthcare provider to determine the most appropriate treatment plan based on individual needs and medical history.

iPeeWell is a home uroflowmetry device manufacturer and dedicated to providing informative and accurate information about urology and urinary health. Please read our articles to learn more about our services and how we can help you maintain optimal urinary health. We care! I pee well. Do you?

References

  1. Wallace SA, Roe B, Williams K, Palmer M. Bladder training for urinary incontinence in adults. Cochrane Database Syst Rev. 2004;2004(1):CD001308. doi: 10.1002/14651858.CD001308.pub2. PMID: 14973967; PMCID: PMC7027684.
  2. Norton C. Improving bladder function. Geriatr Nurs Home Care. 1987 Jun;7(6):22-6. PMID: 3649321.
  3. Hyland N. Continence–training for success. Nurs Times. 1991 Aug 7-13;87(33):60, 62. PMID: 1871020.
  4. Chiarelli PE. Incontinence. The pelvic floor function. Aust Fam Physician. 1989 Aug;18(8):949, 953-4, 956-7. PMID: 2673171.
  5. Talasz H, Gosch M, Enzelsberger H, Rhomberg HP. Geriatrische Patientinnen mit Harninkontinenz-Symptomen und ihre Kontrolle über den Beckenboden [Female geriatric patients with urinary incontinence symptoms and their control over pelvic floor muscles]. Z Gerontol Geriatr. 2005 Dec;38(6):424-30. German. doi: 10.1007/s00391-005-0301-2. PMID: 16362558.
  6. Brown C. Pelvic floor rehabilitation: conservative treatment for incontinence. Ostomy Wound Manage. 1998 Jun;44(6):72-6. PMID: 9739280.
  7. McIntosh LJ, Frahm JD, Mallett VT, Richardson DA. Pelvic floor rehabilitation in the treatment of incontinence. J Reprod Med. 1993 Sep;38(9):662-6. PMID: 8254585.
  8. Moul JW. Pelvic muscle rehabilitation in males following prostatectomy. Urol Nurs. 1998 Dec;18(4):296-301. PMID: 9873356.
  9. Neumann P, Morrison S. Physiotherapy for urinary incontinence. Aust Fam Physician. 2008 Mar;37(3):118-21. PMID: 18345359.
  10. Mehta S, Geng B, Xu X, Harmanli O. Current state of bladder diary: a survey and review of the literature. Int Urogynecol J. 2023 Apr;34(4):809-823. doi: 10.1007/s00192-022-05398-w. Epub 2022 Nov 2. PMID: 36322174.
  11. Newman DK. Prompted Voiding for Individuals With Urinary Incontinence. J Gerontol Nurs. 2019 Feb 1;45(2):14-26. doi: 10.3928/00989134-20190111-03. PMID: 30690650.
  12. Bayrak Ö, Dmochowski RR. Underactive bladder: A review of the current treatment concepts. Turk J Urol. 2019 Feb 4;45(6):401-409. doi: 10.5152/tud.2019.37659. PMID: 30817271; PMCID: PMC6788564.
  13. Huang YC, Chang KV. Kegel Exercises. 2023 May 1. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 32310358.
  14. Vecchio M, Chiaramonte R, DI Benedetto P. Management of bladder dysfunction in multiple sclerosis: a systematic review and meta-analysis of studies regarding bladder rehabilitation. Eur J Phys Rehabil Med. 2022 Jun;58(3):387-396. doi: 10.23736/S1973-9087.22.07217-3. Epub 2022 Feb 1. PMID: 35102733; PMCID: PMC9980558.
  15. Nadler RB. Bladder training biofeedback and pelvic floor myalgia. Urology. 2002 Dec;60(6 Suppl):42-3; discussion 44. doi: 10.1016/s0090-4295(02)02390-7. PMID: 12521595.
  16. Min CH, Min YS, Lee SJ, Sohn UD. The comparative effects of aminoglycoside antibiotics and muscle relaxants on electrical field stimulation response in rat bladder smooth muscle. Arch Pharm Res. 2016 Jun;39(6):863-70. doi: 10.1007/s12272-016-0765-1. Epub 2016 Jun 3. PMID: 27260628.
  17. Toye F, Barker KL. A meta-ethnography to understand the experience of living with urinary incontinence: ‘is it just part and parcel of life?’. BMC Urol. 2020 Jan 16;20(1):1. doi: 10.1186/s12894-019-0555-4. PMID: 31941470; PMCID: PMC6964106.

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