Behavioral Therapy for the Bladder

Fluid Intake

Your fluid intake should be between 4 - 8 cups per day.  Water or dilute juice will keep you hydrated without irritating your bladder.  Caffeine, pop, alcohol and acidic beverages may trigger urinary frequency and urgency, try to avoid these.  Try to complete your daily fluid intake by about 6 or 7 pm, drinking fluids later than this may cause you to wake up at night to empty your bladder.

 

Bowel Regularity

Constipation makes bladder symptoms worse.  Ensure adequate fluid intake as well as a diet with plenty of fruits, vegetables and fibre.  Regular exercise will help maintain bowel regularity and avoid constipation.  Use laxatives sparingly as regular use may inhibit the bowel's normal function and cause dehydration.

 

Bladder Retraining

Normally there should be 2-4 hours between trips to the bathroom. If your body gets
used to urinating more frequently than this, the bladder ‘thermostat” gets set at a low
volume. This will give you the urge to urinate more frequently, even when your bladder
is not full.  You should not void at more than 4 hour intervals.  If this is the case, you should schedule trips to the bathroom at least every 3-4 hours whether you have a strong urge to urinate or not.


Bladder retraining well help you gain control over your urinary frequency and urgency.  If you urinate more often than every 1-2 hours, try the urge inhibition exercises outlined below when you get the urge to go to the bathroom.  Gradually increase the interval between voids by about 10 minutes per day.  Over the course of several days, your bladder will get used to holding a larger volume of urine.  Continue with the exercises until you are comfortably voiding every 2.5 - 3 hours.

 

How to Reduce Urgency

When you experience a sudden urge to empty your bladder:

  • Stop what you are doing, try to relax and take a deep breath.
  • Concentrate on your pelvic floor muscles.  Contract your pelvic floor muscles quickly 5-10 times (like a Kegel's exercise), these are called "quick flicks".  This exercise sends a message to the bladder that it is not time to void and will cause your bladder to relax.  Repeat "quick flicks" as necessary until the urge subsides.
  • When you feel the urge decrease resume your activity.  Ensure you empty your bladder at an appropriate time (no more than 3 hours or so from previous void).

Practice the technique frequently. Control may not be immediate, but with time and practice your urgency and frequency will decrease and you will develop more control.