What is urgency?
Urgency is having a strong desire to pass urine and the need to hurry the toilet.
What is frequency?
Frequency is needing to go the toilet eight or more times in 24 hours. This is caused because your bladder is over sensitive, the bladder muscle starting to contract before your bladder is full. The following advice will help reduce your problems. What is bladder training?
Bladder training is a way of teaching your bladder to hold larger amount of urine. Toileting just in case can make your problem worse as the bladder gets used to holding less urine and can then shrink. Bladder training will help to then cut down the number of times you have to go to the toilet to pass urine.
How much can a bladder hold?
The bladder acts as a storage port, which expands on filling, like a balloon. A normal bladder in a healthy adult can comfortably hold 500mls of urine. You need to aim for 300ml to 400mls.
How often should urine be passed?
This depends on how much has been drunk and your bladder capacity. In general, the bladder should be emptied every three or four hours.
Before doing bladder retaining
You should complete a bladder chart, detailing when and what you drink, when you go to toilet or have accidents. This can then be used as a baseline chart to measure your progress.
How can the bladder be retrained?
You need to gradually increase the time between visits to the toilet. This will take some time and perseverance. You need to start ‘putting off’ going to the toilet by just one or two minutes for the first few days, then five minutes for a week then ten minutes, then fifteen minutes, and so on. Try to distract your mind from your bladder when you get the urge to go. Sit down, recite the alphabet backwards, do pelvic floor exercises (see separate leaflet). Over a few weeks or months you will be able to stretch the times between visits to the toilet. Your aim will be less than eight times a day.
What can you do?
To help monitor your progress, you may find it helpful to record the times and amounts of urine passed. Gradually you should see the amount of urine passed become larger and the amount of times you pass urine becomes less frequent. Be sensible and try and drink four pints of fluid per day. If you drink less, your urine can become concentrated which can make your bladder problems worse. Aim for your urine to look straw coloured. Use the fluid matrix chart that will be given to you at assessment. Have your last drink two hours before you go to bed. Some people find that cutting down on caffeinated drinks such as tea, coffee and fizzy drinks help reduce symptoms. If you choose to stop caffeine drinks, reduce slowly as stopping caffeine completely can cause headaches. It is normal to get up once in the night and as we get older this may increase but this can improve if you follow the given advice.
Do not try to hold on at night. It will only keep you awake. Practicing holding on in the daytime will gradually help nighttime problems.
If you have been prescribed water tablets (diuretics) you must take them no matter how often they make you want to go. For bladder retraining to work you need to be determined and have lots of patience. Keep at it: you will see the results in three or four weeks. Do not be alarmed if your leakage worsens, this can happen at first until your bladder is retrained. If appropriate, medication can help these symptoms.