Bladder
Training
The goal of bladder re-education is to try to re-train
the bladder to empty when you want it to, instead of when
it wants to.
For the purposes of this two-week washout
period, you will be asked to:
- Resist the sense of urgency
to empty your bladder
- Postpone urinating
- Urinate according to a timetable rather than
according to urge
Methods To Overcome The Urge To Void
- Practice pelvic floor contractions
- Try mental distractions such
as mathematical problem solving
(subtract 3 from 100 until urge to void passes)
During
this training period you should:
- Increase your fluid intake to 8 cups of water per day
- Try to break
the habit of going to the bathroom “just in case”
- Get
some exercise (take long walks for example)
Timed Voiding
You should try to go to the bathroom at set times. For
example, try emptying your bladder every hour at first.
When you are able to go without leaking (an incontinent
episode) at hourly intervals, try to increase the
time between visits to every hour
and a half. Repeat this process until you can maintain
4 times intervals without incontinent episodes.
Exercises
Pelvic floor muscles are just like other muscles. Exercise
can make them stronger. Women and men with bladder control
problems can regain control through pelvic muscle
exercises, also called Kegel exercises. Exercising
your pelvic floor muscles
for just 5 minutes, three times a day can make a big
difference to your bladder control. Exercise strengthens
muscles that hold the bladder and many other organs
in place. The part of your body including your hip bones
is the pelvic area. At the bottom of the pelvis, several
layers of muscle stretch between your legs. The muscles attach
to the front, back, and sides of the pelvis bone. Two
pelvic muscles do most of the work. The biggest one
stretches like a hammock. The other is shaped like a
triangle. These muscles prevent leaking of urine and
stool.
How Do You Exercise Your Pelvic Muscles?
You should tighten the two major muscles that stretch
across your pelvic floor. They are the hammock muscle
and the triangle muscle. Here are three methods to
check for the correct muscles.
- Try to stop the flow
of urine when you are in the middle of urinating.
If you can do it, you are using the right muscles.
- Imagine
that you are trying to stop passing gas. Squeeze
the muscles you would use. If you sense a pulling
feeling, those are the right muscles for pelvic exercises.
- For
women, lie down and put your finger inside your
vagina. Squeeze as if you were trying to stop urine
from coming out. If you feel tightness on your finger,
you are squeezing the right pelvic muscle.
Don’t squeeze other muscles at the same time. Be
careful not to tighten your stomach, legs, or other
muscles. Squeezing the wrong muscles can put more pressure
on your bladder control muscles. Just squeeze the pelvic
muscle. Don’t hold your breath. Repeat, but don’t overdo
it. At first, find a quiet spot to practice –your bathroom or
bedroom—so
you can concentrate. Lie on the floor. Pull in the pelvic muscles and hold
for a count of 3. Then relax for a count of 3. Work
up to 10 to 15 repeats each time you exercise.
Do your pelvic exercises at least three times a day,
every day using three positions: lying, sitting, and standing. You can
exercise while lying on the floor, sitting at a desk,
or standing in the kitchen. Using all three positions
makes the muscles strongest. Be patient. Don’t give up. It’s
just 5 minutes, three times a day. Most patients will
notice an improvement after a few weeks.
You can also protect your pelvic muscles
from more damage by bracing yourself before sneezing, lifting or jumping.
Sudden pressure from such actions can hurt those pelvic
muscles. Squeeze your pelvic muscles tightly and hold
on until after you sneeze, lift, or jump. After your
train yourself to tighten the pelvic muscles for these
moments, you will have fewer accidents. |
