How does bladder training work? bladder training

How does bladder training work? bladder training

How does bladder training work??

People with an overactive or weak bladder are often forced to go to the toilet immediately by an increased urge to urinate or lose dropwise urine before they reach the bathroom. A bladder training – also called urotherapy – can then help, at least partially, to regain control of their bladder.

The bladder can learn by training to stretch more and store more urine. A bladder training also includes various behavioral approaches as well as a concrete drinking and toilet plan.

First step: Diary

Basis for a bubble training is a diary. In such a diary you can write down

  • how often you go to the toilet,
  • how much urine goes off and
  • How much fluid is drunk throughout the day?.

Also, information about medications and situations in which unintentionally urine was lost, are important. The records can help with a conversation with the attending physician and provide important information on the cause behind the complaints.

The toilet plan: regularity counts

  • Regular rhythm: In order to get the bladder used to a rhythm, it is important to go to the toilet regularly at a fixed interval. A toilet plan can be helpful. It is often recommended in the context of a bladder training program to set up the intervals between the toilets as evenly as possible after the morning emptying immediately after getting up and possibly again after breakfast.
  • Avoid preventive toilet operations: Those who take preventative measures in too short intervals to the toilet could possibly aggravate the symptoms of an overactive bladder. The bladder can be literally “trained” by this behavior, even with a small filling urge to announce.
  • Do not leave water immediately: Even if the urination is very strong, it usually lasts only a few minutes, then the bubble calms down again. The bladder can not be emptied immediately when it reports, one can practice. Even going to the bathroom quietly and slowly – and not walking – can be helpful.
  • To extend the time between the toilet aisles: It can be helpful to try to extend the distances between the toilets, but slowly and without stress. Also, a toilet plan can help. There you can say, for example, that you want to try in the first few days to endure 5 minutes before you go to the bathroom and keep this rhythm for about half a week. Later, the period from the 5 minutes can be extended to 10, 15 and finally 20 minutes, in which one manages to endure the urinary urgency.

Exercising at night also costs a lot of energy. During the day, more success can be noted. Over time, the training can be extended to the night.

Techniques for distraction

If you try not to give in to urination immediately and extend the time between going to the toilet, there are some techniques you can use to distract yourself:

  • When the bubble comes in, it helps to relax and distract oneself with positive ideas. You can say something in your mind, for example: “In 5 minutes I will go to the bathroom, until then I will think of something else”.
  • It can be helpful to sit on a chair and bend the upper body from the hip forward, as if you want to tie the laces. This position is held until the urge subsides. Due to the bent forward posture, the pressure conditions in the abdomen change and the urethra tilts, so that the urinary urgency subsides.
  • It also helps in sitting with a straight back to tense the pelvic floor and pull inwards.

The Drinking Plan: Drink regularly and drink enough

Many people with a weak bladder drink too little because they are afraid of not being able to reach the toilet on time. But regularity not only helps in emptying, but also in filling the bladder. Therefore, in bladder training, a toilet plan is combined with a hydration plan that keeps track of when to drink and how much. Helpful in many cases, a timer has been found that reminds by an audible signal to the agreed times.

  • Sufficient fluid is still important for another reason: if the water content of the urine is too low, the highly concentrated components of the urine can attack the bladder mucosa. As a result, it is irritated in the long run and the symptoms can worsen.
  • Drink at or before each meal. It is recommended to drink 1 to 2 glasses of non-carbonated water before each meal. In between, juices, during the day in small quantities and coffee and black tea, possible.
  • In order to disturb the sleep as little as possible, it can help to drink less or nothing more from about two hours before going to bed.
  • Coffee, black or green tea and alcoholic drinks have a diuretic effect. But also kidney and bladder tea or nettle tea strengthen the urine formation. Just before bed, it is helpful to completely avoid these drinks.
  • Also, prior to social activities where you travel a lot, it may be helpful to avoid diuretic drinks.

Do not be discouraged by setbacks

  • Even with setbacks you should try to continue to keep a book, because only then success can be recorded and you have an overview of possible setbacks.
  • It is also good to know that setbacks are normal. This can happen, especially in times of great exhaustion or emotional stress.
  • A urinary tract infection, a cold or wet, windy weather may be the reason.

A bladder training is not suitable for all forms of bladder weakness. It is therefore good to discuss individually with the doctor whether such training can make sense for you personally.


Andreae S. Encyclopedia of Diseases and Examinations. Stuttgart: Thieme; 2008.

Jarvis GJ, Millar DR. Controlled trial of bladder drill for detrusor instability. British Medical Journal 1980; 281: 1322-1323.

Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J. Harrison’s Principles of Internal Medicine. New York: McGraw-Hill Companies. 18th ed; 2011.

Pschyrembel W. Clinical Dictionary. Berlin: De Gruyter; 2014.

Wyman JF, Burgio KL, Newman DK. Practical aspects of lifestyle modifications and behavioral interventions in the treatment of overactive bladder and urinary incontinence. International Journal of Clinical Practice 2009; 63: 1177-1191.

Wyman JF, Fantl JA, McClish DK, Bump RC et al. Comparative efficacy of behavioral interventions in the management of female urinary incontinence. Continence Program for Women Research Group. General Obstetrics and Gynecology 1998; 179: 999-1007.

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