‘I’m a Urologist, and This is What You Need to Know About Bladder Training’

As you age (and especially after having a baby) you might find yourself having difficulties holding in your pee until you can rush to the bathroom. While leaking, aka stress incontinence, can be messy and embarrassing, it is actually pretty common. So remove that shame! Instead, work toward training your bladder to better hold in your urine until you can reach the toilet.

There’s something called “bladder training,” which basically conditions your bladder to be able to hold onto liquid longer. “This is usually recommended for people with overactive bladder, meaning they have excessively frequent urination, leakage, or urgent urination. But it can also be helpful for those who encounter the issues later in life or, for example, after pregnancy.

What causes overactive bladder?

Common risk factors for overactive bladder include aging, menopause, and certain neurological conditions. But more often, it’s due to having a baby. “The most common cause of stress incontinence—leaking with coughing, sneezing, and so forth—is vaginal childbirth,” says Karyn Eilber, MD, a board-certified urologist with sub-specialty board certification in female pelvic medicine and reconstructive surgery and the founder of GLISSANT.

The biggest benefit of bladder training is that it helps address urinary symptoms without medication.

Poor pelvic floor strength also plays a role. “Women with a history of pregnancy and delivery, regardless of whether it was cesarean or vaginal, may be more likely to have underactive pelvic floor muscles,” says Aleece Fosnight, PA-C and medical advisor at Aeroflow Urology, a specialist in men and women’s urological care and sexual health. And if you’re an athlete? You could have overactive pelvic floor muscles, she adds. (Sorry.)

Still, there’s no one-size-fits-all fix—and sometimes, it’s hard to pinpoint the cause of overactive bladder. (That’s why speaking to your doctor is important to properly diagnose and treat any bladder issues.) The biggest benefit of bladder training is that it helps address urinary symptoms without medication.

How does bladder training work?

The point of bladder training, says Fosnight, is to diminish leakage and the sense of urgency to urinate. “The goals are to increase the amount of time between emptying your bladder as well as expand the amount of fluids your bladder can hold,” she says. This should also make you feel more comfortable in between bathroom breaks.

On that note, says Dr. Eilber, bladder training involves gradually increasing the time interval between urination. That’s done by following a fixed voiding schedule, whether or not you feel the urge to urinate. If you feel an urge to urinate before the assigned interval, you should use urge suppression techniques—such as relaxation and/or engaging the pelvic floor muscles, such as squeezing, like a kegel. “For instance, if someone urinates every 30 minutes, for one week they would be instructed to postpone urination five minutes, then add on five minutes the following week, and so on,” she says.

How to use bladder training techniques

First, empty your bladder as soon as you get up in the morning, as this kicks off your retraining schedule. Then throughout the day, go to the bathroom at the specific times that have been discussed with your healthcare provider, and increase by minute-long increments, as advised by your doctor.

“Wait until your next scheduled time before you urinate again and be sure to empty your bladder, even if you feel no urge to urinate,” says Fosnight. Follow the schedule during waking hours only. At night, go to the bathroom only if you wake and find it absolutely necessary.

“When you feel the urge to urinate before the next designated time, use urge suppression techniques or relaxation techniques like deep breathing to focus on relaxing all other muscles,” says Fosnight.

At night, go to the bathroom only if you wake and find it absolutely necessary.

If possible, sit down until the sensation passes. If the urge is suppressed, adhere to the schedule. “If you cannot suppress the urge, wait five minutes. Then slowly make your way to the bathroom, where after urinating, you re-establish the schedule,” says Fosnight. She advises repeaingt this process every time you feel the urge to pee.

When you’ve accomplished your initial goal, Fosnight suggests gradually increasing the time between emptying your bladder by 15-minute intervals. Increase your interval each week until you get to a voiding interval of three or four hours.

How long until you see results?

There is no specific amount of time that it will take you to reach your goal.  “A helpful and achievable timeline would be about six to 12 weeks to accomplish your ultimate goal,” says Fonsight.

You may find you have good days and bad days, just like any other part of life.

Don’t be discouraged by setbacks! You may find you have good days and bad days, just like any other part of life. As you continue bladder retraining, you will start to notice more and more good days, so keep practicing. “Keeping a bladder diary can be helpful to understand your triggers,” adds Fosnight.

You’ll boost the speediness of your success by doing your pelvic floor exercises consistently every day, too. And those diaries will also help you see your progress and identify your problem times, as well as track your successes. Before you know it, you’ll be ready to use the bathroom—on your own preferred schedule.

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