Introduction

Your bladder has capacity to store enough urine (up to 500mls) to allow you to do daily activities and have enough sleep. When your bladder is filling up, the bladder muscle (detrusor muscle) is relaxed.

When the bladder is stimulated by the brain that urination is needed, signals go to the sphincter of the bladder to hold on to until it is convenient to go. When we decide to go to the toilet, the bladder muscles begin to contract, and the sphincter relaxes to enable us to pass urine.

Adults usually empty their bladder every three to four hours during the day. At night it is normal to need the toilet once.

If you are over 60 years old, you will probably find you get up to urinate more than once and this is said to increase every decade.

It is normal to empty your bladder between 5-8 times a day.

What is overactive bladder?

Overactive bladder is a condition where the bladder muscles contract or squeezes too frequently, whilst the bladder is filling with urine.

People suffering with this condition will feel a need to visit the toilet frequently even when their bladder is not full.

If you have an overactive bladder, you may have some or all of the following symptoms:

• Urgency
• Frequency
• Pain spasms
• Increased the number of times you get up during the night
• Nocturia
• Urgency incontinence, leaking before getting to the toilet

Urgency and frequency can be affected by:

• Anxiety or stress
• Constipation
• Infection
• Certain medications like diuretics
• Obesity
• Alcohol and drugs
• Fizzy drinks including aspartame
• Caffeinated drinks including green teas

Bladder retraining

Bladder retraining requires you to hold on and not go to the toilet so often.

You will need to do pelvic floor muscle exercises to help you hold on (your nurse will advise you how to do these).

If you wake up in the night with a strong urge to urinate, then use the toilet.

As you progress you may be able to go back to sleep without getting up.

There are two methods of bladder retraining:

Method One

• When you have the urge to urinate, go to the toilet and get ready.
• Count to 60 before you urinate.
• If you leak it won’t be a problem as you are over the toilet.
• Count to 60 each time until you do not leak any urine
• Once you’ve achieved this, start to count to 60 before you go to the toilet and when you get to three, count to another 60
• Then start to extend the time from 60 seconds
• Continue extending the time until you can wait for 15 minutes without any leaking

Your anxiety about your bladder will reduce, your confidence will grow and you’ll feel in control again.

Our Continence Advisory Service can help you regain control of your bladder Overactive bladder.

Method two

• The next time you arrive home, put your key in the door and feel an urgent need to go to the toilet
• Put the key in the door and before opening it, count to 60
• As you master this and the urge gets less, after counting to 60, open the door and go inside
• Go to the toilet and get ready; count to 60 before you urinate.
• If you leak it won’t be a problem as you are over the toilet
• Continue to count to 60 each time until you do not leak any urine
• Once you have achieved this, start to extend the time from 60 seconds

Tips to try

• Start to avoid going ‘just in case’
• Sitting down may help when you have a strong urge
• Watch the television or count back from 100 – it may take your mind off thinking about the toilet
• Always try to avoid going to the toilet on a strong urge.