When you think of bathroom training, you probably think of your little one learning to use the potty for the first time, but it’s for adults too – especially those with urinary incontinence.
It may sound silly, but at some point, if you have urinary incontinence, your body needs to be retrained on proper voiding habits and mechanics. And just what do we mean when we talk about urinary incontinence? You may be familiar with the feeling of a little urine leaking after a cough (known as stress incontinence), as one in three women can relate, but there are other kinds of urinary incontinence as well. There is regular leaking throughout the day (overflow incontinence) due to your bladder not releasing urine when it should, and accidentally urinating before you’re able to get to the restroom in time because the urge is too strong, often described as “key in door” because people tend to leak on their way to the bathroom (urge incontinence). You can even have mixed incontinence, which is a combination of stress and urge incontinence.
Ultimately, the goals of bladder retraining include urinating less frequently, urinating larger and healthier volumes of urine, and increased volitional control over voiding.
Part of bladder retraining is starting a bladder retraining diary that captures what life is like for you on a day-to-day basis with urinary incontinence. It may feel weird to do, but it is a legitimate way to help. You may use your bladder retraining diary to keep track of urges and leaks. You can record what times you go to the bathroom, how much you urinate (no need to measure fluid ounces, as using “Mississippi seconds” to time length of void suffices to gauge how empty or full your bladder is), and the type of fluids you’re drinking. Bladder irritants cause your bladder to contract even if it isn’t yet full, and this leads to incontinent episodes. The top three biggest offenders are caffeine, alcohol, and carbonated beverages. You may even choose to abstain from said food or drink. You may feel disheartened when you are first keeping track of what’s going on, but the idea isn’t to feel bad when accidents or setbacks are recorded in your diary, rather to use the diary in your detective work to help create patterns which will help you solve the problem.
As for how you’ll actually retrain your bladder, you’ll start by extending the time you wait to urinate by 15 minute intervals. (People who don’t have urinary incontinence generally go to the bathroom six to eight times per day and zero to one time at night.)
Kegels, or performing a pelvic floor muscle contraction, are a great bladder suppression technique. In other words, when you turn the pelvic floor muscles on while performing a Kegel, a message is sent to the bladder to turn off, which allows it to fill up for longer before needing to void.
Speaking of Kegels, your pelvic floor physical therapist can demonstrate exactly how to perform Kegels properly. Don’t be embarrassed to ask us for a demonstration! They can be difficult to master, and helping you resolve urinary incontinence is what we are here for! The other reason why it’s best to check with a pelvic floor PT prior to initiating a Kegel strengthening program is because KEGELS AREN’T FOR EVERYONE. If a person has a history of overactivity, or tightness of the pelvic floor, Kegels exercises are contraindicated as they can exacerbate the problem. Some signs that may indicate overactivity or tightness of the pelvic floor muscles include pelvic pain, urinary frequency, and constipation, to name a few.
Urinary incontinence can feel embarrassing, but you shouldn’t let that embarrassment keep you from speaking to your doctor or physical therapist about your symptoms. If you are determined to retrain your bladder, recognize, though, that it is a commitment. It may take as long as 12 weeks to see improvement. You may want to carefully choose a calm time in your life to embark on this journey, versus a time when you know it may be tougher to remain compliant. Still, it’s worth it because urinary incontinence can hold you back from enjoying all the things you love to do: seeing movies at the theater, taking long car trips, and traveling. It’s time to show your bladder who’s boss! I encourage you to talk to your doctor and physical therapist (or contact me for a free consultation) so you can get back to living life leak-free!