Bladder Retraining

Bladder retraining after a urinary catheter can help reduce leakage and that ‘urgent’ need to go to the toilet.

With a little bit of work, bladder retraining exercises can reduce the number of times that you have to pass urine during the day and give you more independence.

How to retrain your bladder

The first step to retrain your bladder is to get a clear picture of what your bladder is doing. Keep an accurate record for at least three days of the following:

• How much, what time and what you are drinking
• How much and what time you are passing urine
• When, if at all, you are wet

What should you drink?

It is important to make sure you are drinking enough fluids. Drinking very large amounts i.e. in excess of 2 litres (4 pints) a day may be a little excessive, and will not help in retraining your bladder.

While it is acceptable to drink tea and coffee, please remember to drink clear fluids, such as water and cordials.

Try to avoid excessive intake of alcohol and drinks containing caffeine, as caffeine can be a bladder irritant (these include tea, coffee and cola). If you decide to change to decaffeinated drinks, make sure you introduce them gradually. If you are drinking the right things in the right amounts, your urine should be a light straw colour.

Urine colour test

This urine colour chart is a simple tool you can use to assess if you are drinking enough fluids throughout the day. The lighter the colour, the better hydrated you are.

Frequency Volume Input and Output Chart

Please complete this frequency volume input and output chart for 3 days. Your day starts when you get up.

Input

Measure all drinks, record time drunk and state the type of fluid drunk (eg.10am, 250mls, tea).

Output

Measure and record time and amount of urine passed on each occasion (mls).

Leak

Please record time and tick whenever you leak urine.

How to retrain your bladder after catheter removal

Firstly, when embarking on bladder retraining after catheter removal, use the procedure below to give you a good indication of what your bladder is capable of holding and for how long:

• Use the Bladder Record to count how many times you pass urine in 24 hours
• Look at the longest time you were able to go between visits to the toilet
• Look at the largest volume of urine you have passed during this period

Your aim is to increase the time between visits to the toilet. For example, if you find that you go every hour, you should try to go every 1.5 hours or as close to this as you can get.

If this also proves difficult, it may help to stand still or sit down on a hard surface when you feel the need to pass urine and wait for the sensation to pass, then go to the toilet next time the sensation returns.

When you have achieved this, continue to extend the time between visits to the toilet by a further 15-30 minutes.

Eventually, when you have retrained your bladder, you should find that you are only passing urine 6 – 7 times a day and either once or not at all during the night. Please remember that it is quite normal to need the toilet once during the night if you are over the age of 60 and sometimes more as you reach your 70s.

When things have improved, it is advisable to complete another 3-day record and compare the two. By this stage you should see a noticeable reduction in the number of times you go to the toilet and an increase in the volume of urine you pass each time.

Good luck with your bladder retraining programme.

Please remember you are not alone; many people are experiencing the same problems as you. Help and support are available and if you need further advice, please contact your healthcare professional.

This information has been produced with the kind assistance of the Clinical Nurse Advisors at Fittleworth.