Learn about urethra and bladder training for urinary incontinence.
Incontinence is a common, but frustrating issue. The good news is that several urinary incontinence treatment options exist to help resolve or ease symptoms. And some of those options are bladder-training techniques you can do at home and throughout the day to train either your urethra or bladder, depending on the type of incontinence you are experiencing: stress or urge.
“The urethra’s job is to maintain continence,” said Dr. Rony Adam, a urogynecologist at Vanderbilt Center for Women’s Health. “The bladder’s job is to empty itself when it needs to empty and to hold comfortably when it needs to hold.”
What is urethra training?
Urethra training may help with what’s called stress incontinence, which is when you leak urine involuntarily when you laugh, cough, sneeze or do physical activity. Kegel exercises for the pelvic floor muscles can be beneficial.
“What these exercises do is increase the ability of the urethra to squeeze closed,” Adam said.
However, some technique nuances are crucial.
“What these exercises do is increase the ability of the urethra to squeeze closed.”
“There are two different kinds of muscle fibers in the levator ani muscle, which is the Kegel muscle,” he said. “It’s thought that training both types of fibers is beneficial.”
Long and slow contractions train slow-twitch muscle fibers, while shorter and faster contractions train the fast-twitch muscle fibers. For the latter, a person squeezes hard for a second and then releases.
With long and slow contractions, Adam explained, the goal is to train the muscle to be able to grab for longer and longer periods. With the briefer contractions, the goal is to increase the amount of repetition before the muscle fatigues.
What is bladder training?
Bladder training is used to teach the bladder to hold more volume in a gradual manner. It’s a useful treatment option for those experiencing urge incontinence, also called overactive bladder.
“We do things like time voiding where, whether you think you need to go or not, you go to the bathroom at a certain interval,” Adam said.
“Once we have a baseline frequency and we see that it’s abnormal, then we could tell patients to do time voiding at that interval and then gradually start increasing those intervals by small increments.”
Your care provider can help determine the right interval based on your baseline urinary frequency.
To determine the baseline frequency, Adam encourages the use of a bladder diary for a few days to log when you go to the bathroom and how much urine you void.
“We send patients home with what we call a bladder hat that sits in the toilet and measures the urination each time,” he said.
The bladder diary helps determine the actual frequency rather than what’s self-reported, since remembering when you went and guessing how much is inaccurate.
“Once we have a baseline frequency and we see that it’s abnormal, then we could tell patients to do time voiding at that interval and then gradually start increasing those intervals by small increments,” Adam said. “That’s what we actually mean by true bladder training.”
Avoiding bladder irritants
Another factor in bladder training is to eliminate certain items from your diet.
“None of this works if you don’t knock out the caffeine and the alcohol and the other things that make a kidney make more urine more quickly.”
“None of this works if you don’t knock out the caffeine and the alcohol and the other things that make a kidney make more urine more quickly,” Adam said.
These substances are also considered bladder irritants, which can make your urinary incontinence symptoms even worse.
Paying attention to how much water you drink may also be beneficial. While staying hydrated is important, the kidneys will get rid of excess fluid, causing someone to have to go more frequently if they’re drinking much more water than necessary, Adam said.
When to see a doctor for urinary incontinence
If you’re experiencing incontinence, Adam said to first assess what you’re drinking and how often you’re drinking. Does cutting caffeine or alcohol help? Or if you’re drinking an excessive amount of water or other fluids, does reducing the amount help?
“I believe in self-empowerment,” Adam said.
However, if the incontinence continues despite these changes, he recommends consulting with your OB-GYN or a urogynecologist.
Keep in mind that some medications, such as diuretics used to treat heart conditions, can increase the need to go. Do not stop taking your medications, however, Adam cautioned. Consult your doctor regarding any side effects.
Back to a fuller life
As women’s health and urogynecology experts, the Urogynecology and Pelvic Reconstructive Surgery team at Vanderbilt offers personalized care for females experiencing bladder-related symptoms and conditions. These experts are here to help find answers and treatment so you can live a fuller life. Call 615-343-5700.