Bladder retraining is a self-help process by which patients suffering from conditions that produce urinary urgency and/or frequency learn to control their urge to urinate to help improve their symptoms. For patients who symptoms are varied and for whom pain is the major symptom, the pain must be addressed before bladder retraining can be effective. However, if urinary urgency is the only symptom, improvement can be evident within several weeks. With more severe urgency and frequency, bladder retraining may take longer. On average, it takes about three months to retrain the bladder.
Whenever a patient experiences pain or urgency in the bladder, the normal impulse is to urinate in order to stop the symptom. This establishes a pattern of frequent voiding, which can be difficult to reverse. The goal of the bladder retraining is to follow a series of simple steps to achieve longer and longer periods between urinations. Rehabilitation of the weakened bladder muscle is the objective, with increased urinary capacity and reduction of discomfort the expected result.
Working with a urologist, a program is established for each patient beginning with a four week period of holding the urine for a minimum of a certain number of minutes or hours (based on the individual’s current average voiding schedule). The patient is encouraged to wait a specified period after the first urge is felt before urinating (15 minutes, for example). If pain is felt before the period has elapsed, voiding is encouraged. If after waiting, the need to urinate has diminished, then the patient waits to urinate until the next urge to void is felt. At the end of one month, the time interval is increased, and at the end of the second month, the interval is increased again. The goal is to have the patient meet the required interval most of the time. It is acceptable if intervals are occasionally longer or shorter, as long as the minimum interval occurs most of the time.
For many people with IC, changes in diet can also help control symptoms. There are also over-the-counter products that may help control symptoms of urgency and frequency.
Revised November 2, 2008