If you have conditions that produce urinary urgency or frequency, such as interstitial cystitis (IC), you can use bladder retraining to learn to control your urge to urinate and improve your symptoms, once your pain is under control.

Bladder retraining involves learning to urinate (void) on a set schedule, not when your bladder tells you to. Bladder retraining is usually part of an overall IC treatment plan that includes other therapies, but if you have no pain and only mild urinary urgency and frequency symptoms, bladder retraining may be the only therapy you need.

If your symptoms are varied and pain is your major symptom, you and your healthcare professional need to address the pain before you attempt bladder retraining.

Why “Retrain” the Bladder?

Whenever you experience pain or urgency in the bladder, the normal impulse is to urinate to stop the symptom. This establishes a pattern of frequent voiding, which can be difficult to reverse, even after your pain is controlled. To retrain your bladder, you will follow a series of simple steps to achieve longer and longer periods between urinations. Increasing bladder capacity is the objective, meaning that you will be able to hold more urine in your bladder and will not need to go as often.

How Do You Get Started?

Ask your healthcare provider to help you develop a bladder retraining program that suits your needs. If your symptoms are mild, you can even attempt bladder retraining on your own. Working with your healthcare team will encourage your success with bladder retraining methods and can help you stay with the program. Or, ask your healthcare provider for written instructions to explain the best approach for you and schedule regular follow-up visits to monitor your progress and encourage you. Keeping a bladder retraining diary can also help you monitor your progress and stay on track.

What is a Typical Program?

Often, programs begin with a four-week period of holding your urine for a set amount of time that is somewhat longer than your average voiding interval. For example, if you tend to void every 30 minutes, at your 30-minute mark, wait to void for 15 more minutes. Although the goal is to try to wait for the specified amount of time, even if you have the urge to void, go ahead and void if you have pain or discomfort before the time is up. On the other hand, if you feel the urge to urinate diminish after you wait, then try to keep waiting to stay on schedule.

Usually, after one month of training, you will increase your wait time, and after another month, you will increase it again. Although you will be trying to meet your voiding interval most of the time, it is okay if intervals are occasionally longer or shorter. Also, you don’t need to practice this technique throughout the night. The progress that you make during the day will help you to achieve a better voiding pattern around the clock.

Do Kegel Exercises Help People with IC?

Some bladder retraining programs recommend practicing Kegel exercises as part of bladder retraining. Kegel exercises are very frequently used to treat incontinence but can actually make IC symptoms worse. This is because Kegel exercises are designed to tighten the pelvic floor muscles. But people with IC often have pelvic floor dysfunction (PFD), and their pelvic muscles are too tight. For these patients, Kegel’s can cause further muscle tension and muscle spasms. There are, however, other exercises and stretches that you can do to ease muscle tension and reduce spasms. Ask your healthcare provider for a referral to a physical therapist who treats people with IC and pelvic floor dysfuction.

How Long Does It Take to Work?

If urinary urgency and frequency are your only symptoms, you may see improvement in a few weeks. If you have more severe urgency and frequency, bladder retraining may take longer. On average, it takes about three months to retrain the bladder. By using this technique, you can take more control of your urinary urgency and frequency symptoms.

What Else Can be Done?

For many people with IC, changes in diet can also help control symptoms. To learn more, check out the information about IC and food sensitivities. There are also over-the-counter products and prescription medicines that may help control symptoms of urinary urgency and frequency (as well as pain).

Revised Tuesday, May 26th, 2015