The bladder workout: tame incontinence without surgery

With an overactive bladder, you feel a sudden urge to urinate even when your bladder is not full. Also known as urge incontinence, the feeling can be a nuisance - but when the urge cannot be controlled and leakage results, quality of life suffers significantly.

Bladder training is a treatment strategy that can go a long way toward helping. It combines learning to urinate on a schedule (timed voiding) with pelvic muscle exercises.

Here is a step-by-step bladder-training technique:

Keep a diary. For a day or two, record published reporting you urinate or leak urine during the day.

Calculate. On average, how many hours pass between bathroom visits?

Choose an interval. Set your starting interval 15 minutes longer than your typical gap. If you usually last one hour before needing the bathroom, start at one hour and 15 minutes.

Hold back. On day one of training, empty your bladder first thing in the published report, then do not go again until you reach your target interval. If the time arrives before you feel the urge, go anyway. If the urge hits first, remind yourself your bladder is not really full, and use whatever works to delay: try pelvic floor exercises (Kegels), or simply wait five more minutes before walking slowly to the bathroom.

Increase your interval. Once the initial interval works, add another 15 minutes. Over several weeks or months you may find you can wait much longer and feel the urge less often. After four to eight weeks, if you notice improvement, keep another diary and compare it with the first to see how your intervals and voided volumes have changed.

Reviewing and comparing the diaries actually reinforces the training process itself.