Bladder training

The aim of bladder training is to help you gain better control over your bladder.  This will allow you to:

  • reduce the constant need to go to the toilet (frequency)
  • put off going to the toilet until your bladder is full, and
  • increase the volume of urine you pass when you do go to the toilet. 

What are normal bladder habits?

A healthy bladder can hold one and a half to two cups (300-400mls) of urine during the day and about four cups (800mls) at night.  It is normal to pass urine five or six times a day if you drink between 6-8 glasses of fluid.  It is usual to empty your bladder when you get out of bed in the morning, three times during the day, and before you go to bed at night. As we age this pattern may change, as older people tend to make more urine at night.

A bladder training program

The Continence Foundation recommends working with a continence nurse advisor or physotherapist to design a bladder training program to suit your individual needs. Bladder training programs may take up to three months, with weekly or fortnighly appointments to monitor your progress and measure your improvement.

Most bladder training programs will start by asking you to keep a bladder diary. Download notes to help fill out a bladder diary. Every time you pass urine, you record the date, time and how much urine you passed. You will need to do this for a few days to idenitfy how much your bladder holds and how often you need to empty it. You should also include comments about leaking or other symptoms such as burning or pain.

How do I measure my urine?

To measure the amount of urine you pass, put a container (like an ice cream container) in the toilet bowl. Sit on the toilet and pass urine into the container. When you have finished, measure the urine by tipping it into a measuring jug. For men, you may prefer to stand and pass urine directly into the measuring jug.  You should note the measurement from the jug in your bladder diary, then tip the urine into the toilet and flush.

You can also use abosrbent pads to work out how much urine you leak over one or two days. This is done by using a dry pad that has been weighed in a plastic bag. When you change the wet pad you put it back in the plastic bag and weight it. If you take away the weight of the dry pad from the weight of the wet pad you can work out how much urine you have leaked. One millilitre (ml) of urine weighs one gram.

For example:

 Wet pad

350 grams 

 Dry pad

150 grams 

 Weight difference

250 grams 

 Amount leaked

250 mls 

What will I learn?

Your continence professional will teach you how to use your pelvic floor muscles. These muscles support your bladder and urethra (the tube that carries urine from the bladder to outside) and help to hold back the strong urge to pass urine. This will help you defer (put off) going to the toilet, or hold it in until you reach a toilet.

Over time, you should notice not needing to go to the toilet all the time, being able to stop yourself from going and passing more urine when you do go.  You will also learn about diet and lifestyle modifications, including how to manage constipation (and straining), which can cause poor bladder control.

Bladder training takes time, so don't worry if it feels like things are not improving right away. The important thing is to keep trying, make note of the things that make a difference, and stay positive.