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Bladder Retraining forBladder Retraining for
Overactive BladderOveractive Bladder
Thursday, November 17, 2011Thursday, November 17, 2011
Presented by Jeannine McCormick, RN, MSN, CRNPPresented by Jeannine McCormick, RN, MSN, CRNP
Objectives & GoalsObjectives & Goals
 To equip individuals with the self-mastery toolsTo equip individuals with the self-mastery tools
of retraining their bladdersof retraining their bladders
 Empower individuals to be their own healthcareEmpower individuals to be their own healthcare
advocates through health educationadvocates through health education
 To understand and embrace the concept ofTo understand and embrace the concept of
“combination therapy” in which multiple“combination therapy” in which multiple
interventions are used in unison to manage andinterventions are used in unison to manage and
even alleviate symptomseven alleviate symptoms
Urge Incontinence (UUI): leakage dueUrge Incontinence (UUI): leakage due
to a sudden urge to urinateto a sudden urge to urinate
 Most common cause:Most common cause:
Overactive bladderOveractive bladder
(OAB)(OAB)
 OAB is characterizedOAB is characterized
by urinating more thanby urinating more than
8 times/day.8 times/day.
Astellas Pharmaceuticals
Urge IncontinenceUrge Incontinence
Possible Causes of OAB/Possible Causes of OAB/
Urge Incontinence:Urge Incontinence:
 Nerve damage caused by abdominalNerve damage caused by abdominal
trauma, pelvic trauma, or surgerytrauma, pelvic trauma, or surgery
 DiabetesDiabetes
 Drug side effectsDrug side effects
 Neurological disease and SCINeurological disease and SCI
(e.g., multiple sclerosis, Parkinson's(e.g., multiple sclerosis, Parkinson's
disease, stroke, spinal cord lesions)disease, stroke, spinal cord lesions)
NIDDK
Overactive Bladder TreatmentOveractive Bladder Treatment
 BehavioralBehavioral
 Dietary ChangesDietary Changes
 Fluid ManagementFluid Management
 Pelvic Muscle Exercises (Kegel exercises)Pelvic Muscle Exercises (Kegel exercises)
 BiofeedbackBiofeedback
 Bladder RetrainingBladder Retraining
 Pharmacological (Drug Therapy)Pharmacological (Drug Therapy)
 InvasiveInvasive
 Percutaneous tibial nerve stimulation (PTNS)Percutaneous tibial nerve stimulation (PTNS)
 Sacral nerve stimulation (SNS)Sacral nerve stimulation (SNS)
 BotoxBotox
Brain & Sphincter FunctionBrain & Sphincter Function
 Urine is made by the kidneys and
flows into the bladder where it is
stored.
 As the bladder fills and stretches, a
message goes to the brain that it is
time to urinate.
 The brain sends a message down to
the sphincter muscle whether or
not it is a good time and place to
go.
 The sphincter’s tension releases andThe sphincter’s tension releases and
the bladder muscle contracts tothe bladder muscle contracts to
empty itself of urine through theempty itself of urine through the
urethra to the body’s outlet.urethra to the body’s outlet.
Urinary Systems – Male & Female
Urinary AnatomyUrinary Anatomy
The urinary system is composed of two kidneys, twoThe urinary system is composed of two kidneys, two
ureters, a bladder, and a urethra.ureters, a bladder, and a urethra.
 KidneysKidneys- remove waste from- remove waste from
the blood, produce urine.the blood, produce urine.
 UretersUreters- move urine from the- move urine from the
kidneys to the bladder.kidneys to the bladder.
 BladderBladder- stores urine until it- stores urine until it
flows out of the body through theflows out of the body through the
tube-liketube-like urethraurethra..
 The sphincter-The sphincter- circular musclecircular muscle
that controls the activity of the urethra.that controls the activity of the urethra.
Think of the bladder as a balloon andThink of the bladder as a balloon and
the sphincter as the knotthe sphincter as the knot
 The bladder is an elasticThe bladder is an elastic
muscle that stretches tomuscle that stretches to
hold urine being senthold urine being sent
from the kidneys viafrom the kidneys via
ureters.ureters.
 The sphincter muscleThe sphincter muscle
remains tightly shut,remains tightly shut,
preventing urine frompreventing urine from
leaking out.leaking out.
www.medicineonline.com
The sphincter and the bladder areThe sphincter and the bladder are
perfectly coordinatedperfectly coordinated
When full, the bladderWhen full, the bladder
signals the brain, and thesignals the brain, and the
brain in turn signals thebrain in turn signals the
sphincter to relax andsphincter to relax and
open. The bladder thenopen. The bladder then
contracts and squeezescontracts and squeezes
all the urine out. Thenall the urine out. Then
the sphincter closesthe sphincter closes
tightly so the refilling cantightly so the refilling can
resume.resume.
The Good NewsThe Good News
 Controlling the bladder and sphincter muscle is
hard to do and may get more difficult as we get
older.
 Success for those experiencing symptoms of
urge incontinence and urgency associated with
overactive bladder (OAB).
Is Bladder Retraining for You?Is Bladder Retraining for You?
Do these symptoms describe you?Do these symptoms describe you?
 Urge Incontinence is the urgent need to pass
urine without warning and the inability to get to
the toilet in time. "When I have to go...I have to
go...“
 Overactive Bladder (OAB) is represented by
urgency, frequency exceeding eight times in 24
hours, and awakened at night two or more
times in order to urinate.
How to Prepare for an AppointmentHow to Prepare for an Appointment
to discuss Bladder Retrainingto discuss Bladder Retraining
 If you think that you have urge incontinence, stress urinary
incontinence, symptoms of both, or OAB, make an appointment
with your healthcare provider.
 For at least two days before your healthcare provider’s
appointment, complete a "Uro-Log" (Voiding Diary).
 http://www.nafc.org/uploads/pdf/OnlineUroLog.pdf
 Take the completed forms and this Bladder Retraining pamphlet
to your appointment to find out if the healthcare provider thinks
you will be helped by bladder retraining.
 Always consult your healthcare provider before trying anything
recommended in this or any other publication that speaks to
general health issues.
A Six Week Program to Retrain
your Bladder
 You Will Need:You Will Need:
 a “NAFC Continence Chart” from NAFC’s Bladder
Retraining pamphlet - available here:
http://www.nafc.org/online-store/consumer-leaflets-and-pamphlets/general-au
/
 a pencil or pen
 a clock
 a kitchen or pocket timer
 determination to stick with it
Week OneWeek One
 Urinate when you first get up in the morning.Urinate when you first get up in the morning.
 Empty your bladder as completely as you can and put a checkEmpty your bladder as completely as you can and put a check
( ) in the gray column beside the hour you used the toilet. Now✓( ) in the gray column beside the hour you used the toilet. Now✓
set your timer for one hour.set your timer for one hour.
 When the timer sounds, go to the toilet, even if you do not feelWhen the timer sounds, go to the toilet, even if you do not feel
the need to empty your bladder. If you urinate, put a check ( )✓the need to empty your bladder. If you urinate, put a check ( )✓
in the gray column. If not, leave it blank. Then set the timer forin the gray column. If not, leave it blank. Then set the timer for
one hour.one hour.
 When the timer sounds, go to the toilet, even if you do not feelWhen the timer sounds, go to the toilet, even if you do not feel
the need to empty your bladder. If you urinate, put a check ( )✓the need to empty your bladder. If you urinate, put a check ( )✓
in the gray column. Set the timer again for one hour. Continuein the gray column. Set the timer again for one hour. Continue
this through the day until you go to bed.this through the day until you go to bed.
Learning to Control the UrgeLearning to Control the Urge
 When you feel the urge to urinate before the timer sounds, try to
distract yourself.
 Think about a very complex task:
 balancing your checkbook
 naming the streets through your city to a mall on the other
side of town
 remembering all the words to a favorite song, nursery
rhyme, or hymn 
 Think about something especially fun:
 vacationing on an exotic island
 lying in a hammock in the shade
 watching the sunset over the ocean
Week TwoWeek Two
 Urinate when you first get out of bed in the morning.
 Put a check ( ) in the gray column beside the time you✓
used the toilet.
 Now set a timer or clock for 1½ hours. When the
timer sounds, go to the toilet. If you urinate, put a
check ( ) in the gray column beside the time. If not,✓
leave it blank.
  Set your timer or alarm clock for 1½ hours. When the
timer sounds, go to the toilet. If you urinate, put a
check ( ) in the gray column. Continue this all day.✓
Week Three through SixWeek Three through Six
 In weeks three through six, you will increase the
time between urination to one hour 45 minutes
in week three, two hours in week four, two
hours and 15 minutes in week five, and
anywhere between 2½ and three hours in week
six, depending on individual progress.
 Compare continence charts each week to review
improvement.
Tips for SuccessTips for Success
 If you find that complex mental tasks or relaxing thoughts do
not make the urge to urinate go away, you may try the following:
 Squeeze the muscles that hold back a bowel movement and
hold back urine until the urge passes — then relax.
 Roll up a bath towel and keep it on a firm chair. Sit on this
roll when you have a strong urge to urinate.
 Place a rolled towel between your legs and push it up against
your body
 Believe that you will be successful.
 Follow the program’s directions
 Give bladder retraining a full 6 to 8 weeks, and do not give up if
your progress stops for several days or if you have a setback.
Don’t be Discouraged by SetbacksDon’t be Discouraged by Setbacks
 Your bladder control problems may be worse
 when you are tired.
 when you have your mind on many things.
 when you feel tense and nervous.
 when you have a cold or stomach flu.
 on cold, rainy, windy days.
 right before a menstrual period (for women).
Mixed Incontinence: a combinationMixed Incontinence: a combination
of stress and urge incontinenceof stress and urge incontinence
Symptoms of one type of incontinence may be moreSymptoms of one type of incontinence may be more
severe than the other.severe than the other.
Canadian Continence Foundation
More Ideas for SuccessMore Ideas for Success
 Behavioral:
 Avoid alcoholic beverages, coffee and tea.
 Drink plain water as much as possible.
 Drink normal amounts of fluid evenly throughout the day. Six to eight glasses of water.
 Establish regular bowel habits. If you are constipated, add fiber to your diet, or use a laxative.
Discuss this with your health professional.
 Avoid going to the toilet "just in case." This may turn into a bad habit, and lead to frequent
urination.
 Pharmacological:
 Drug therapy may be used in conjunction with behavioral modifications to improve bladder
control.
 Invasive:
 Nerve stimulation is another treatment option. It uses mild electric pulses to stimulate a
sacral nerve in the lower back. This nerve influences the bladder and surrounding muscles
that control urinary function.
ResourcesResources
 To purchase a Bladder Retraining Pamphlet visit:To purchase a Bladder Retraining Pamphlet visit:
http://www.nafc.org/online-store/bladderretraining
 To purchase a Uro-Log Voiding Diary visit:To purchase a Uro-Log Voiding Diary visit:
http://www.nafc.org/online-store/urologhttp://www.nafc.org/online-store/urolog
 To become a member of NAFC visit:To become a member of NAFC visit:
http://www.nafc.org/support-nafc/http://www.nafc.org/support-nafc/
Support NAFCSupport NAFC
 “Like” us on Facebook at
http://www.facebook.com/BladderHealth
 Donate
 Subscribe to our newsletter and forward to friends
 By following NAFC on Twitter:
http://twitter.com/#!/BladderHealth
 Ask your doctor to support us by becoming a
professional member and ordering our patient
education materials for all their patients
Become a Member of NAFCBecome a Member of NAFC
 Benefits of Becoming a Member:Benefits of Becoming a Member:
 Patient ReferralsPatient Referrals
 NAFC Frontline Quarterly NewsletterNAFC Frontline Quarterly Newsletter
 Quality Care Monthly NewsletterQuality Care Monthly Newsletter
 Resource Guide – directory of products & services forResource Guide – directory of products & services for
bladder & bowel controlbladder & bowel control
 Caregivers Desk ReferenceCaregivers Desk Reference
 Bulk leaflet discounts for professional membersBulk leaflet discounts for professional members
 Online Inspire CommunityOnline Inspire Community
 1-800-BLADDER to speak with the Health Educator1-800-BLADDER to speak with the Health Educator
 http://www.nafc.org/support-nafc/http://www.nafc.org/support-nafc/
Thank you!Thank you!
Thank you for participating in the Bladder RetrainingThank you for participating in the Bladder Retraining
webinar. We will now have Jeannine answer somewebinar. We will now have Jeannine answer some
questions that you had during the presentation.questions that you had during the presentation.
Want Additional Info? Got questions?Want Additional Info? Got questions?
Call: 1-800-BLADDER (252-3337)Call: 1-800-BLADDER (252-3337)
E-mail: memberservices@nafc.orgE-mail: memberservices@nafc.org
Visit: www.nafc.orgVisit: www.nafc.org
This webinar is supported by anThis webinar is supported by an
educational grant fromeducational grant from

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Bladder Retraining

  • 1. Bladder Retraining forBladder Retraining for Overactive BladderOveractive Bladder Thursday, November 17, 2011Thursday, November 17, 2011 Presented by Jeannine McCormick, RN, MSN, CRNPPresented by Jeannine McCormick, RN, MSN, CRNP
  • 2. Objectives & GoalsObjectives & Goals  To equip individuals with the self-mastery toolsTo equip individuals with the self-mastery tools of retraining their bladdersof retraining their bladders  Empower individuals to be their own healthcareEmpower individuals to be their own healthcare advocates through health educationadvocates through health education  To understand and embrace the concept ofTo understand and embrace the concept of “combination therapy” in which multiple“combination therapy” in which multiple interventions are used in unison to manage andinterventions are used in unison to manage and even alleviate symptomseven alleviate symptoms
  • 3. Urge Incontinence (UUI): leakage dueUrge Incontinence (UUI): leakage due to a sudden urge to urinateto a sudden urge to urinate  Most common cause:Most common cause: Overactive bladderOveractive bladder (OAB)(OAB)  OAB is characterizedOAB is characterized by urinating more thanby urinating more than 8 times/day.8 times/day. Astellas Pharmaceuticals
  • 4. Urge IncontinenceUrge Incontinence Possible Causes of OAB/Possible Causes of OAB/ Urge Incontinence:Urge Incontinence:  Nerve damage caused by abdominalNerve damage caused by abdominal trauma, pelvic trauma, or surgerytrauma, pelvic trauma, or surgery  DiabetesDiabetes  Drug side effectsDrug side effects  Neurological disease and SCINeurological disease and SCI (e.g., multiple sclerosis, Parkinson's(e.g., multiple sclerosis, Parkinson's disease, stroke, spinal cord lesions)disease, stroke, spinal cord lesions) NIDDK
  • 5. Overactive Bladder TreatmentOveractive Bladder Treatment  BehavioralBehavioral  Dietary ChangesDietary Changes  Fluid ManagementFluid Management  Pelvic Muscle Exercises (Kegel exercises)Pelvic Muscle Exercises (Kegel exercises)  BiofeedbackBiofeedback  Bladder RetrainingBladder Retraining  Pharmacological (Drug Therapy)Pharmacological (Drug Therapy)  InvasiveInvasive  Percutaneous tibial nerve stimulation (PTNS)Percutaneous tibial nerve stimulation (PTNS)  Sacral nerve stimulation (SNS)Sacral nerve stimulation (SNS)  BotoxBotox
  • 6. Brain & Sphincter FunctionBrain & Sphincter Function  Urine is made by the kidneys and flows into the bladder where it is stored.  As the bladder fills and stretches, a message goes to the brain that it is time to urinate.  The brain sends a message down to the sphincter muscle whether or not it is a good time and place to go.  The sphincter’s tension releases andThe sphincter’s tension releases and the bladder muscle contracts tothe bladder muscle contracts to empty itself of urine through theempty itself of urine through the urethra to the body’s outlet.urethra to the body’s outlet. Urinary Systems – Male & Female
  • 7. Urinary AnatomyUrinary Anatomy The urinary system is composed of two kidneys, twoThe urinary system is composed of two kidneys, two ureters, a bladder, and a urethra.ureters, a bladder, and a urethra.  KidneysKidneys- remove waste from- remove waste from the blood, produce urine.the blood, produce urine.  UretersUreters- move urine from the- move urine from the kidneys to the bladder.kidneys to the bladder.  BladderBladder- stores urine until it- stores urine until it flows out of the body through theflows out of the body through the tube-liketube-like urethraurethra..  The sphincter-The sphincter- circular musclecircular muscle that controls the activity of the urethra.that controls the activity of the urethra.
  • 8. Think of the bladder as a balloon andThink of the bladder as a balloon and the sphincter as the knotthe sphincter as the knot  The bladder is an elasticThe bladder is an elastic muscle that stretches tomuscle that stretches to hold urine being senthold urine being sent from the kidneys viafrom the kidneys via ureters.ureters.  The sphincter muscleThe sphincter muscle remains tightly shut,remains tightly shut, preventing urine frompreventing urine from leaking out.leaking out. www.medicineonline.com
  • 9. The sphincter and the bladder areThe sphincter and the bladder are perfectly coordinatedperfectly coordinated When full, the bladderWhen full, the bladder signals the brain, and thesignals the brain, and the brain in turn signals thebrain in turn signals the sphincter to relax andsphincter to relax and open. The bladder thenopen. The bladder then contracts and squeezescontracts and squeezes all the urine out. Thenall the urine out. Then the sphincter closesthe sphincter closes tightly so the refilling cantightly so the refilling can resume.resume.
  • 10. The Good NewsThe Good News  Controlling the bladder and sphincter muscle is hard to do and may get more difficult as we get older.  Success for those experiencing symptoms of urge incontinence and urgency associated with overactive bladder (OAB).
  • 11. Is Bladder Retraining for You?Is Bladder Retraining for You? Do these symptoms describe you?Do these symptoms describe you?  Urge Incontinence is the urgent need to pass urine without warning and the inability to get to the toilet in time. "When I have to go...I have to go...“  Overactive Bladder (OAB) is represented by urgency, frequency exceeding eight times in 24 hours, and awakened at night two or more times in order to urinate.
  • 12. How to Prepare for an AppointmentHow to Prepare for an Appointment to discuss Bladder Retrainingto discuss Bladder Retraining  If you think that you have urge incontinence, stress urinary incontinence, symptoms of both, or OAB, make an appointment with your healthcare provider.  For at least two days before your healthcare provider’s appointment, complete a "Uro-Log" (Voiding Diary).  http://www.nafc.org/uploads/pdf/OnlineUroLog.pdf  Take the completed forms and this Bladder Retraining pamphlet to your appointment to find out if the healthcare provider thinks you will be helped by bladder retraining.  Always consult your healthcare provider before trying anything recommended in this or any other publication that speaks to general health issues.
  • 13. A Six Week Program to Retrain your Bladder  You Will Need:You Will Need:  a “NAFC Continence Chart” from NAFC’s Bladder Retraining pamphlet - available here: http://www.nafc.org/online-store/consumer-leaflets-and-pamphlets/general-au /  a pencil or pen  a clock  a kitchen or pocket timer  determination to stick with it
  • 14. Week OneWeek One  Urinate when you first get up in the morning.Urinate when you first get up in the morning.  Empty your bladder as completely as you can and put a checkEmpty your bladder as completely as you can and put a check ( ) in the gray column beside the hour you used the toilet. Now✓( ) in the gray column beside the hour you used the toilet. Now✓ set your timer for one hour.set your timer for one hour.  When the timer sounds, go to the toilet, even if you do not feelWhen the timer sounds, go to the toilet, even if you do not feel the need to empty your bladder. If you urinate, put a check ( )✓the need to empty your bladder. If you urinate, put a check ( )✓ in the gray column. If not, leave it blank. Then set the timer forin the gray column. If not, leave it blank. Then set the timer for one hour.one hour.  When the timer sounds, go to the toilet, even if you do not feelWhen the timer sounds, go to the toilet, even if you do not feel the need to empty your bladder. If you urinate, put a check ( )✓the need to empty your bladder. If you urinate, put a check ( )✓ in the gray column. Set the timer again for one hour. Continuein the gray column. Set the timer again for one hour. Continue this through the day until you go to bed.this through the day until you go to bed.
  • 15. Learning to Control the UrgeLearning to Control the Urge  When you feel the urge to urinate before the timer sounds, try to distract yourself.  Think about a very complex task:  balancing your checkbook  naming the streets through your city to a mall on the other side of town  remembering all the words to a favorite song, nursery rhyme, or hymn   Think about something especially fun:  vacationing on an exotic island  lying in a hammock in the shade  watching the sunset over the ocean
  • 16. Week TwoWeek Two  Urinate when you first get out of bed in the morning.  Put a check ( ) in the gray column beside the time you✓ used the toilet.  Now set a timer or clock for 1½ hours. When the timer sounds, go to the toilet. If you urinate, put a check ( ) in the gray column beside the time. If not,✓ leave it blank.   Set your timer or alarm clock for 1½ hours. When the timer sounds, go to the toilet. If you urinate, put a check ( ) in the gray column. Continue this all day.✓
  • 17. Week Three through SixWeek Three through Six  In weeks three through six, you will increase the time between urination to one hour 45 minutes in week three, two hours in week four, two hours and 15 minutes in week five, and anywhere between 2½ and three hours in week six, depending on individual progress.  Compare continence charts each week to review improvement.
  • 18. Tips for SuccessTips for Success  If you find that complex mental tasks or relaxing thoughts do not make the urge to urinate go away, you may try the following:  Squeeze the muscles that hold back a bowel movement and hold back urine until the urge passes — then relax.  Roll up a bath towel and keep it on a firm chair. Sit on this roll when you have a strong urge to urinate.  Place a rolled towel between your legs and push it up against your body  Believe that you will be successful.  Follow the program’s directions  Give bladder retraining a full 6 to 8 weeks, and do not give up if your progress stops for several days or if you have a setback.
  • 19. Don’t be Discouraged by SetbacksDon’t be Discouraged by Setbacks  Your bladder control problems may be worse  when you are tired.  when you have your mind on many things.  when you feel tense and nervous.  when you have a cold or stomach flu.  on cold, rainy, windy days.  right before a menstrual period (for women).
  • 20. Mixed Incontinence: a combinationMixed Incontinence: a combination of stress and urge incontinenceof stress and urge incontinence Symptoms of one type of incontinence may be moreSymptoms of one type of incontinence may be more severe than the other.severe than the other. Canadian Continence Foundation
  • 21. More Ideas for SuccessMore Ideas for Success  Behavioral:  Avoid alcoholic beverages, coffee and tea.  Drink plain water as much as possible.  Drink normal amounts of fluid evenly throughout the day. Six to eight glasses of water.  Establish regular bowel habits. If you are constipated, add fiber to your diet, or use a laxative. Discuss this with your health professional.  Avoid going to the toilet "just in case." This may turn into a bad habit, and lead to frequent urination.  Pharmacological:  Drug therapy may be used in conjunction with behavioral modifications to improve bladder control.  Invasive:  Nerve stimulation is another treatment option. It uses mild electric pulses to stimulate a sacral nerve in the lower back. This nerve influences the bladder and surrounding muscles that control urinary function.
  • 22. ResourcesResources  To purchase a Bladder Retraining Pamphlet visit:To purchase a Bladder Retraining Pamphlet visit: http://www.nafc.org/online-store/bladderretraining  To purchase a Uro-Log Voiding Diary visit:To purchase a Uro-Log Voiding Diary visit: http://www.nafc.org/online-store/urologhttp://www.nafc.org/online-store/urolog  To become a member of NAFC visit:To become a member of NAFC visit: http://www.nafc.org/support-nafc/http://www.nafc.org/support-nafc/
  • 23. Support NAFCSupport NAFC  “Like” us on Facebook at http://www.facebook.com/BladderHealth  Donate  Subscribe to our newsletter and forward to friends  By following NAFC on Twitter: http://twitter.com/#!/BladderHealth  Ask your doctor to support us by becoming a professional member and ordering our patient education materials for all their patients
  • 24. Become a Member of NAFCBecome a Member of NAFC  Benefits of Becoming a Member:Benefits of Becoming a Member:  Patient ReferralsPatient Referrals  NAFC Frontline Quarterly NewsletterNAFC Frontline Quarterly Newsletter  Quality Care Monthly NewsletterQuality Care Monthly Newsletter  Resource Guide – directory of products & services forResource Guide – directory of products & services for bladder & bowel controlbladder & bowel control  Caregivers Desk ReferenceCaregivers Desk Reference  Bulk leaflet discounts for professional membersBulk leaflet discounts for professional members  Online Inspire CommunityOnline Inspire Community  1-800-BLADDER to speak with the Health Educator1-800-BLADDER to speak with the Health Educator  http://www.nafc.org/support-nafc/http://www.nafc.org/support-nafc/
  • 25. Thank you!Thank you! Thank you for participating in the Bladder RetrainingThank you for participating in the Bladder Retraining webinar. We will now have Jeannine answer somewebinar. We will now have Jeannine answer some questions that you had during the presentation.questions that you had during the presentation. Want Additional Info? Got questions?Want Additional Info? Got questions? Call: 1-800-BLADDER (252-3337)Call: 1-800-BLADDER (252-3337) E-mail: memberservices@nafc.orgE-mail: memberservices@nafc.org Visit: www.nafc.orgVisit: www.nafc.org
  • 26. This webinar is supported by anThis webinar is supported by an educational grant fromeducational grant from

Editor's Notes

  1. Many studies over the years have supported the success of bladder retraining programs for both women and men
  2. Urge - The frequency of this occurrence determines the severity of the problem. OAB - Individuals can have OAB with or without urinary incontinence.
  3. It is important to prepare for this appointment in order to give your healthcare provider the most accurate information about your symptoms to obtain a complete diagnosis, as each set of symptoms is treated somewhat differently The uro-log records every time you eat or drink something and every time you use the toilet to urinate or have an accident and accidentally lose urine. If you have already been diagnosed and just learned about bladder retraining as a behavioral tool, ask your healthcare specialist if you can begin the program.
  4. (Use the Continence Chart included and mark it Week One.) If you have a hard time making it to the toilet when you get up, squeeze the muscle that holds back your urine before you get out of bed and count slowly to five. Then stand up and walk slowly to the toilet.
  5. The feeling that you need to go should pass and you may be able to wait until the timer sounds. If you cannot wait, go ahead and use the toilet. Make a check (✓) in the gray column corresponding to the hour that this urge occurred and you urinated. Resume your hourly scheduled toileting. Whenever you leak urine, put a check (✓) in the white column corresponding to the hour it happens. Write "D" for damp or "W" for wet beside the check in the white column corresponding to the hour this occurs. Change the damp or wet pad to a dry one. You are ready to progress when, for a one week period, you are able to urinate every hour without leakage in between and when you are able to control the urge in between.
  6. (Use the Continence Chart included and mark it Week Two.) If you feel like you may not make it to the toilet, squeeze the muscle that holds back urine before you get up and count to ten. Then get out of bed and walk slowly to the toilet. In Week Two, just as in Week One, you will record any leakage you have in the white column by the hour in which it happened. Be sure to discard wet pads and put on a dry one. When you feel the need to urinate before the timer has sounded, practice the distraction or relaxation techniques to control the urge until it passes. If you get uncomfortable and still have the urge to go, you may use the toilet. Do not be discouraged if this happens; it is normal. Your bladder problems did not happen overnight and they will not be cured overnight — or even in a week or two.   If you feel the need to urinate before the timer sounds when set at 1½ hours, you may opt to set the time for one hour and 15 minutes during Week Two. Then you can add increments of 15 minutes in the weeks that follow (Three through Six). Personalize our six week program as needed.   Once you have had 4-5 good days without leakage, you are ready to progress again.
  7. (Begin each week with a new Continence Chart.)