What to know about bladder training for overactive bladder, and how to do it

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Bladder training goes by several other names, including “bladder retraining,” “bladder re-education,” and “bladder drill.” Although scientists have not yet decided on a standard definition of balder training, this non-pharmacological treatment generally involves the following elements:

• educating the individual about how bladders and urination work
• a training program for urinating at fixed intervals, which gradually increase over time
• a program of positive reinforcement to maintain the practice

The average length of bladder training therapy is between 8-12 weeks. People can receive bladder training therapy individually or as part of a group.

OAB is a condition that makes people experience frequent and urgent needs to urinate. As a 2020 article explains, bladder training might improve someone’s OAB in several different ways:

• by helping people to divert their attention from the felt need to urinate
• by helping people to relax, making them less anxious about frequently urinating
• by cultivating the willpower to urinate less frequently
• by increasing a person’s physiological capacity to hold urine

It is worth noting that doctors may recommend other therapies alongside bladder training. These could include other non-pharmacological interventions such as pelvic floor muscle training.

A doctor’s recommended treatment plan may also include some pharmacological treatments.

One important benefit of bladder training is that it is a very low risk treatment option. Of course, whether the intervention is beneficial will also depend on its effectiveness. However, there is scientific evidence that bladder training can improve symptoms of OAB.

For example, a 2018 randomized control trial looked at a group of women aged 22 and 65 who all had OAB.

The trial asked these women to record the severity of their symptoms and their quality of life over a 12-week period. During this time, those women who received bladder training therapy reported the following:

• improved quality of life
• less frequent urges to urinate
• weaker urges to urinate
• fewer accidents

Bladder training may also prove effective in treating urinary incontinence, which is when someone struggles to control when they urinate.

One small pilot study noted an improvement in bladder control amongst a group of older women who combined bladder training with exercise.

A 2019 study also suggests that bladder training could improve urinary incontinence when implemented alongside pelvic floor muscle training.

However, both studies had obvious limitations. To fully understand its effectiveness, scientists must produce more research into the use of bladder training for OAB.

Bladder training exercises can vary from program to program. Some commonalities nonetheless do exist. One study lists them as follows:

• keeping a bathroom schedule with the intention of urinating at regular intervals throughout the day
• slowly increasing the length of those intervals by 5, 10, 15, or 20 minute periods
• avoiding going to the bathroom without a strong urge to urinate
• trying to wait a few moments before urinating, despite any strong urge to urinate

It can be more difficult to keep to this program during the night. Beginning the program as a daytime exercise may be more helpful for most people, at least in the initial stages of bladder training.

OAB is a common condition. However, its effects can be serious.

As a 2018 review explains, one symptom of OAB is nocturia, which means waking up during the night to urinate. Nocturia disrupts people’s sleep, which is a vital bodily process. There is evidence that nocturia can lead to the following health problems:

• poor quality sleep
• decreased quality of life
• depression

Anyone experiencing nocturia may wish to speak with a doctor about bladder training and other OAB therapies. The same goes for people with OAB who do not experience nocturia since even daytime symptoms can be disruptive.

Common treatments for OAB include lifestyle modifications, avoiding bladder irritants, and pharmacological therapy.

Patients with bladder symptoms who have not yet received a diagnosis should see a doctor to ensure they do not have an infection, blood in the urine, cancer, or other problems.

OAB is a common condition that can significantly impact peoples’ lives.

Although a more detailed picture will emerge with more research, scientists have shown that bladder training could help some people to manage their OAB.

There is also evidence that bladder training could help some individuals with urinary incontinence problems.