II. Indication
- Urge Incontinence (without Cognitive Impairment)
III. Mechanism
- Retrain pelvic mechanisms and CNS to inhibit urge Sensation between voids
IV. Technique
- Baseline voiding interval obtained
- Ask patient to void every 30-60 minutes
- Patient voids regardless of voiding Sensation
- Suppress urge to void before scheduled time
- Remain stationary at time or urge Sensation
- Concentrate on decreasing urge Sensation
- Rapid successive pelvic floor Muscle Contractions
- Distraction with other activities (e.g. math problems, crossword, soduko)
- Relaxation Techniques (e.g. breathing Exercises)
- After controlling urge Sensation walk slowly to bathroom to void
- Gradually extend intervals between voids to at least 30-60 minutes
- Longterm goal to extend voiding intervals to 3-4 hours without Incontinence
V. Monitoring
- Keep voiding and Incontinence diary
- Follow-up in clinic weekly
VI. Goals
- Increase voiding interval by 30 minutes per week
- Ultimately increase voiding interval to 2.5-3 hours