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Bladder Retraining Drill
Aka: Bladder Retraining Drill, Bladder Training
- See Also
- Incontinence
- Low Pressure Urethra (Type 3)
- Overflow Incontinence
- Urge Incontinence
- Stress Incontinence
- Functional Incontinence
- Medication Causes of Incontinence
- Three Incontinence Questions
- Enuresis
- Indication
- Urge Incontinence (without cognitive Impairment)
- Mechanism
- Retrain pelvic mechanisms and CNS to inhibit urge sensation between voids
- 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
- Monitoring
- Keep voiding and Incontinence diary
- Follow-up in clinic weekly
- Goals
- Increase voiding interval by 30 minutes per week
- Ultimately increase voiding interval to 2.5-3 hours
- Reference
- Fanti (1991) JAMA 265:609-13 [PubMed]
- Hersh (2013) Am Fam Physician 87(9): 634-40 [PubMed]
- Khan (2004) Clin Geriatr Med 20(3): 499-509 [PubMed]