Training The Bladder To Hold It

Yu Shing Ting
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Friday - May 16, 2007
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Anything over eight times a day is considered an overactive bladder
Anything over eight times a
day is considered an
overactive bladder

The other day I was stuck in traffic on the Pali Highway (Kailua bound) when I realized that I needed to go to the restroom. I was about halfway up the Pali and we were not moving.

I started to panic. The urge only got greater and I couldn’t do anything about it, except pray. Somehow I managed to get home without an “accident,” but I had to park, sprint and drop to safety.

“The best thing to do (when you’re in that emergency situation) is to take a deep breath, focus on tensing the pelvic floor muscles to the count of five, take another deep breath and hold tight again,” says Dr. Aileen Yee, urogynecologist and pelvic reconstructive surgeon. “Doing an effective Kegal squeeze will set up a reflex mechanism to relax the bladder and curb the sense of urge.”

According to Yee, it’s not necessarily bad to “hold it” in as long as it is within a reasonable time. Holding it too long could increase the risk of an urinary tract infection and temporary difficulties in emptying complete. A reasonable time frame is enough time where you can get to the restroom comfortably - without having to drop everything and run.

“What is considered normal (for the number of times an average adult should be going to the restroom) is eight times a day and waking up less than twice,” adds Yee. “Anything more than eight times a day is what’s considered an overactive bladder.”

An overactive bladder can be caused by a bladder infection, intake of various food and beverages that can act as bladder irritants (such as caffeinated beverages, alcohol, and acidic foods and juices), medications, diuretics and pregnancy. Some disease processes also can lead to voiding frequently, such as diabetes that is in poor control.

“Much of how to gain control of your bladder depends on the cause of poor bladder function,” notes Yee. “Generally speaking, there are pelvic floor exercises or Kegal exercises. This involves squeezing the muscles of the pelvic floor as if you are holding in urine or a bowel movement.

“Also, proper fluid management - drinking adequate but not excessive amounts of fluid or water, and avoiding intake of bladder irritants. For problems of urge incontinence or overactive bladder time voids, this involves trying to defer voiding and slowly increase the intervals between voids.

“For example, if you are voiding every one and a half hours without difficulty, you then would try to void every one hour and 45 minutes and week by week increase the interval between voids until voiding at a more reasonable time scale. In this manner you slowly retrain your bladder to get used to holding a more reasonable volume of fluid.”

In addition to those emergency bathroom trips, there are also those occasional “leaks” while sneezing, laughing or exercising.

Yes, you’re not the only one! According to Yee, it’s quite common, especially for women, and more so in women who have had multiple vaginal deliveries, especially women who have experienced difficult deliveries, have a history of pelvic surgery and a job or lifestyle requiring heavy and repetitive lifting.

“Leakage of urine is a common but not a normal part of the aging process,” says Yee. “If it is affecting your lifestyle - preventing you from doing what you want to be doing - there are a number of treatment options that are available that range from exercises, non-surgical options, medications, minimally invasive procedures that can help.

“You are not alone! Ask your doctor for further assistance.”

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