Bladder Training

Bladder training- Continence (Bladder) Training

Goal:
• to restore the bladder to normal function.
• Bladder training can be used with cognitively intact patients
experiencing urge incontinence.
• It requires the client to postpone voiding, resist or inhibit
sensation of urgency and void according to a time-table
rather than according to urge to void.
• The goals are gradually to lengthen the intervals between
urination to correct client’s frequent urination, to stabilize
the bladder, and to diminish urgency.
• This form of training may be used for clients
who have bladder instability and urge
incontinence.
• Initially voiding may be encouraged every 2
to 3 hours except during sleep and then
every 4 to 6 hours.
• A vital component of bladder training is
inhibiting the urge-to-void sensation. To do
this, the nurse instructs the client to practice
deep, slow breathing until the urge
diminishes or disappears.
Guidelines for Bladder Training
- Determine the client’s voiding pattern at those
times, or establish regular voiding schedule toileting
based on fixed schedule, not the patient’s urge to
void and help the client to maintain it, whether the
client feels the urge or not The schedule may be set
by a time interval, every 2 t0 3 hours or at times of a
day such as before meals and after meals (e.g. on
awakening, every 2 to 3 hours during the day and
evening, before retiring at night, every 4 hours at
night).
- The stretching – relaxing sequence of such
schedule tends to increase muscle bladder
tone and promote more voluntary control.

- Encourage the client to inhibit the urge to void

sensation when a premature urge to void is
experienced. Instruct the client to practice
slow, deep breathing until the urge diminishes
or disappears.
- When the client finds that voiding can be controlled,
the intervals between voiding can be lengthened
slightly without loss of continence.

- Regulate fluid intake particularly in the evening hours,

to help reduce the need to void during night.

- Encourage fluids between the hours of 0600 to 1800.

- Avoid excessive consumption of citrus juices,

carbonated beverages, (especially those containing
artificial sweeteners), alcohol, and drinks containing
caffeine because these irritate the bladder, increasing
the risk of incontinence.
- Schedule diuretics early in the morning

- Explain to clients that adequate fluid intake is required

to ensure adequate urine production that stimulates
the micturation reflex.

- Apply protector pads to keep bed linen dry and

provide especially waterproof underwear to contain
the urine and decrease the client’s embarrassment.
Avoid using diapers, which are demeaning and suggest
that incontinence is permissible.
- Assist the client with an exercise program to increase the
general muscle tone and a pelvic muscle exercise program
aimed at strengthening the pelvic floor muscles. This exercise
program is commonly called Kegel exercise work by increasing
the pressure within the urethra by strengthening the pelvic
floor muscles & inhibiting unwanted bladder contractions.

- Provide positive reinforcements to encourage continence.

Praise clients for attempting to toilet for maintaining
continence.