Bladder training for urge incontinence

[Oppy]

Hi, I'm seeking success stories about bladder training for urge incontinence. I need some support!! I've always experienced "urge" to pee whenever I go near a bathroom, ever since being a child, but in the past 18 months the urge has become productive, sometimes quite prolifically productive. This is horrible when I'm on shift (I'm a ward nurse) and I'm with patients, especially if I'm helping them to the toilet...
My gp has recommended bladder training. I'm a few days in. It's so hard and I'm determined to give it good go but would love to hear that it might work. I'm 52, had one vaginal birth 16 years ago and a caesar 13 years ago, I'm slim and in reasonable shape. I was in much better shape prior to Covid. I have been on HRT for about 7 years - estrogen/Mirena/Testosterone gel. xx

Very timely post!

I saw recently a SM video from a Dr saying don’t go to the toilet ‘just in case’.

She basically confirmed that all the times I’ve gone to the loo before I get in the car, before I go somewhere, before I get in bed …then half an hour later because I’m getting really close to being able to drop off and wake myself up thinking ‘do I need to go?’ I have just trained myself to need the toilet when there is only a tiny bit in my bladder so now I have urinary urgency and need to retrain my bladder.

Did the Dr give you any information or just tell you to Google? Seemingly it should take 6-12 weeks?

I googled & this says 7-8 visits to the toilet a day! I can go every 30 mins -more if I’ve been but then need to go out so I have to go to the loo again.
www.ouh.nhs.uk/patient-guide/leaflets/files/65610Poveractivebladder.pdf

If you are a few days in how often, if you don’t mind me asking, were you going and are now going?

I really hope it works as I have been dangerously close to not getting to the toilet in time. I had been doing PFE religiously the last 3 years in the hope I didn’t get any worse. I know now what I have to do.

It’s not going to be easy at all.

Hi, the doc sent me link to bladder and bowel (oh the glamour)
www.bladderandbowel.org/bladder/bladder-conditions-and-symptoms/urgency-and-urge-incontinence/

I read somewhere that 6 or 7 pees a day is normal. I do way over that but I've not counted yet because I keep forgetting. I'm building up to starting a diary. Because it's so hard to control when I'm up on my feet, what I've been doing is waiting/trying to ignore for a set few minutes (ie not "as long as I can" because it's too scary) then when I sit on the loo I try to count to 20 before I release, and then only when the urge has gone. It comes in waves and it's very very hard to control, it's like a spasm but I think peeing when the wave has abated will count towards training. I don't really know what to do to be honest. Maybe it's abating a bit, but until I start the diary which I intend to do properly tomorrow, I can't really tell.

If you start doing daily pelvic floor exercises. Two times a day ten times each time.

This should tighten up the pelvis slowly.

I started things week ago I am 58 and my periods only stopped August 2019 at age 56. always drink a lot of water. Once a week I drink a Dioralyte sachet for electrolytes. I really do think in time the Level exercises will help plus am commencing Pilates classes from Apri l. Will help tighten uterus bladder bowel back and hips.

Good luck

Kegel not level. My tablet has a mind of its own.

I have the NHS Squeezy app.
It reminds me to do pelvic floor exercises 4 x a day so mine isn’t a muscle issue, it a bladder signaling issue.

Thanks for the link Oppy, will have a read when I get in from work. I will do my best not to go so often today but I’m already on number 2!

Do pelvic floor exercises work effectively specifically with stress incontinence? I don't have trouble when running or jumping or sneezing etc so not sure if I have a physical weakness there. I'll try the squeezy app though just in case, thanks. I'm going to try and pee to a schedule today whether I need to or not like in the advice

Pelvic floor muscles weaken during menopause because of the reduction in oestrogen. Keeping PFM strong can really help.

There’s a great women’s physio who is passionate about helping women & she gives a good description of how to do the exercises properly at the bottom of this link. I had no clue I’d spent the last decade doing them ineffectively! All this ‘squeeze as if stopping the flow of urine’ - nope! You have to clench your bum as if you want to stop a fart escaping.

www.gussetgrippers.co.uk/corona-virus-and-pelvic-floors

I forced myself to miss a couple of toilet trips yesterday, the urge actually went once I kept myself busy so I will keep it up and see how it goes. I didn’t write them down though & wish I had so I can check my progress, I will start that today.

Are you on any vaginal oestrogen (Vagifem)? The urge you describe can be due to lack of oestrogen in the tissues of the bladder as well as the vagina. Just a thought.

Urge incontinence is not the same as stress incontinence as you said OP.

Sometimes pelvic floor exercises can make UI worse - tight pelvic floors have issues too :)

has your gp not suggested meds? There are meds for urgency- one was Vesicare- might be a different name now. I'd suggest you ask about this and use it along with bladder training.

I'd also second the suggestion of using vaginal estrogen which is used for urgency. Many women use this as well as hrt.

@Dontbeatroll

Pelvic floor muscles weaken during menopause because of the reduction in oestrogen. Keeping PFM strong can really help.

There’s a great women’s physio who is passionate about helping women & she gives a good description of how to do the exercises properly at the bottom of this link. I had no clue I’d spent the last decade doing them ineffectively! All this ‘squeeze as if stopping the flow of urine’ - nope! You have to clench your bum as if you want to stop a fart escaping.

www.gussetgrippers.co.uk/corona-virus-and-pelvic-floors

I forced myself to miss a couple of toilet trips yesterday, the urge actually went once I kept myself busy so I will keep it up and see how it goes. I didn’t write them down though & wish I had so I can check my progress, I will start that today.

you have to clench and lift all 3 openings. You aren't supposed to clench your bum cheeks, just the area where you'd fart! (as well as the vagina and where you pee- all 3 at once.)

You aren't supposed to clench your bum cheeks

I know, I didn’t mean bum cheeks & I just meant it’s not just stopping the flow of urine we were told to do in the 80’s/90’s, I was typing quickly before running out the door for work, but I did put the link there as there is a very full explanation of technique.

Happy to say I’ve got my toilet visits down -mostly. Just dragging the time between visits out. There has been a few near misses though but I will persevere.

Vagifem and Ovestin made my bladder less sensitive. It may help with all the other stuff you are doing.

Interesting thread. I went to my GP a year ago (well, phoned her up) with what I was calling 'a weak bladder' and she was very robust that it was NOT my age, not a weak bladder and that I just needed to do bladder training. It fell off because of getting Covid (i.e. I had other fires to fight) but I really must get back on with it. She gave me zero resources though, so this is all very helpful.

I take Vesicare /Regurin/Solfenaci n for Overactive Bladder. It helps a bit, but I'm still very anxious about being out and about. Could that be a solution for you?

Just Seen this thread and I'm going to follow with interest.
I think I have trained myself to need the toilet all the bloody time (if that makes sense).
I'm nearly 49 with no menopause in sight (I'm regular as clockwork and no other symptoms), but this must be on the horizon somewhere.

@OnTheHillNotOverIt

Vagifem and Ovestin made my bladder less sensitive. It may help with all the other stuff you are doing.

I use vagifem, can ovestin be used at the same time?

I use the Ovestin on my vulva and the vagifem as a pessary.

Thanks for the advice and pessary and cream tips. Not something I had considered. I’ve been counting my visits to the toilet for wees and I think just doing this helps. Because I’m now down to hovering between 7-9 which is not too bad. When I’m at home I’m actually peeing in a measuring jug because I’m curious to see what I’m capable of holding. I looked up the average and it’s between about 300 and 700 per void. I’m fairly tiny… my voiding is about 250 to 300, and my morning one is 400. So void volume okay, number of visits not bad. I’m hoping to improve both a bit though. Even 50 mls would be helpful (representing maybe up to an hour kidney filtering) So my problem is the overwhelming spasming I experience. I’m trying so hard to hold off, wait til the spasm abates, sit on the toilet and wait for whatever I can count to, I’m pulling up all my holes (PMSL) but keep losing a bit of wee almost every time. I’m still using normal panty liners but I know I should really upgrade to Tena type things. I’ll have to soon if I can’t get a grip on this situation because work have ordered me pale grey uniforms (I’m in navy atm) I just can’t quite bear to buy them because someone might see 😳

@OnTheHillNotOverIt

I use the Ovestin on my vulva and the vagifem as a pessary.

How do you get ovestin on your vulva?

Ovestin is a cream like canestan. It can just be smoothed on. It also comes with an applicator to use in vagina.

I found a perifit really helped

@OnTheHillNotOverIt

Ovestin is a cream like canestan. It can just be smoothed on. It also comes with an applicator to use in vagina.

I see so it’s still a measured dose. I worry about using the varied amounts of hormones because I used to cause myself all kinds of problems when I was a bit slap dash and inconsistent with my sprays and gels. My hrt mix is working really well now (took a good couple of years to balance) and I don’t want to upset it so I’ll speak to go about the pessary and cream. If the help with spasms is a matter of getting all that area into good condition then I’m not sure if it would be of benefit because all is good (for now) in my undercarriage region

@Alonelonelylonersbadidea

Just Seen this thread and I'm going to follow with interest. I think I have trained myself to need the toilet all the bloody time (if that makes sense). I'm nearly 49 with no menopause in sight (I'm regular as clockwork and no other symptoms), but this must be on the horizon somewhere.

I think I did that too - just went to the loo whenever I got the remotest urge. Got a lot of disconnecting to do between brain and bladder now. Why did no one tell us this might happen?!

@absolutelynotfabulous

I take Vesicare /Regurin/Solfenaci n for Overactive Bladder. It helps a bit, but I'm still very anxious about being out and about. Could that be a solution for you?

Maybe, but I know antimuscarinics are not without side effects. Are they the sort of things that can help you to re-train them you can stop or are you on them forever? They must help you? Significantly?

I don't have a lot of advice but I'm joining this thread as I'm very much affected by these 'spasms' combined with leaks, and you've spurred me to do something about it.

I'm wearing my period underwear this week (Modibodi - already had these to cope with crazy peri bleeding) as a bit of a safety net so I can yell NO! at my spasms and ignore them as long as possible!

It will difficult if walking around a ward but I've found sitting on a hard chair helps with holding things in til the urge passes. Standing is much harder.