How To Train Your Bladder To Reduce Bathroom Trips

Liquid Intake and Urge Incontinence

Drinking 10 to 12 glasses of water a day—80 to 96 ounces—may cause you to go pee every hour or two. This frequency is too often, especially for those with overactive bladder, Harvey Winkler MD, co-chief of urogynecology and director of female pelvic medicine and reconstructive surgery at North Shore–Long Island Jewish Health System in Great Neck, N.Y., told Health.

Cheryl Iglesia, MD, section director of female pelvic medicine and reconstructive surgery at Washington Hospital Center, in D.C., told Health that she tells patients to drink when thirsty, but limit the total to 70 ounces of liquid a day.

Also, avoid caffeine and alcohol because of their diuretic effects, which means they help you move extra fluid and salt out of your body, causing you to urinate more frequently.

Log Your Bathroom Trips

The first step in bladder training is to keep a voiding diary. For two or three days, make a note of every time you urinate as well as what you drink. This information will give you a baseline as you work on reducing trips.

As you go through the bladder training process, a voiding diary helps you gauge your progress and keeps you motivated.

Timimg Trips During Bladder Training

Based on the information from your voiding diary, come up with a comfortable interval between bathroom trips. Then set an interval timer or stopwatch and keep to this schedule during your waking hours.

This is known as "timed voiding." If the time is up and you don't have to go, empty your bladder anyhow. You should also empty your bladder when you wake up in the morning. At night, only go if you wake up and feel the urge.

Increase Time Between Trips

Once you're comfortable with your voiding schedule, extend the amount of time between bathroom trips by 15 minutes. For example, if you're urinating every hour and 15 minutes, stretch that out to an hour and a half for a week.

Once you're ready, you can shoot for an hour and 45 minutes. The goal is to get to the point where you're urinating every three hours or so. However, the specific timing is up to you.

Wait Five Minutes

If you feel the urge to go before the scheduled time, see if you can hold off for five minutes.

"What we're trying to do is retrain so the mind is in control of the bladder," Thinh Duong, MD, an associate at Southern California Permanente Medical Group, in Los Angeles, told Health.

Use techniques—including Kegel exercises and deep breathing—to fight the urge to urinate. If your "mind over bladder" efforts succeed, stick to your schedule. If these efforts do not work, go to the bathroom and then restart your schedule.

Be Patient

It may take up to three months to reach your bladder training goals, and you may have a few setbacks, but try not to get discouraged.

You should start seeing steady progress by six weeks or so, and some patients see results after only one week, said Dr. Iglesia, who also serves on the American College of Obstetricians and Gynecologists' board for patient education.

Bladder Training With Kegel Exercises

Kegel exercises—which involve contracting the muscles around the vagina almost as if you were "lifting" your pelvic floor—can greatly improve your chances of bladder training success.

Have a healthcare provider examine you while you do a Kegel to make sure you've got it right, said Dr. Iglesia, adding that about half the people in her practice do the exercises incorrectly.

Dr. Iglesia also suggested starting with 10 quick contractions, and then another 10 "reps" that you hold for five to 10 seconds each. Aim for two to three sets a day.

Consider Biofeedback

Some people have a hard time figuring out how to do Kegel exercises. A technique called biofeedback can help.

It involves placing a device with a sensor inside the body to measure pelvic muscle activity. A small tampon-like device is usually inserted in the vagina, or the therapy is done with sensors that fit in the anus.

As you do Kegels, you'll get visual or auditory feedback that will show whether you're contracting the right muscles, and how strong your contractions are.

Try Electrostimulation

While most people with vaginas can learn to do Kegels, some have childbirth-related damage to the nerves and muscles that make it nearly impossible to perform these contractions.

In this case, you can try electrostimulation, which involves stimulating muscles of the pelvic floor and bladder with electric impulses. Studies have found that electrical stimulation can be as effective as medication at improving incontinence.

For instance, a study in Physiotherapy Theory and Practice found that pelvic floor muscle electrical stimulation significantly improved urinary incontinence in study subjects.

Get Support

While you can train your bladder on your own, getting support from a professional really helps.

"Just like with any exercise, we slack off," said Dr. Winkler. Support and feedback can keep you on track.

A healthcare provider can refer you to a continence nurse practitioner or a physical therapist with expertise in bladder training.

Try Vaginal Weights

Vaginal weights can help in the effort to train your bladder by helping to ensure you work the right muscles during Kegels. You may have seen devices, usually weighted cones or balls, that promise to strengthen pelvic muscles when placed in the vagina.

Still, they are not a silver bullet. Studies, such as a 2013 study published in Cochrane Library, have found that weights are no more effective than Kegels alone or electrostimulation.

"Don't just go order them out of the catalog without asking your doctor," said Dr. Iglesia. "It could be a waste of your money and very discouraging."

If you decide to use weights, which involves inserting balls or cones in the vagina and squeezing the pelvic muscles to hold them in place, do these exercises in the morning. The muscles become tired later in the day.