bladder training


Bladder Training

 

Definition

Bladder training is a behavioral modification treatment technique for urinary incontinence that involves placing a patient on a toileting schedule. The time interval between urination is gradually increased in order to train the patient to remain continent.

Purpose

Bladder training is used to treat urinary urge incontinence. Urge incontinence occurs when an individual feels a sudden need to urinate and cannot control the urge to do so and, as a consequence, involuntarily loses urine before making it to the toilet.

Precautions

Incontinence may be controlled through a number of invasive and non-invasive treatment options, including Kegel exercises, biofeedback, bladder training, medication, insertable incontinence devices, and surgery. Each patient should undergo a full diagnostic work-up to determine the type and cause of the incontinence in order to determine the best course of treatment.

Description

Bladder training may be prescribed and implemented by a general physician, urologist, or urogynecologist. A urination schedule is created for the patient. The schedule typically starts out with fairly short intervals between bathroom breaks (e.g., an hour). As soon as the patient is able to consistently remain continent for several days at a certain toileting time interval, the time span is increased. Bladder training continues until the patient regularly achieves continence at a time interval he/she feels comfortable with.

Preparation

A complete evaluation to determine the cause of urinary incontinence is critical to proper treatment. A thorough medical history and physical examination should be performed on patients considering bladder training. Diagnostic testing may include x rays, ultrasound, urine tests, and a physical examination of the pelvis. It may include a series of exams called urodynamic testing that measure bladder pressure and capacity and the urinary flow. The patient may also be asked to keep a diary of their urination output and frequency and episodes of incontinence over a period of several days or a week.

Risks

Bladder training may not be successful in all patients with urge incontinence. Patients who demonstrate a strong desire to control their continence and are committed to sticking with a training program tend to have the most success with bladder training.

Normal results

Patients who undergo successful bladder training gain complete or improved control over their urination. In some cases, additional alternate treatment such as biofeedback or pelvic muscle exercises may be recommended to supplement the progress made with bladder training.

Resources

Organizations

American Foundation for Urologic Disease. 1128 North Charles St., Baltimore, MD 21201. (800) 242-2383. http://www.afud.org.National Association for Continence. P.O. Box 8310, Spartanburg, SC 29305-8310. (800) 252-3337. http://www.nafc.org.

Key terms

Biofeedback — Biofeedback training monitors temperature and muscle contractions in the vagina to help incontinent patients control their pelvic muscles.Pelvic muscle exercises — Exercises that tighten and tone the pelvic floor, or perineal, muscles. Also known as Kegel and PC muscle exercises.

training

 [trān´ing] 1. a system of instruction or teaching.2. preparation by instruction and practice; see also education.assertiveness training instruction in techniques for handling of interpersonal conflicts and threatening situations without either submissiveness or aggression; see also assertiveness training.in the nursing interventions classification, a intervention" >nursing intervention defined as assistance with the effective expression of feelings, needs, and ideas while respecting the rights of others.autogenic training in the nursing interventions classification, a intervention" >nursing intervention defined as assisting with self-suggestions about feelings of heaviness and warmth for the purpose of inducing relaxation.bladder training a program designed to help a patient gain better control over the flow of urine; examples include voiding" >prompted voiding, drill" >bladder drill, toileting" >patterned urge response toileting, pelvic floor exercises, and void" >double void. Called also urinary bladder training.bowel training a program to help a patient to learn to evacuate the bowel at specific intervals; see also bowel training.gait training systematic activities designed to promote walking with or without assistive devices.impulse control training in the nursing interventions classification, a intervention" >nursing intervention defined as assisting the patient to mediate impulsive behavior through application of problem-solving strategies to social and interpersonal situations.memory training in the nursing interventions classification, a intervention" >nursing intervention defined as facilitation of memory.urinary bladder training 1. bladder training.2. in the nursing interventions classification, a intervention" >nursing intervention defined as improving bladder function for those with incontinence" >urge incontinence by increasing the bladder's ability to hold urine and the patient's ability to suppress urination.urinary habit training in the nursing interventions classification, a intervention" >nursing intervention defined as establishing a predictable pattern of bladder emptying to prevent incontinence for persons with limited cognitive ability who have urge, stress, or incontinence" >functional incontinence.

bladder retraining

The use of behavioural therapy to manage an overactive bladder, which basically consists of not urinating for 10 or 15 minutes, to re-accustom the bladder to holding larger volumes.

bladder training

A type of biofeedback therapy used in Pts with urinary incontinence, a condition that affects13 of ♀ ≥ age 60; BT is based on a combination of behavior modification, scheduling of voluntary micturition, and Pt education that emphasizes neurologic control of lower urinary tract function. See Biofeedback training, Behavioral modification.

blad·der train·ing

(blad'ĕr trān'ing) A predetermined schedule of voiding and toileting to maintain or improve bladder functioning.