Tips to Decrease Urinary Urgency and Frequency

Anyone who has dealt with symptoms related to an overactive bladder knows it’s no fun! Worrying about when you may need to use the restroom can lead to discomfort and anxiety, and can disrupt daily activities. Here are a few tips and habits from Pelvic Health Physical Therapist Katie Ouillette, PT, DPT that can help you re-train and take control of your bladder.

UNDERSTANDING URGE

The first urge to urinate generally occurs when the bladder is about half full. If your bladder is more on the sensitive side, or if you are someone who suffers from urinary frequency and urgency, it may feel that your bladder is full, even though it’s not. Your bladder is likely getting false information due to ongoing habits you have done for long periods of time.

For example, a history of leaking may make you want to go to the bathroom right way, which makes the urge even stronger. Or, you may go the bathroom “just in case,” which increases bladder sensitivity.

“RIDE THE WAVE”

The urge to urinate is often described as a “wave.” When the urge first appears, sit quietly. Be aware that the urge will continue to get stronger and peak, just like a wave. This is when it’s good to try urge suppression techniques described below. Once the urge subsides, walk calmly to the bathroom if the urge is still present, or continue to wait if the urge is no longer strong to avoid poor bladder habits.

DECREASING URGE AND FREQUENCY

To help make it to the bathroom on time:

• Slow down: hurrying to the bathroom can cause an adrenaline rush. This will make your bladder muscles contract, which makes the urge to urinate feel stronger. By walking slowly and staying calm, you are helping the bladder relax.
• Diaphragmatic/deep belly breathing: this can help calm the nervous system, which decreases input to the bladder helping to decrease urgency.
• Autogenic training: repeating positive sentences or affirmations in conjunction with a breathing pattern helps control the mind-body connection. For example, inhale saying “I am in…,” exhale saying slowly “control.”

To help delay urination until convenient

• Sit down: pressure on the perineum (area between the anus and genitals) inhibits bladder contractions. For example – sitting on the edge of a couch/chair or on your hand, rolled up towel, and crossing your legs.
• Quick kegels: perform 4-5 quick, strong pelvic floor contractions/kegels. This uses an inhibition reflex between the pelvic floor and bladder muscle to decrease urgency and leakage.
• Distraction: do math in your head, sing a song, do a crossword puzzle, watch TV, visualize your favorite time or place, play on your phone.

Scheduled or “Timed” Voids

If you find yourself going to the bathroom more than 7-8 times daily, scheduling your bathroom trips can help increase the time between each visit until you have retrained your bladder to have healthier habits. For example, if you currently go about every two hours, start to slowly increase that time frame by small intervals. Use the techniques above to stretch the time between your next visits to 2 hours and 15 minutes.

Once this becomes easy to achieve, space it out another 15 minutes until you are going every 3-4 hours, with 4 hours being ideal. If you are using the set increments to urinate and do not have the urge to go once you hit the scheduled time, try to delay urination until you have a stronger urge. Going to the bathroom when the urge isn’t strong trains the bladder-brain connection to become more sensitive.

IF SYMPTOMS CONTINUE, SEEK HELP!

While incontinence is an incredibly common issue affecting both men and women, it’s not a normal part of life and there is treatment available. Renue Physical Therapy offers pelvic floor physical therapy to help you connect to and strengthen key muscles that can help relieve symptoms of incontinence and help you regain control of your body. Learn more or request an appointment or free screening at www.renuept.com/pelvichealth.