Living With Urinary Urge Incontinence: Strategies to Calm and Retrain Your Bladder (part 1)

August 24, 2023

Do you frequently experience a sudden, uncontrollable urge to pee? Are you constantly going to the bathroom “just in case,” or always looking for the nearest restroom wherever you go? Are you embarrassed by unintentional bladder leaks?

If any of these challenges sound familiar, you might be living with urinary urge incontinence. Let’s talk about things you can do to relieve your symptoms and improve your quality of life.

What is urinary urge incontinence?

Urinary urge incontinence is the sudden and intense urge to urinate, typically followed by an involuntary release of urine (leaking or dribbling pee). Many things can cause it, including pelvic floor dysfunction—weak, overactive, and/or tight pelvic floor muscles that cause the bladder to contract when it’s not supposed to.

People with urge incontinence usually feel like they have to go a lot (even if it’s a very small amount), often to the point where they have to wake up multiple times in the night to relieve themselves affecting their sleep I often hear people with urge incontinence say they frequently go to the bathroom “just in case.” Unfortunately, this habit can actually make urge incontinence worse!

Urinary urge incontinence is different from stress incontinence. The latter happens when you unintentionally leak urine due to increased pressure on the bladder and pelvic floor, such as when you cough, laugh, sneeze, jump, or lift something heavy. But while some people have both types of urinary incontinence—both of which, by the way, can benefit from pelvic floor physical therapy—there is a technique you can use to calm and retrain your bladder if you’re dealing specifically with urgency. The American Physical Therapy Association (APTA) calls it bladder retraining.  I call this the urge deference technique because, you can use this technique to help calm your bladder urges down and put off the need to go to the bathroom.  This technique can be used to retrain your bladder by allowing you to extend the time between your voiding and decreasing the frequency you have to go.

Can you really “retrain” your bladder?

The short answer: yes! The longer answer: yes, and I can summarize how. The APTA outlines a few helpful steps for calming your urge to go.. Here are the basics:

  1. Whenever you feel a sudden strong urge to urinate, stop what you’re doing, sit down if possible, relax, and take some slow deep breaths.
  2. Contract your pelvic floor muscles. This helps inhibit bladder contractions, allowing the bladder to relax and hold urine. To do this perform a “squeeze and lift” motion in your vagina (if you are female), anus, and perineum, as if you’re trying to stop the flow of urine and passage of gas. Most people find that quick short contractions (without 100% letting go) is quite helpful in calming the urge. You can also try to hold the contraction—or until the urge subsides. Experiment and see what works best for you.
  3. Once the urge subsides, stay relaxed and head to the bathroom. Do your best not to sit on the toilet until the urge is gone. You might need to stop walking and repeat steps 1 and 2 if the urge returns before you make it to the toilet. Be patient, and know that this takes practice.

The idea of bladder retraining is to improve pelvic floor function and stop those sudden bladder contractions, which will ultimately alleviate your symptoms and allow you to go with less urgency. Imagine how much of a relief that would be!

Keep your eyes peeled for part 2 of Strategies to Calm and Retrain Your Bladder on ITR’s next blog!

In the meantime

Do you need help managing urinary urgency symptoms?

Contact ITR Physical Therapy in Bethesda, MD and McLean, VA to connect with a pelvic floor specialist near you and find relief from urinary urge incontinence.

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