The main function of the bladder is to store urine. It can hold 300 – 500ml at one time. On average, you will pass around 1,500ml (3 pints) per day. For bladder comfort, it is recommended that you pass about 300 – 400ml each time, making a normal daily frequency of 6 – 8 times.

Frequent toileting (more than 8 times per day) makes you and your bladder adapt to this, meaning you go too often. Less frequent toileting may suggest you are not drinking enough. Frequency (going too often) and urgency (unable to hold on) can affect your quality of life. This can create a vicious cycle, as these symptoms make you go to the toilet more frequently.

However, this problem is not a disease, only a loss of normal physiological function. Bladder training to regain normal function can be re-learned, just as you learned it as a child.

The following bladder drill may help you gain better bladder control by increasing bladder capacity and improving your ability to make it to the toilet.

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Bladder Drill

1. If you feel the urge to go, attempt to ‘hold on’ as this is vital for success.
2. Try tightening your pelvic floor muscles to assist. Sitting on a hard surface (e.g., chair or desktop) can also help.
3. You are trying to increase the time between toilet visits.
4. Continue to progress as each new toileting target is reached, e.g., holding for 2 minutes, then 5 minutes.
5. The final aim is a frequency of about 6–8 per day with a total output of about 1,500ml per day.
6. Do not restrict your fluid intake. Maintaining a good fluid balance will encourage improved bladder capacity. Your physiotherapist will advise you on how much you should be drinking per day (usually about 2 litres, depending on your activities).
7. Success is less likely if your bladder drill is being run concurrently with a busy and/or stressed lifestyle. Try to reorganise your weekly schedule if this is the case.
8. If toileting at night is a problem, this should reduce as toileting targets are reached. Avoid drinking a lot before going to bed.
9. Good pelvic floor muscle strength is important in preventing or reducing urinary incontinence. Pelvic Floor Muscle Exercises should be done at the same time.
10. If you are on bladder medication, this, along with your efforts, should improve bladder control and confidence.
11. In summary, self-motivation is the key to success. To assist you, it is important that you keep your appointments with your physiotherapist.