Healthy bladder: tips to help you develop good bladder habits
It is normal to go to the toilet between four and eight times per day and no more than once a night.
Poor bladder habits can lead to poor bladder control and sometimes incontinence.
Here are some simple steps that everyone should follow to keep their bladder healthy.
Step 1 - Fluid intake
Try to drink at least 1.5 litres (six to eight cups) of fluid per day unless advised otherwise by your
doctor. Limit the amount of caffeine and alcohol you drink as they irritate the bladder. Don't drink
too much coffee, tea or cola. (Instant coffee contains less caffeine than percolated coffee. Tea
contains less caffeine than coffee.)
Step 2 - practice good toilet habits
Don't get into the habit of going to the toilet “just in case” as this tends to result in the bladder
developing a smaller capacity. Try to go only when your bladder is full and you need to go.
(However, emptying your bladder before going to bed is fine.) Take your time when urinating so that
your bladder has an opportunity to empty completely. If you rush, this may result in incomplete
emptying of your bladder and possible urinary infections.
Step 3 - Maintain good bowel habits
Keep your bowels regular and avoid constipation. Persistent straining when using your bowels can
weaken your pelvic floor muscles.
Pelvic floor exercises
What are the pelvic floor muscles?
The floor of the pelvis is made up of layers of muscle and other tissues. These layers stretch like a
hammock from the tail bone at the back to the pubic bone in front. It supports the urethra (front
passage), the vagina (birth canal) and the rectum (back passage) in females. In men it supports the
bladder and the rectum.
The pelvic floor muscles can be weakened by:
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pregnancy and childbirth
prostate or bladder surgery in men
continual staining to empty your bowels (constipation)
a persistent heavy lifting
a chronic cough (such as smoker's cough or chronic bronchitis and asthma)
being overweight
changes in hormone levels at menopause
Anyone with stress incontinence, that is, those who regularly lose urine when coughing, sneezing or
exercising, should especially benefit from these exercises.
Doing pelvic floor exercises
Sit or lay down comfortably with the muscles of your thighs, buttocks and abdomen relaxed.
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Tighten the ring of muscle around the back passage as if you are trying to control diarrhoea
or wind. Relax it. Practice this movement several times until you are sure you are exercising
the correct muscle. Try not to squeeze your buttocks.
Holding that squeeze then pull up the vagina / penis and the urethra all at once, lifting them
up inside. Try to hold this contraction strongly as you count to five and then release and
relax. You should have a definite feeling of “letting go”.
Repeat (“squeeze and lift”) and relax. It is important to rest for about 10 seconds in between
each contraction. If you find it easy to hold for a count of five, try to hold for longer - up to
10 seconds.
Repeat this as many times as you are able, up to a maximum of eight to 10 squeezes.
Now do five to 10 short, fast, but strong contractions.
Do this exercise routine threetimes every day.
While doing the exercises: do not hold your breath. Do not push down instead of squeezing and
lifting up. Do not tighten your tummy, buttocks or thighs.
What is an overactive bladder?
An overactive bladder is when the bladder contracts suddenly without you having control, and when
the bladder is not full. Overactive bladder syndrome is a common condition where no cause can be
found for the repeated and uncontrolled bladder contractions.
Overactive bladder syndrome is sometimes called an irritable bladder and may give symptoms such
as:
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Urgency. A sudden urgent desire to pass urine. You are not able to put off going to the toilet.
Frequency. Going to the toilet often - more than seven times a day. In many cases it is a lot
more than seven times a day.
Nocturia. This means waking to go to the toilet more than twice at night
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Urge incontinence occurs in some cases. This is a leaking of urine before you can get to the
toilet when you have a feeling of urgency.
What are the treatments for overactive bladder syndrome?
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Some general lifestyle measures (see steps 1-3, above) may help.
Bladder training is a main treatment. This can work well in up to half of cases.
Medication may be advised instead of, or in addition to, bladder training.
Pelvic floor exercises (see above) should also be practiced at the same time.
Bladder re-training
The aim of bladder re-training is decrease the time between each visit to the toilet by holding on for
as long as possible before you go to the toilet. This will seem difficult at first. For example, if you
normally go to the toilet every hour, it may seem quite a struggle to last one hour and five minutes
between toilet trips. When trying to hold-on, try distracting yourself. For example:
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Sitting straight on a hard seat may help
Try counting backwards from 100
Try doing some pelvic floor exercises
With time, it should become easier as the bladder becomes used to holding larger amounts of urine.
The idea is gradually to extend the time between toilet trips and to train your bladder to stretch
more easily. It may take several weeks, but the aim is to pass urine only five to six times in 24 hours
(about every three to four hours). Make sure you drink a normal amount of fluids when you do
bladder training (see above).