Urinary Urge Suppression Techniques

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First, a little bladder education:

What is normal?

  • Normal urinating is 8-10 times during waking hours (~every 2-4 hours) and 0-1 time during sleeping hours.
  • Each void should be about 8-15 seconds.
    • Less than 8 seconds = not fully voiding OR voiding too frequently.
    • More than 15 seconds = over-holding & should have gone sooner!
  • If you are going to the bathroom too frequently, or leaking on your way to the bathroom, urge suppression techniques may help.

Water:

  • Water intake (plain water without carbonation) should be approximately 1/2 your body weight in fluid ounces.
  • Example: if you weigh 150 pounds, approximately 75 fluid ounces would be the goal.
  • Sipping water throughout the day is better than chugging water so it filters in more slowly.

Bladder science:

  • When the bladder wants to empty, it talks to the brain in a wave-like pattern, with the first “wave” or urge more gentle than the next one.
  • The first urge signal should be sent to the brain when the bladder is about 1/2 full. A full bladder can hold about 2 cups of fluid (or even up to 4 cups during sleeping!)
  • When the bladder wants to empty, the muscle lining the bladder (the detrusor muscle) will start to contract/quiver slightly. When this urge is present, it’s important that you are in charge of telling your bladder when it’s okay to empty, and not the other way around.
    • The bladder is highly trainable!
  • When the bladder is allowed to be in control of the urges and the timing of voiding, it will start to give more and more frequent urges.
  • The bladder is easily excitable, and responds quickly to stress, up-regulating and ramping up urge signals in response to increased stress. It is important for urinary urgency and urinary incontinence to decrease both life stressors and your stress response when feeling an urge to go.
  • When possible, avoid going to the bathroom “Just in case” you think you will have to go soon.
    • “Just in case-ing” on a regular basis will allow the bladder to empty more frequently, and it will begin to send urge signals when it is less and less full, resulting in more frequent urinary urgency.

What to do:

  • If an urge to urinate occurs and you need a bit more time to make it to the bathroom, try these urge suppression techniques to avoid leaking
    • You can read the tips listed below and/or watch this video:

Lifestyle Recommendations

1. Pause what you are currently doing!

– Mindfulness

Stop activity, stand quietly, or calmly sit down. Avoid rushing to the toilet. IF you are in a private place- pressing on your urethra can help It may help to try the Pelvic Floor Isolation position: Knees and hips slightly bent, toes turned in.

2. Deep breath

– Exercise

Take a deep diaphragmatic (belly breath and let it out slowly. Then, contract your pelvic floor muscles on and off quickly by squeezing and LIFTING, then relax– 5 to 6 times. Pelvic floor contractions send a message to the bladder muscle to relax and hold urine. If you don’t have any urine loss with the quick contractions, progress to Contract, Relax slower and rhythmically 5 to 6 times to decrease the urgency.

3. Distraction techniques

– Mindfulness

Relax. Do not rush to the toilet. Think positive thoughts (“I am in control.” “I have enough time.” “My bladder is elastic and can expand to fill.” “I am in charge.” “I just went to the bathroom and know that my bladder is trying to control me.”) Try to distract yourself by thinking of something other than going to the bathroom. Look around you and distract your mind by reading any text you can see (billboard, a nutrition label, a text message, etc.)

4. Calmly walk to the bathroom.

– Exercise

When you feel the urge subside, walk normally to the bathroom (don’t rush!). Do not undo your belt, button, or pull down your pants on the way there. Urinate after you fully sit on the toilet and take a deep breath.

5. Ensure you fully void

– Mindfulness

It’s important that you fully relax while urinating. Do not try to push urine out (this can cause lots of other problems). After you think you are finished, try taking one more deep belly inhale and exhale just to make sure.

Feel another urge to go to the bathroom right after you just went?

– Exercise

1) Did you fully void?? If you feel the need to go to the bathroom right after you just went, you can try “double voiding:” After fully urinating, go ahead and stand up all the way. Then sit back on the toilet and repeat your belly breaths, relaxing to allow the flow of urine. You can also try gently rocking your chest forward, backward, and side to side to see if that helps urine flow. Another technique to try is bladder tapping. Tap gently on your bladder area a few times to help activate the bladder muscle to fully empty. We talk about this here: https://youtu.be/Xsszi8HUp-M?t=278

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