Bladder retraining can be important in treating the symptoms of overactive bladder. It involves teaching yourself to hold on. It is a form of behavioural therapy.

The idea behind it is to learn to suppress the desire to urinate and go back to a normal pattern of toilet visits. This is done by forcing the bladder to cope with being stretched as it fills. This doesn't happen quickly or easily, but can be very effective.

Bladder retraining teaches your bladder to stretch as it fills. It teaches you to ignore the initial urge to visit the toilet.

The aim is to restrict bladder emptying to no more than 6-8 times a day. The bladder should be able to hold upwards of 400mls of liquid before it needs to be emptied. The first urge to urinate should not normally occur until the bladder is half full.

Part of bladder retraining involves keeping a diary of how often you visit the toilet during the day. This might be kept initially for a week. It is also useful to record any accidents.

The amount of water you pass can be measured using a simple kitchen measuring jug. This information can be included in your diary.

It is understandable that someone who has an overactive bladder develops the habit of going to the toilet just in case. However, this can make the detrusor muscle instability even worse.

A target should be set with a view to reducing the number of times you pass urine. For example you might add an extra half hour between toilet visits. There are various techniques that can be tried to help you hold on for the extra time:

• Do five squeezes of the pelvic floor muscle. This sends a message to your bladder to help it calm down.
• Sitting on a hard seat or a tightly rolled towel puts pressure on the pelvic muscle.
• Do something to distract yourself from thinking about it.
• Try to relax and do deep breathing so you won't get stressed.

Set goals and when you achieve them, set new ones. The aim is to reach a point where you are only visiting the toilet every three hours or so and you are passing about half a pint of urine. However, you should not go longer than 4-5 hours (except at night).

Bladder retraining takes determination. It may be weeks or months before you achieve your goals. Sometimes this is undertaken along with drug treatment.

A programme can be worked out for you in conjunction with a physiotherapist or a continence nurse specialist. Your GP can organise a referral.

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