Rigi10™ Malleable Penile Prosthesis
Also Known As
Bladder retraining, bladder drill, bladder reeducation, timed voiding, scheduled toileting, urinary retraining
Definition
Bladder training is a structured behavioral therapy technique designed to increase bladder control and manage urinary incontinence by gradually increasing the interval between voids and the volume of urine the bladder can hold.1 This therapeutic approach involves following a fixed voiding schedule, implementing urge suppression techniques, and maintaining a bladder diary to track progress.2 Bladder training aims to modify urination habits through a combination of scheduled bathroom visits, distraction techniques, and relaxation methods to diminish leakage and the sense of urgency associated with urinary incontinence.3 The bladder muscle is trained to stretch more, enabling it to hold more urine, while simultaneously teaching patients to resist the immediate urge to urinate when not necessary.4
Clinical Context
Bladder training is primarily used in the clinical management of urinary incontinence, particularly for stress incontinence, urge incontinence, and mixed incontinence.1 Patient selection typically includes individuals experiencing frequent urination, urgency, or involuntary urine leakage who have not responded adequately to other interventions.2 The approach is often recommended as a first-line, non-pharmacological treatment before considering medication or surgical options.3
The implementation process begins with a comprehensive assessment, including a bladder diary to establish baseline voiding patterns.4 Clinicians then develop an individualized schedule that gradually extends the time between bathroom visits, typically starting with intervals that the patient can reasonably achieve.1 Patients are instructed to follow this schedule strictly during waking hours, regardless of whether they feel the urge to urinate.2
Urge suppression techniques, including pelvic floor muscle exercises (Kegels), deep breathing, and distraction methods, are taught to help patients manage urgency between scheduled voids.3 The voiding interval is progressively increased by 15-30 minutes as the patient demonstrates success, with the ultimate goal of achieving a comfortable interval of 3-4 hours between voids.2
Expected outcomes include reduced frequency of urination, decreased episodes of incontinence, increased bladder capacity, improved quality of life, and enhanced self-efficacy in bladder management.4 Clinical studies indicate that bladder training can be effective in reducing incontinence episodes by 57% on average, though results vary among individuals.1 The typical treatment duration ranges from 6-12 weeks, with regular follow-up to monitor progress and adjust the training program as needed.3