Bladder training
Depending on your medical condition you may be suitable for bladder training. Many ladies have to rely on this form of bladder management as they may not wish to be permanently catheterised and find the use of pads distasteful and intermittent catheterisation difficult. You should discuss the type and scope of bladder training (also known as triggering) with your consultant or
urology specialist, after completing a urodynamic examination.
If your doctor advises you carry out bladder training, men are advised to do it whilst wearing a condom drainage system and women with a suitable absorbant pad.
Bladder training helps:
- decrease dependancy on a sheath drainage system
- increase and perfect the automation of the bladder
- reduce distention of the bladder
- reduce the amount of residual urine
Intervals for bladder training
Even people who have partial or no sensation learn to notice changes in their bodies which act as a sign of a full bladder. These signs are important for people who rely on bladder training or intermittent catheterisation to manage their bladders. Such signs are:
- goose pimples on your back, arms, face or forehead
- sweating in specific places such as at the hairline on your forehead
- pins and needles, itching on the back of your arms
- feeling of pressure/tension in the head
- Muscle spasm in legs and abdomen
You can organise the intervals between training by these signs. If no signs occur, you should perform bladder training every 4 hours (except during the night).
Risks
The unbalanced pressure of the bladder (Detrusor-Sphincter-Dys-Synergy) can increase through bladder training and cause long-term damage to the bladder tissues and ultimately damage the kidneys.
Intermittent Catheterisation
You can prevent these risks linked to bladder training by intermittent catheterisation. The catheterisation ensures a pressure and residual-free bladder drainage. If you can’t or don’t want to perform this procedure yourself or have it done by a carer throughout the day, you should do it at least twice a day (morning and evening). Wheelchair users should take their feet off the footrests and push their pelvis as far forward as possible in order to straighten the urethra as much as possible before passing the
catheter.
Performing bladder training
You can use individual stimuli to release the reflexes (the trigger mechanism) by:
- Knocking on the bladder
- Stimulating the skin on the abdomen, the external genitals, or the inside of the thigh
- Rectal manipulation (stretching of the anal sphincter)
Make sure you are in relaxed position!
When sitting: Push the pelvis as far forward as possible
When lying: Lie on your side with your knees bent
Those with a limp bladder paralysis should empty the bladder by intermittent catherisation. Pressing with your hands on the bladder can cause long term damage.
