Timed Voiding is used to treat the symptom of urinary urgency – a sudden compelling desire to pass urine that is difficult to postpone. Urgency may be associated with a fear of leakage of urine or with actual leakage of urine.
Usually the urge is all of a sudden with little prior warning that you need to pass urine. Your bladder has become unreliable at indicating how full it is and when you are likely to next need to pass urine.
The urge comes on without your control. Timed Voiding and Bladder Training are about teaching you to regain voluntary control over your bladder. At least to begin, don’t try doing it overnight, just do it during the day.
Timed Voiding starts by going to the toilet before you get the urge, on the clock, even if you don’t feel like you need to pass urine. What time intervals you choose to start is determined by looking at your bladder diary and seeing how often you usually get the urge. This approach is used for people who can't defer without incontience. For those who can hold on they may not need to use time voiding and can go straight to bladder retraining where they try to gradually extend the time interval they can hold on for.
For example if you usually get the urge or leak with urge every 1 1/4 hours then you start by going every hour. Once you are dry on this regime you gradually increase the time interval between going to the toilet, day by day. Generally you stay at a time interval until you have mastered it before moving on so you may spend a few days at one level. You need to be pretty strict about the timing. As you increase the time interval, usually by 15 to 30 minutes each day, you need to try to hold on in between. You are aiming to be able to hold on for 3 – 4 hours eventually.
If you get an urge to pass urine you may be able to stop it by doing a pelvic floor contraction. This is why a pelvic floor exercise program in combination with bladder training is essential. You may also be able to take your mind off it by doing something else. For example if you get the urge when you walk in you front door, rather than rushing to the toilet try collecting the mail, and then with time even opening it first. Once the urge goes you can then slowly make your way to the toilet, rather than running.
Other measures include reducing things in the diet that may irritate the bladder such as caffeine found in coffee, tea, chocolate, cola drinks, and alcohol. Also avoid constipation.
Medications to treat the urge may be used with this programme.
Don’t worry about set backs. It takes at least 4-6 weeks to see results. Keep trying and think positively.
Version: V3, July 2017