The “urge wave,” starts, grows, peaks, and subsides (see Fig. 1). Urge strategies are used when that wave is peaking so as to lessen the sensation. Rushing to the toilet in response to urgency can be counterproductive as it can increase the awareness of bladder fullness, exacerbating the sense of urgency and causing a bladder contraction. So, as urgency peaks, avoid rushing to the toilet. Instead, walk at a normal pace. Follow strategies to suppress urgency, the prescribed time to delay a void is 5 min. Once successful, gradually expand voiding interval even further, 15–20 min at a time. Goal is to urinate no less than every 3–4 h during the day (see Fig. 2). -
Strategies to suppresses urgency include:
Not rushing to the bathroom at the time of urgency. Perform 5 quick PFM contractions followed by complete relaxation with slow deep breathing. Distraction to a nonphysical task (such as doing handwork, working on a puzzle, playing a game on an iPad or computer, and/or making a “to-do” or grocery list), counting backwards from 100 by 7s or reciting a poem, use self-affirmations (repeating to self, eg, “I am in control, not my bladder,” “I can wait,” and/or “I can do this”).
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Following these healthy bladder habits can improve bladder emptying and promote healing.
Find a relaxed and private place to urinate as worry and tension can make it more difficult to empty your bladder. Do not stand or hover over the toilet to urinate. Instead, sit on the toilet. Sit on the toilet with your feet supported on the floor. If your feet dangle, place a book under your feet for support. Do not bear down or strain to start urinating. Instead, relax your pelvic floor and stomach muscles. Make sure your bladder is completely empty before rising off the toilet.
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