What’s normal? 

Voiding every 2-3 hours is normal during the day, so that’s 6-8 voids per day. It’s normal to wake up once per night, or not at all. If you’re 65 years and older, it’s normal to wake up twice per night. 

Do not strain or push to start the flow, and it should continue to flow for 7-8 seconds minimum. You’ll notice the urine stream stops near the end of the void, and then starts again for the final emptying. This is normal. 

It shouldn’t hurt to pee, and you should feel empty at the end of your void. After you wipe, you shouldn’t feel damp or dribble as you walk away from the toilet. 

Tips for healthy bladder function: 

  • Stay hydrated

  • Reduce bladder irritants

  • Sit right down on the seat - don’t hover above it

  • Take your time! Don’t push to start the flow, and give yourself enough time to completely empty. 

  • Avoid “just in case” voids. If you void before your bladder is full, it can lead to decreased bladder capacity and increased bladder sensitivity over time. 

Urge suppression strategies:

  • Stop and sit down if possible

  • Add pressure to the perineum by sitting down or pressing on the space over the urethra.

  • Take deep, slow breaths to calm your system. Urgency means your bladder muscle is contracting. This contraction cannot last forever and it will pass in a few moments. 

  • There are bladder control centres in your brain, so try some ‘mind over bladder’ techniques to calm the urge: 

    • “No. Stop. You will wait.” 

    • “I am strong and I can do this.”

    • “I control my bladder and it does not control me.” 

  • Try using distraction:

    • Count backwards from 10

    • Spell your name backwards

  • Do some pelvic floor contractions to calm the bladder. This activates the perineo-detrusor reflex and the neuromuscular connection between your pelvic floor muscles and your bladder muscle.

  • Rise up on your toes and rub the backs of your thighs. This is another neuromuscular hack to provide a distraction to your bladder. The result? Less urgency!

Bladder Retraining:

Want to decrease urinary frequency? Try to retrain your bladder. Here are the steps:

  1. Establish your comfortable voiding interval. This is the length of time you KNOW you can wait between trips to the toilet. For some people this is a few hours, for others it might just be a few minutes.

  2. When you feel the urge to void, use the urge suppression techniques above to delay your void by one minute. You MUST wait one minute before you void again. Wait until the strong urge passes, then calmly walk to the toilet. The key is to stay calm. 

  3. Ensure you are completely emptying. Sit right on the seat, take your time, and perhaps do a ‘double void.’ This means that you sit right back down after you’ve stood up, and try a second void. Your brain might just think you’re voiding for the first time, and voila!, more urine comes out. 

  4. Now that you’re confident that you’ve completely emptied, you are back on to your schedule. Remember that you must for wait the full voiding interval time to pass before your next void. Consistency is key when you are trying to retrain your bladder, so no cheating!

  5. After one week, you can try to increase your voiding interval by one minute. Gradually, the weeks will pass, and you will be retraining your bladder to stay calm as it learns to hold larger and larger volumes. Be patient, be confident, and be consistent!

Tips for Managing Bladder Irritation

Here are some tips to help you manage and reduce bladder irritation:

  1. Keep a Bladder Diary: Track what you eat and drink, and note any symptoms you experience. This can help identify your personal triggers.

  2. Eliminate Potential Irritants: Gradually remove suspected irritants from your diet, one at a time, to see if your symptoms improve.

  3. Stay Hydrated: Urine should be light yellow or clear. Drink plenty of fluids to dilute your urine, but avoid excessive intake. Sip fluids throughout the day instead of taking all your fluids at one time. 

  4. Time Your Intake: Avoid drinking 2-3 hours before bedtime, especially if you struggle with waking up frequently in the night to urinate.

  5. Consult a Healthcare Professional: The above techniques are not meant to treat bladder pain or a suspected urinary tract infection.  If you experience persistent bladder issues, consult a doctor or other healthcare provider.