MS Supporting Bladder Retraining Booklet

Supporting you with
bladder retraining for an
improved quality of life

According to the World Health Organisation,
bladder problems affect more than 200 million
people worldwide and, in the UK, the NHS
has estimated that between three and six
million people have some degree of urinary
incontinence. So, if you are suffering due to
urinary incontinence, you are not alone, and
we want to help and support you as much
as possible.

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Bladder retraining

Bladder retraining is a form of behavioural therapy that helps you regain
control over toileting habits. It teaches you to hold on to your urine for longer
periods of time and to be able to avoid leaks. Ultimately, if you are able to
dedicate the time to retrain your bladder you will become more independent
and have an improved quality of life.

Where to start Day 1 Date: Day 2 Date: Day 3 Date: Output Leak
Time Intake Output Leak Time Intake Output Leak Time Intake
The first step is to get a clear picture
of your bladder habits from Day 1. 7am 250 7am 150 (T) 150 7am 150 (T)
To do this, you will be asked to
complete a frequency/volume chart 8am 150 (T) 9am 150 8am 250 
(see pages 7-8): 11am 150 250 (W) 250 (W)
12  10am 10am
● Record ALL of your drinks; 250 (FJ)
what time you drink them, what 11am  11am
type of drink it was (T=Tea,
FJ=Fruit Juice, A=Alcohol, etc) 2pm 150 (W) 100 12 200 12 100
and what volume/how much. 3pm 100 200 (T) 1pm 200 (T)
 2pm
● Measure and record EVERY
‘wee’ that you do. 4pm 200 (T) 4pm 100 3pm 200 (W) 100 
6pm 350 (W) 200 250 (T) 
● Record any leaks and at what 8pm  5pm 4pm 100
time they occurred. 9pm 100 200 250 (W) 100
10pm 200 (A) 200 6pm 100  6pm 200 (A)
200 (A)
8pm 7pm

9pm  9pm

11pm 200 10pm 250 (A) 10pm 150 (A) 200

2pm
100 11pm 200 12pm 200

4pm 100 1pm 100 3pm 100

Total fluid Total fluid Total fluid Total fluid Total fluid Total fluid
intake (ml): output (ml): intake (ml): output (ml): intake (ml): output (ml):
1,500 1,150
1,500 1,100 1,200 1,400
Total daytime Total nighttime
visits: Total nighttime Total daytime Total nighttime Total daytime visits:
5 visits: visits: visits: visits: 4

55 34

It is important to record this information for at least three consecutive days
and for the full 24-hour period of each day.

Your fluid intake

It is vital that you drink enough fluids
to ensure a healthy bladder. A healthy
adult should drink at least two litres
of fluid a day. Please remember that
your bladder needs you to be drinking
plenty of clear fluids and NOT all tea
and coffee. Water or water-based
drinks are a necessity to maintain a
healthy bladder and you should aim to
drink six-eight glasses of water a day.

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Important information:

Drinks containing caffeine can irritate the bladder and make your symptoms
worse. Some foods can also irritate the bladder, so please be aware of these
and consume them in moderation.

Food and drink that can irritate the bladder

● Caffeinated tea, coffee, green tea and hot chocolate
● Carbonated drinks such as Cola
● Alcohol
● Grapefruit, orange, lemon and pineapple
● Citrus fruit juices
● Tomatoes and tomato products
● Flavour enhancers – hot peppers, spicy food, chilli
● Artificial sweeteners
● Mexican, Thai and Indian food

Food and drink less bothersome to the bladder

● Water
● Milk
● Bananas, blueberries, honeydew and watermelons
● Leafy green vegetables
● Mushrooms, peas, squash, potatoes
● Poultry
● Red meat
● Seafood
● Grains – oats and rice
● Snacks such as pretzels and popcorn

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Warning:

If you have always consumed
large volumes of normal tea
and coffee and wish to change
over to decaffeinated drinks,
please do so gradually.

Cutting out caffeine suddenly
can lead to severe headaches.

Urine colour

If you follow advice and drink the correct volumes of the correct fluids,
your urine will be a light yellow/straw colour.

You can use this chart as a simple guide to determine whether or not you
are drinking enough. If your urine matches numbers 1-3, you are well
hydrated, if 4-5 you are dehydrated and need to increase your fluid intake
and between 6-8 you are severely dehydrated and MUST drink more.

123 Target range – correct volumes of fluid
45 Dehydrated – increase your fluid intake
Severely dehydrated – MUST drink more
678

Please note some medical conditions or medication can impact the
colour of your urine. If you have any concerns, please contact your
healthcare professional.

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How to retrain your Bladder

Make sure that you have completed an accurate three-day
frequency/volume chart as mentioned previously.

● Look at your chart and count ● When you have achieved your
how many times you pass initial goal, continue to extend the
water in a 24-hour period. time between visits to the toilet
by a further 15-30 minutes.
● Check for the longest time
you were able to hold on ● When you have successfully
between visits to the toilet. retrained your bladder, you should
only need to pass urine between
● What was the largest volume six and eight times a day.
of urine you passed during
that 24-hour period? ● You should only need to get up
once or not at all during the night.
● You are aiming to increase
the time between your visits ● It is quite normal to need to get
to the toilet. out of bed to use the toilet once
during the night, especially when
● If from your chart you can see you are over 60.
that you go to the toilet every
hour, initially you should aim Retraining your bladder will take
to extend this to 1½ hours. time and commitment, but when
things have improved please
● This may prove a challenge, do complete a further three-day
so you could extend by just frequency/volume chart.
15 minutes to begin with, but Compare the results from both of
stick with it. your charts and you should be able
to clearly see the improvement.
TIPS: When you get the initial You should see longer times
urge to pass water, try standing between visits to the toilet and
still or sitting on a hard surface larger volumes of urine passed.
until that sensation passes.
Go to the toilet to pass water
when that sensation next returns.

Avoid constipation as this will affect your ability to empty your bladder
properly and lead to you wanting to go more frequently.

Remember, if you are dehydrated and producing strong, concentrated
urine, you will need to visit the toilet frequently as your bladder will be
irritated by your urine.

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Please turn over for the frequency/volume chart

You can also download an editable frequency/volume
chart at http://online.anyflip.com/eams/oteq/mobile/
or scan the QR code.

Manfred Sauer Care will support you in any way possible, but please do
stay in contact with your local healthcare professional.

Your nurse is: Nurse contact number:

Your prescription requirements

Manufacturer Product Prescription Pack
code size

To order further supplies on prescription, please contact Manfred Sauer Care
(see back page).

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Frequency/volume chart

Measure in millilitres (mls) how much your usual glass and mug hold and fill them
to the same level each time you have a drink. This will make recording your intake
a lot easier. Keep an old measuring jug in the bathroom to measure your output
and record the volume (in mls) every time you visit the toilet.

Day 1 Date: Output Leak Day 2 Date: Output Leak
Time Intake Time Intake

Total fluid intake (mls): Total fluid output (mls): Total fluid intake (mls): Total fluid output (mls):
Total daytime visits: Total nighttime visits: Total daytime visits: Total nighttime visits:
8 | FREEPHONE: 0800 999 5596

Record ALL of your drinks; what time you drink them, what type of drink
it was (W=Water, T=Tea, C=Coffee, FJ=Fruit Juice, A=Alcohol, etc) and
what volume/how much. Intake column example would be: 250 (FJ).
Just enter a tick in the Leak column if you have any urinary leaks.

Day 3 Date: Output Leak Day 4 Date: Output Leak
Time Intake Time Intake

Total fluid intake (mls): Total fluid output (mls): Total fluid intake (mls): Total fluid output (mls):
Total daytime visits: Total nighttime visits: Total daytime visits: Total nighttime visits:

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www.manfredsauercare.co.uk

Manfred Sauer Care
Unit 3
The IO Centre
Barn Way
Lodge Farm Industrial Estate
Northampton
NN5 7UW

FREEPHONE: 0800 999 5596

Email: [email protected]
Open: Monday-Friday, 9.00am-5.00pm

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