Bladder Training for Urge Leaks: How the Schedule Works Before You Try Pills

Urge leaks are the “gotta go now” kind: a sudden, strong need to urinate and sometimes not making it in time. Before reaching for a prescription, the American College of Physicians (ACP) strongly recommends bladder training for women with urge leaks.¹ If training doesn’t work well enough, medicine is the next step.¹

What bladder training is

Bladder training means urinating on a schedule instead of whenever the urge hits, then gradually stretching the time between trips so your bladder learns to hold more.² It usually starts with a bladder diary.

How to do it, step by step

1. Keep a diary for a few days. Write down when you urinate, how much you drink, and any leaks or urges.² Our guide to the bladder diary shows what to record.
2. Pick a starting interval with your clinician, usually close to the shortest time you now go between bathroom trips.
3. Go on the clock, not the urge. Use the bathroom at your scheduled times during the day, even if you don’t feel the need.²
4. When an urge hits between times, many clinicians teach this: stay still, take slow breaths and squeeze your pelvic floor muscles quickly a few times until it fades, then walk calmly to the bathroom if you still need to.
5. Lengthen the interval gradually as it gets easier, at a pace your clinician suggests.²
6. Keep recording so you and your clinician can see progress.²

Most people need several weeks of practice before they notice a clear difference.

Pair it with pelvic floor training

Stronger pelvic floor muscles help hold urine.² For mixed leaks (urge plus leaks with coughing or lifting), ACP recommends pelvic floor training plus bladder training.¹ A pelvic floor physical therapist can help.² Our guides to doing Kegels correctly and pelvic floor therapy costs explain more.

Other steps that help

• Weight loss and exercise are recommended for women with obesity and leaks.¹ See our article on the PRIDE weight-loss trial.
• Caffeine can make urgency worse for some women. Our guide to caffeine and leaks covers it.
• Don’t cut fluids too much. Our article on fluid restriction explains why.

If training isn’t enough

ACP recommends medicine for urge leaks when bladder training hasn’t worked, chosen by side effects, ease of use and cost.¹ Our articles on beta-3 agonists and bladder pills and dementia risk compare options.

Try: “I’m running to the bathroom every hour and sometimes leaking on the way. Could we try a bladder-training plan first, and how should I set my schedule?”

Laugh, Sneeze, Jump includes an appointment prep sheet. Use it to bring three days of bladder diary notes to your visit.