Imagine you are half-way through a hike with your neighbourhood walking group, hosting a dinner party for friends and family, or on the verge of falling asleep after a long day when you feel a sudden desire to urinate. This urge is hard to manage, leaving you rushing to the nearest bathroom for relief repeatedly during the day and night, and at times even accidentally urinating (1-3). These symptoms collectively represent “overactive bladder”, a condition that can have people feeling embarrassed, isolated, and stressed, thereby impacting everything from their mental health to their quality of life (1;3;4).
If you do experience these symptoms and the negative effects that follow, know that you are not alone. In Canada, it is estimated that over one in five older adults deal with issues related to controlling their bladder (5). With many people impacted, finding effective treatments is key.
Behavioral therapies are one available treatment category. In fact, they tend to be the first type of strategy recommended by healthcare providers (1;6;7). These therapies include strategies such as bladder training and pelvic floor muscle training. Bladder training is particularly interesting given that research into effective strategies often lumps it in with other bladder conditions rather than looking at it on its own (1). This might have you wondering where the evidence currently stands around bladder training for overactive bladder.
Well, wonder no more! A systematic review worked to remedy concerns related to this research gap by investigating the impacts of bladder training in adults with overactive bladder, specifically. Here, bladder training involved patient education on how the bladder and urination work, training patients to urinate following a set schedule to enhance control, and positively encouraging patients to keep training (1).
What the research tells us
The review compared bladder training to no treatment, pelvic floor muscle training, and a class of medications known as anticholinergics. Research shows that compared to no treatment and anticholinergics, bladder training may be more effective at curing or bettering symptoms of overactive bladder in adults. Additionally, bladder training may decrease the number of episodes of accidental urination compared to no treatment. When it comes to improving quality of life and the number of episodes of accidental urination experienced within 24 hours, there may not be much of a difference between bladder training and pelvic floor muscle training.
That said, these results do need to be grounded in several considerations. First, the current results are based on very low to low certainty evidence. This means that the evidence is uncertain, and results are likely to change as more research comes out. Second, more high-quality research is needed to support these findings and provide a better understanding of bladder training for overactive bladder (1).
Folks interested in trying bladder training should work with their healthcare team to develop a urination schedule and a plan for receiving education and psychological support.
