аЯрЁБс>ўџ 24ўџџџ1џџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџьЅС% №Пьbjbj%ч%ч , GG™RџџџџџџlАААААААФЎЎЎ8ц ђФvЖё ё ё Ябббббб$, LŠѕАё Я "ё ё ё ѕ‘ААЕ 0‘‘‘ё jААЯ‘ё Я‘†‘:ы,ААs  „Рb7‘ХФъЎ[ v s\:<v!Rжб Ржs‘ФФААААйBladder Retraining  What Is It? Bladder retraining is a way to treat some problems with urination. It helps to reduce: Frequency - when you urinate more than 8 times a day. Urgency - the sudden strong desire to urinate. Nocturia - getting up more than once a night to urinate and Urge incontinence - when urine leaks before you can get to the toilet. Stress incontinence – when urine leaks when you laugh, cough, sneeze, bend over These are common problems that can cause embarrassment. They are also a bother. Bladder retraining works for many people. It may help you avoid the need for medicines or surgery. Why Does the Bladder Need Retraining? The bladder is a muscle that fills and holds urine. When you urinate, the bladder squeezes and empties. If the bladder muscle squeezes when it is not supposed to it can cause problems for you. Urgency, frequency and incontinence are caused when the bladder squeezes when it shouldn’t or with no warning. What Is The Purpose? The purpose of bladder retraining is to increase the amount of urine that the bladder can hold. It can hold at most about two 8-ounce cups of urine. Bladder retraining works to help you urinate less often, about every 3 to 4 hours. With retraining, you may even notice some improvement in a few weeks. The Training Program Bladder retraining increases the amount the bladder can hold by controlling urgency. Here is how you start: Instead of going to the toilet when you first feel the urge to urinate, wait 5 minutes before going to the toilet. This might not be easy to do at first. You may only be able to wait a few minutes. Keep trying! Slowly increase the waiting period from 5 to 10 minutes. Keep adding minutes until you can wait 30 minutes. By increasing your waiting time, you are learning how to stop the bladder from squeezing. Filling the bladder with more urine stretches the bladder wall so it will hold more. Try to keep from going to the toilet 'just in case'. You should try to empty your bladder only when it is full. The only exception is when the bladder wakes you at night. Fluid Intake It is important to drink a normal amount of fluids. This means taking in the equivalent of 8 to 10 glasses of liquid a day. Remember that we get fluid from many of the foods we eat. More than this is too much. Try not to drink anything within 2 hours of going to bed. Many people find that drinks with caffeine--like soft drinks, tea, coffee, hot chocolate--and alcohol make their bladder problem worse. It might help to cut back on these beverages. Ways to Control the Urgency One or more of these techniques may help to control the bladder when sudden or severe urgency is there. They all take practice and can be used together. 1) Do Pelvic Floor Muscle Exercises - These exercises help prevent leaking when you have an urgent need to urinate. Your healthcare provider might give you a sheet of exercises called “Exercising Your Pelvic Muscles”. They work best if you do them as soon as you feel the urge. 2) Sit on the Arm of a Chair. – Put pressure on the perineum by sitting on the arm of a chair or the edge of a firm chair. The perineum is the area between the vagina and the rectum. It can help to stop the bladder from squeezing. 3) Think About Other Things - When you have a sudden urge to urinate, try to distract your mind. Think about something besides the toilet and your bladder. Any distraction will do. Think about chores you need to do, or places you would like to go. Breathing exercises and relaxation techniques may also take your mind off your bladder. Drug Therapy Some medicines can help the bladder relax. They may also decrease the number of times the bladder squeezes. Ask your healthcare provider if medicines would be helpful to you. Bladder retraining takes time, but has no side effects. Stick with it!  Adapted from the Sydney Urodynamic Centres by the UCLA Division of Geriatrics and the University of Chicago Section of Geriatrics For more information, contact: National Association for Continence www.nafc.org (800) BLADDER The Simon Foundation for Continence www.simonfoundation.org (800) 23-SIMON American Urological Association www.aua.net.org (410) 727-1000     Compliments of (Medical Group Name & Phone # to be inserted here) ГД{  ХыоўZ”Ъхно'+.АБа™šœŸ ЂЃЅГшыьњыњпњињбњбњЪњбњУМњКБКЌКЇЇЇЇŸ—К56OJQJ6CJOJQJ jU 56h6B*CJphh B*]ph 6B*ph B*\ph 5B*ph >*B*phB*cHdhŒВ—ІphjB*UmHnHphu B*ph#"{Вх"iКo•Ъп $ { ‡ О 5 6 C   §§їёїчччччїёїёїёїїннёёїїї & F$If & F$If$If$If™ыўў  )ФХоЩ*но')*+,-.АБаУxНЗЗЗЗЗНЗЗЗЗЗУЕЕЕАЕЕ$a$$If$If<$$Ifж0n#‘#€n#€#іжџџжџџжџџжџџaіаZ™›œžŸЁЂЄЅчшщъыь§§§§§§§§§§§єСМ§§§$a$3$$If–l4”hж”џR&О&іжџжџжџжџ4ж laі $$Ifa$* 00PАа/ Ар=!А "А # $ %АА  i4@ёџ4 NormalCJ_HmH sH tH <A@ђџЁ< Default Paragraph Font.>@ђ. 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