00:00If you're someone who does a just-in-case wee, just before leaving the house, maybe before a meeting or
00:06before bed, sometimes even twice, this is really important for you.
00:10It might actually be making your bladder symptoms worse.
00:14I see this all the time in clinic, people going again, even when they've just been, because it feels safer
00:20than risking urgency or waking up in the middle of the night to go.
00:24But here's what's really happening. Your bladder is a muscle and it works with your nerves to tell your brain
00:31when it's full.
00:32Now, normally that signal up to your brain shouldn't come until your bladder is holding around 300 to 500 mils
00:38of urine.
00:39But if you keep emptying it early, you know, those just-in-case wee's, you start to retrain that system
00:47between your bladder and your brain.
00:49And over time, your bladder gets used to being emptied at lower volumes.
00:53I always say to my patients, it's like a car alarm that's become too sensitive.
00:57At first, it only goes off when there's a real threat, but then it starts going off at everything.
01:04A gust of wind, someone just walking past. That's what your bladder is doing.
01:09It starts sending, I need to go now, signals, even when it's barely full.
01:15That's how urgency and urge incontinence develop or get worse.
01:20Because instead of emptying everything, you're teaching your bladder to signal to your brain, you need to go earlier and
01:27earlier.
01:28So you end up waking up in the middle of the night needing to go, even when your bladder isn't
01:33that full.
01:34And even though you went before you went to bed, you might not have needed to, but you went anyway.
01:39So what's the solution?
01:40Well, you need to retrain the alarm system.
01:43That's bladder training.
01:44Try to cut down on those just-in-case wheeze.
01:47Stick to going every three or four hours rather than constantly and space out those wheeze more and more.
01:53If urgency hits, pause, breathe, stay still.
01:57Let it pass before going to the toilet.
01:59You're teaching your bladder this isn't an emergency.
02:03And also, don't forget, reduce caffeine, avoid large drinks right before bed, and those pelvic floor exercises.
02:11This all takes time.
02:12Most people notice a small improvement in two to four weeks, but it can take six to 12 weeks to
02:17really retrain that bladder.
02:20And this is how I describe pelvic floor exercises to my patients.
02:23Bear with me.
02:23Right, you're on the toilet having a whee.
02:25You're halfway through and then the doorbell goes and it's an Amazon driver or a delivery that you've been waiting
02:30ages for.
02:30You can't miss it, so you have to hold in your whee halfway through, run downstairs.
02:34Those are your front pelvic floor muscles.
02:37Now you're holding them in.
02:38And you're in a lift now, and Rihanna walks in, and you need to fart.
02:42But you can't fart in front of Rihanna, so you're holding in a fart, and you're holding in that halfway
02:46whee too.
02:47Those are your back and front pelvic floor exercises.
02:50Train them well.
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