Bladder Training

TriciaJ, RN · Mar 19, 2017

Prior? I think the foley has to come out first.

amoLucia · Mar 19, 2017

Prior? I think the foley has to come out first.

NO, I think the old method used to be a timed schedule of clamping and then unclamping to drain on & off. The intention was to give the bladder sensory nerves some chance to feel 'fullness' and then signal the brain to tell the pt 'time to go'. And then the pt would tell us he/she had 'to go'.

FWIW, I didn't think all that clamping helped any! JMO

I've been retired a while and even back then in LTC, an indwelling was usually there for a specific indicated diagnosis. We avoided foleys if we could.

tyvin, BSN, RN · Mar 19, 2017

You have broached a subject of great magnitude. You don't have to have had a foley to have bladder training. In my experience bladder training is for people who need to control their amount of times they go to the bathroom. Other things involved like diet changes, possible medications, Kegel exercises, ect. Stress incontinence can drive a person wild.

If someone's been on a foley for months or has had surgery and needed to have a foley for months: bladder training is prescribed. It's usually the urologist or the nurse that will give them a program to follow. A journal is usually involved with kegels, diet, etc... There is the clamping method but I've never had the opportunity and foley's were there for a reason long term.

It all depends on why they need the bladder training. This is not a one size fits all program but the goal is pretty much the same...to be able to pee like a normal person without having to memorize where every bathroom is when you go out. Just joking: there are many goals with bladder training: as I said it all depends on the situation.

Keep in mind that we use 100% of our brain and you are never too old to learn. Visualization with bladder training brings great success.

Do a search on the subject with your specific concern in mind...you'll get lots of information.

amoLucia · Mar 19, 2017

to tyvin - oh how well you speak the truth! As someone with OAB, I learned that sonar bathroom location is a skill necessary to master!

This past summer, I had to have a cysto for renal calculi and I was cathed. All the 'nursey' things went thru my head as I couldn't wait to pee just as soon as I sat up. And all the self-monitoring afterwards...

TriciaJ, RN · Mar 19, 2017

Yes, I remember now. I used to work on a surgical specialties floor and we had a lot of patients who had pelvic floor shoring up procedures. When I first started there, we did use a clamping schedule but we abandoned it along the way because it didn't seem to help much.

The surgeon would do rounds on day shift and order the foleys out. Then on evening shift, when everyone still hadn't voided, I had to put them all back in. Sometimes it just took a couple of days before things got back in gear. But of course these were short-term foleys. LTC would have been a different ballgame.

MrFoley · Oct 28, 2017

Hi!

I know what do you mean... After long term foley wear the bladder needs to be "retrained" by stopping the urine flow and let the bladder fill. When the bladder filled or the patient had strong urge declamp the foley and let the urine out for a few minutes. A few years ago I had to wear a foley for two weeks. One day before the removal the nurse started the training. It was so strange to feel my bladder filling with the foley in me. The nurse said that the foley had to be clamped for three hours. After the first hour I felt so intense urge to utrinate and called the nurse to release the calmp or I'll explode. She got only 250 ml out of me and said I'll have to ignore the urge let it fill more. At the second round I reached the three hour limit and produced 450 ml after declamp. And repeat! But it was so hard to ignore the very strong urge to urinate. Finally after the removal everything gone back to normal so fast. So , I think it was useful.