This information explains what a urination (peeing) schedule is and how to follow it after your neobladder surgery. You will follow this schedule once your Foley® catheter is taken out.
This information also has tips for emptying your neobladder and managing urinary leakage. Urinary leakage is also called urinary incontinence (in-KON-tih-nents). It’s when your urine leaks and you cannot control it.
Urination schedule to empty your neobladder
When you have a neobladder, you will need to urinate (pee) on a schedule. This is called a voiding schedule or a urination schedule. It’s important to follow a urination schedule as you heal from surgery. It will help keep you from overfilling your neobladder.
You may find it hard to get used to a urination schedule at first. That’s OK. It takes time and practice. In time, you will get into a routine that’s right for you.
Below is a sample urination schedule of when to empty your neobladder. Your doctor may tell you to follow a different schedule. Follow your doctor’s instructions.
| Sample urination schedule to empty your neobladder | ||
|---|---|---|
| Daytime | Nighttime | |
| Week 1 | Empty your neobladder every 1 to 2 hours. Do not wait more than 2 hours to empty it. | Empty your neobladder every 3 hours. Do not wait more than 3 hours to empty it. |
| Week 2 | Empty your neobladder every 2 to 3 hours. Do not wait more than 3 hours to empty it. | Empty your neobladder every 4 hours. Do not wait more than 4 hours to empty it. |
| Week 3 | Empty your neobladder every 3 to 4 hours. Do not wait more than 4 hours to empty it. | Empty your neobladder every 5 hours. Do not wait more than 5 hours to empty it. |
| Week 4 | Empty your neobladder every 4 hours. Do not wait more than 4 hours to empty it. | Empty your neobladder every 5 hours. Do not wait more than 5 hours to empty it. |
| Week 5 | Empty your neobladder every 4 hours. Do not wait more than 4 hours to empty it. | Empty your neobladder every 6 hours. Do not wait more than 6 hours to empty it. |
Tips for following a urination schedule
- Never go more than the scheduled number of hours without emptying your neobladder. If you wait longer than the scheduled time, your neobladder can become overstretched. This can harm or burst your neobladder.
- Set an alarm clock to wake you up in the middle of the night to empty your neobladder.
- You may feel pressure or fullness between the times you’re scheduled to empty your neobladder. If you do, urinate before the next scheduled time.
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You may have urinary leakage between the times you’re scheduled to empty your neobladder. If you do, shorten the number of hours between emptying your neobladder. For example, if you’re scheduled to urinate every 3 to 4 hours, try urinating every 2 to 3 hours instead.
- As the weeks go on, you may still have urinary leakage between the times you empty your neobladder. If you do, go back to last week’s schedule. Your neobladder may not be able to hold the higher amount of urine.
Emptying your neobladder
Some people do not feel any sensation when they need to empty their neobladder. If you feel a sensation, it will be different than what you felt when you needed to urinate before your surgery. You may feel:
- Pressure
- Fullness
- Mild cramps in your abdomen (belly)
Follow these instructions to empty your neobladder:
- Sit on the toilet and relax your pelvic floor muscles. It’s important to sit while you urinate, even if you have a penis. Sitting will help relax your pelvic floor muscles.
- Take a deep breath and hold it.
- Bear down, as if you’re trying to have a bowel movement (poop). Purse your lips and blow out, like you’re trying to blow up a balloon.
- Hold this position for 10 to 15 seconds.
- Open your mouth and breathe out.
As you heal from surgery, your doctor will check to see how well your neobladder is emptying. It may not be emptying completely. If so, you may need to put a catheter through your urethra into your neobladder to empty it. A catheter is a thin, flexible tube. If you need to use one, a member of your care team will show you how.
Tips for emptying your neobladder
Follow these tips when emptying your neobladder.
- Sit on the toilet seat. Sit all the way back on the seat with your feet flat on the floor. Do not squat over the seat.
- Keep your mouth open. This can help relax your pelvic floor muscles during urination.
- Do not rush, strain, or use any force. Relax and release your pelvic floor muscles while taking deep breaths.
- Breathe in through your nose and out through your mouth, or gently hiss through your teeth. Gently direct the air down toward your neobladder, while contracting your abdominal muscles (bearing down). Urine should start to flow.
- Whistle. This can help put pressure on your abdomen, which helps urine flow.
- Lean forward. This can help move urine out of a pocket in your neobladder where it may have collected.
- Practice double urination. Double urination is when you empty your neobladder twice. To do this, sit on the toilet and urinate as you normally do. When you’re done urinating, wipe yourself, stand up, shake your hips, and sit down again. Then, lean forward to see if any more urine comes out.
Managing urinary leakage
After your Foley catheter is taken out, you will probably have urinary leakage. This is when your urine leaks and you cannot control it. You will need to use urinary pads or briefs (such as Depends®) for the first few months after surgery.
The leakage will get better over time as your pelvic floor muscles get stronger. Urinary leakage at night and under stress conditions will take longer to stop. A stress condition is something that puts pressure on your neobladder, such as when you cough, sneeze, or strain.
Talk with your doctor if the leakage does not get better and is bothering you.
Make your pelvic floor muscles stronger
You will use your pelvic floor muscles when you empty your neobladder. To make your pelvic floor muscles stronger after surgery, you will need to do Kegel (KAY-gull) exercises. Doing Kegel exercises will also help you control when you urinate and prevent urinary leakage.
Your nurse will give you information on how to do Kegel exercises. You can start doing them once your Foley catheter is taken out. In time, you will start to have better urinary control during the day. Nighttime control will follow.
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