[Training of patients with residual urine and/or recurrent urinary tract infections]

The principles for voiding instructions to patients with symptoms due to residual urine and to patients with recurrent urinary tract infection are reviewed and motivated. Residual urine may be reduced by triple voiding at one-minute intervals, fixed voiding intervals of three hours and by treatment of constipation. Additional abdominal straining and manual suprapubic expression may be necessary. To improve the voiding technique, pelvic floor training or bio-feed-back are advocated with the purpose of teaching the patients to strain without squeezing the pelvic floor muscles. In cases without symptomatic relief, clean intermittent self-catheterization is advocated. The frequency of recurrent, uncomplicated, symptomatic, bacterial urinary tract infections may be halved by copious fluid intake (at least 2 litres per day), voiding every three hours in the daytime regardless of desire to void, triple voiding until the bladder is empty and regular bowel emptying. Women are advised to void after sexual intercourse.