54 Because she seems to have trouble emptying her over-distended bladder, she gets instructions on double voiding. She can try to do it every time she voids or at least morning and before she goes to bed. We talk about how she could achieve the different steps of the treatment. Does she need some sort of reminder to help her with drinking and toilet visits? She has a mobile phone and can use that to set reminders in school and at home. She gets another bladder diary to complete at home before the next visit. Posture toilet Lisa sits on the toilet with her pants way up on her thighs and with her legs together. She can take her time on the toilet and can easily sit 5-10 minutes watching her phone. Lisa gets information about the correct toilet posture with her pants down below her knees and sitting with legs apart and her feet on the floor. She gets training instruction not to try to push her urine out but to relax the belly, buttocks, and thighs so that she doesn’t tighten the pelvic floor. It’s good that she takes her time on the toilet, but she seems to sit longer if she is having her phone. Contact by phone with Lisa and her mother after 1-2 weeks Lisa has worked on her toilet and drinking routine. She has now 5-6 toilet visits a day but can’t always pass urine every time. She has set an alarm on the phone every 2-3 hours and tries to follow this. She drinks a little more than before during the day. Her incontinence has happened one time since the visit, which is an improvement. When sitting on the toilet she thinks about the advice about posture and not to try to push the urine out. She feels that sometimes all the urine doesn’t come out but does not try to push it out now. When she double voids, some urine will come out. Her mother feels that Lisa is taking the training seriously and her parents don’t need to remind her a lot.
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