Prevalence of Incontinence  

This article discusses the importance of considering sustainability when selecting/recommending incontinence management solutions. It is estimated that 14 million men, women, young people and children of all ages are living with bladder problems. 1 in 10 of the population are affected by faecal incontinence. Over half a million adults suffering from faecal incontinence. Urinary and faecal incontinence are conditions affecting one in three people living in residential care. As well as, two in three nursing home residents.

Anyone of any age or with any medical condition who has a continence problem should seek healthcare professional support and advice. Often there solutions to resolve the problem or reduce the impact. However, for some, achieving continence is not possible, so effective containment is vital to quality of life, independence, dignity and self-esteem. 

We are all aware of the importance in reducing our climate footprint. How can we be more sustainable when it comes to incontinence products?

 Sustainability

Sustainable healthcare is a major goal both worldwide and for the NHS. Single-use products are a key contributor to plastic waste (Sustainable Development Unit, 2020). Incontinence management is heavily dependent on single-use products; many of which contain non-biodegradable materials including plastics. These include urinary drainage sheaths and catheters as well as containment products. NHS Inform (2020) estimates that three million to six million people in the UK experience urinary incontinence and that demand for containment products is likely to rise because risk factors for incontinence are increasing. These include advancing age, lifestyle factors, dementia, neurological conditions, complex comorbidities and obesity.

A more sustainable approach to containment product provision currently depends on a reduction in use of single-use products and their substitution with reusable alternatives. There are advantages and disadvantages to both washable (reusable) and single-use products. A ‘mix and match’ approach is key.

For many people, the introduction of washable products may be acceptable. However, some will only be able to manage these in combination with other single-use versions for specific times of the day. Working towards strategies for sustainability in continence care; such as reduce, reuse, recycle – requires a thorough understanding of the lifecycle of products and associated processes. This is the responsibility of us all. This includes product manufacturers, policymakers, purchasing agencies, prescribers, researchers, health professionals and end users.

Environmental sustainability

Both cloth and disposable containment products have environmental impacts. Some of these include: the consumption of natural resources, energy usage, health issues, air and water pollution and waste disposal. However, the damaging impact from cloth containment products is less than that of disposable containment products.

Disposable containment products are usually made with wood pulp, oil and plastics. Cloth products are often made of cotton or other natural fibres. Choosing cloth instead of disposable containment products represents a significant way to reduce oil and tree consumption.

Billions of containment products end up in landfills and an estimated three billion disposable containment products are thrown away every year in the UK. This accounts for 2-3% of all household waste, according to recycling charity WRAP. Methane is released into the air during the decomposition of disposable containment products. This contributes significantly to global warming. Disposable containment products have a negligible recycling rate. The absorbent gels and plastic components found in disposal containment products take up to 500 years to decompose.

For the millions of people who are affected by incontinence, management products are an important part of their lives and ensure dignity, self-esteem and allow them to continue with their usual activities

Introducing Washables Incontinence Underwear

Washable incontinence underwear is largely produced from natural materials such as cotton or bamboo, biodegradable and renewable resources. A pack of seven washables can be used up to 250 times per pair – lasting about two years at very low cost. Therefore, healthcare providers can save significant amounts of money each year and increase sustainability by sensibly switching to washables for the right patients according to a good clinical care pathway.

Washable pants may provide adequate absorbency during the day for some patients who have light to moderate bladder leakage, or those who experience only occasional light leakage (perhaps just after urinating) and want some form of protection “just in case”. They are very good at staying in place and are relatively discreet. They may be the best solution for those who are physically active. Overnight use of washable containment products may be better suited for men and women who sleep on their backs with light leakage. When selecting washable containment products, it is important to consider whether they are the right size, the right absorbency, and whether the patient and/or their carers/relatives can manage them.

Most washable containment underwear for adults is adapted to fit either male or female anatomy. With more padding at the front for men and more padding in the middle for women. There are a diverse range of styles available, ranging from classic briefs to boxers for men and full cut pants through high leg, lace and mid-rise to bikini styles for women. Similarly, for children there are pant and boxer styles available.  

Initial Preparation & Washing:

The garment should be washed once before using. Underwear can be washed in a normal wash cycle without bleach or fabric softener. The garment must be fully dry before it is worn.

In a care home setting, it can be useful to label underwear with indelible ink. It may also be helpful to put the used product into the washing machine in a net bag to ensure easy identification.

To conclude, sustainability is vitally important to us all. The NHS is the first health service in the world to commit to reaching carbon net zero. This is in hopes to address the increasing threat to human health of climate change.  All those with an interest in continence care should be adopting solutions that maintain the dignity, independence and quality of life of patients while reducing the reliance on disposable single-use containment products.

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Incontinence is a very common condition. In fact, urinary incontinence is said to affect approximately 14 million people in the UK alone, while nearly half a million people are estimated to experience some form of bowel incontinence. 

However, despite these high figures, many people who struggle with incontinence can be reluctant to talk about it. This can be for all sorts of reasons, such as embarrassment or generational differences. At the same time, family members may find it hard to broach the subject as well, either due to the nature of their relationship or a lack of knowledge about the condition. 

But talking about incontinence is an important step towards getting your loved one the help they need, and preventing them from suffering in silence.  

In this blog post, we’ll provide you with some practical tips on how to approach a family member you believe may have incontinence with sensitivity and a positive mindset. We’ll also outline the steps you can take to help your loved one manage their condition. 

Conversation tips 

While incontinence may be a tough subject to talk about, if you believe your family member is experiencing incontinence, having that difficult conversation can make a huge difference to their overall wellbeing. It can feel tricky to start the conversation so you might want to try using an article, leaflet or advert as a prompt for the initial chat. 

Acknowledging that it’s an awkward topic can make the conversation a little easier for those who don’t like talking about bathroom habits. 

Remind them that incontinence is a very common problem and that there is plenty of help available. 

Another important aspect when talking about incontinence is to mirror the language your family member uses. For instance, if they refer to it as ’pee’ instead of ’urine’, match the terminology they use.  

Using language that is too formal could also make your conversation feel too clinical if your family member doesn’t usually talk in that way.   

It can also help to start the conversation side by side rather than face to face, for example, while out on a walk or in the car. Being side by side stops the conversation feeling like an interrogation and your family member may be more comfortable opening up. 

What is needed for a positive conversation? 

Making the conversation about incontinence a positive one gets you both off to a good start. Don’t rush the conversation and make sure to talk to them when you know you won’t be interrupted. It’s important to give the conversation the time and attention it needs. 

It’s also important for your loved one to feel relaxed, in control and free from judgement during your conversation. So, try not to talk about their situation with other people without their consent. Even though it may be coming from a place of love and concern, if your loved one found out, it could make them feel embarrassed or reluctant to talk about it at all.  

It can be useful to explain to your family member that incontinence is just like any other health problem, and encourage them to talk about it with their loved ones even if they feel embarrassed.

To ensure the conversation stays positive, maintain a sense of dignity and privacy throughout and respect their decisions. Keep the conversation confidential but let them know the door is always open if they want to discuss it further. 

Next steps 

Knowing what to do next is important for both you and your family member. This way, the conversation will be seen as productive and help promote their independence. One of the most important first steps they can take is to see a healthcare professional to rule out any potential underlying health conditions. 

Let your family member know there is a lot that can be done to help with incontinence. Even something as simple as assisting them when booking an appointment with the doctor can be enough for them to regain some confidence and control over their health.  

Arming yourself with information about incontinence before you have a conversation with your family member can also help you support them in making an informed decision. By ensuring they have more knowledge of their condition, they may feel confident enough to speak with you and a healthcare professional further.  

Helping them choose the right incontinence product can also be a big help. With so many options available, your loved one may feel overwhelmed. But by sharing the job between the two of you, they will feel supported and more secure in their decision. 

Visit Bowel & Bladder UK for printable resources which you can offer to your family member. They could read them in their own time and then talk with you about it afterwards.  

With different resources, you can provide them with a range of options and methods of support. Whether it’s their GP, a continence nurse, Bowel & Bladder UK or elsewhere, with the right help, your family member can feel confident in their incontinence management.

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Incontinence is a common issue that can affect people of all ages. But incontinence doesn’t affect everyone and is not an inevitability of ageing.  

There are also varying degrees of the condition, with some people only experiencing small leaks now and then, while others can lose control of their bladder or bowel completely if unable to reach a bathroom in time. 

In this article, we discuss the signs of incontinence across all age ranges. We also provide you with practical tips on how to support family members with incontinence and some of the best preventative measures that can be used to help.  

Signs to look out for in people of all ages

A lot of people will often feel embarrassed about their incontinence, and it is common for people of all ages dealing with incontinence to hide the fact there is a problem at all. 

When this happens, your loved one won’t receive the help and support they need to manage their condition, which can worsen their condition and lead to increased feelings of anxiety and isolation.  

If you discover one of your family members is dealing with incontinence, it’s normal to feel stressed about the situation – especially if you’re going to be caring for them. It’s important your family member doesn’t feel ‘caught out’ or as though there is something to feel ashamed of.  

People with incontinence deserve the same dignity and respect as those without the condition, so knowing how to support them during such a challenging time is essential.  

Some of the key signs of incontinence – to look out for in people of all ages – can include:  

• Choosing different drinks – for example, drinking decaffeinated drinks instead 
• Stopping drinking after a certain time of day 
• Hiding incontinence products  
• Being secretive about going to the bathroom 
• A smell on their person or in their home 
• A strong scent of cleaning products in the bathroom on a regular basis 
• Personal hygiene issues 
• Staining of their underwear 
• Frequent changing or washing of clothes 
• Buying toilet rolls more often due to increased use 
• Finding tissue in their underwear or washing machine 
• Avoiding social situations 
• New changes to their diet 
• Carrying spare clothes whenever they leave the house 
• Going to the toilet more frequently 
• Needing to get to the bathroom quickly 
• Staying in the bathroom for longer than usual 
• Using sanitary pads 
• Wearing more than one pair of underwear 
• Changes in their mood 
• Finding laxatives in their home that weren’t there before 

If you spot any of these signs, it’s important to speak with your family member in a way that displays empathy, sensitivity and understanding.  

Try to have possible solutions and support in mind before having the conversation. That way, you can help give your loved one hope and ensure they feel fully supported.

Incontinence in children

Children can also experience incontinence. Although you might think it’s easier to spot, children are still good at hiding things they are embarrassed about.  

Here are some signs that a child might need help with their incontinence: 

• Finding wet or soiled underwear 
• Denying wetting or soiling themselves despite their underwear or bedding being wet or soiled 
• Needing to use the toilet more often  
• Often needing to go at the last minute  
• Withholding (standing or sitting in different positions, such as with their legs crossed, to prevent accidents) 
• Avoiding social situations, especially ones like sleepovers or school trips  
• Excessive use of sanitary products  
• Needing to leave the classroom a lot to use the bathroom 
• Trying to avoid going to school – such as claiming to be unwell or becoming angry in the mornings or Sunday evenings

It’s worth remembering that bullying and mental health problems can be linked to incontinence in children. Sometimes changes in behaviour can be misconstrued as ‘naughtiness’. However this isn’t the case; incontinence can not only cause feelings of shame in children but also cause them to behave in ways that they feel will be most helpful to manage the wetting or soiling.

What to do next

If you think a family member or someone close to you is struggling with incontinence, it’s important to talk to them about it from a place of understanding and sincerity. Try to encourage them to speak with a healthcare professional as well so that they can get the support they need.  

If they are embarrassed about the situation, you could even offer to assist them when talking to the healthcare professional. 

In our article, How to talk to a family member about incontinence, we provide further tips and information on how best to approach this difficult subject, such as finding out more information and researching different incontinence products to help them manage the incontinence while they wait for assessment and treatment.  

Doing your own research, for example, can help ease the pressure on your family member’s shoulders. By providing them with options you can help them feel less overwhelmed and ensure they are on the way to getting the right support for them.

Bladder & Bowel UK is a registered charity that has multiple resources to help loved ones support and spot signs of incontinence in both adults and children. They also have a confidential helpline where you can receive specialist continence advice. 

Finding support for both you and your loved one is important when dealing with incontinence. Whether you help them speak to a healthcare professional or find the right incontinence product, showing that you’re there for them can make a big difference. 

The post Signs a family member may need help with incontinence appeared first on Bladder & Bowel UK.

Incontinence can have a serious impact on wellbeing for the person experiencing the issue. What is less often talked about is how hard it can be to support someone suffering with incontinence. 

In fact, we know that in some serious situations, difficulties with managing incontinence can contribute to families making the tough decision to move loved ones to supported housing or care homes.  

Struggling with bladder and/or bowel control can create feelings of isolation, but it is important to know you are not alone if you, or someone you know, are affected. Silence around the issue can be a barrier to getting the help you and your loved one needs, which is why it’s important to shine a light on the issue. 

In this article, we look at the different ways incontinence can impact anyone giving support, including family members and friends, and why it is such an important issue. 

Difficulties for caregivers 

If someone we care about is struggling with incontinence, it is normal to want to help them. However, it’s realistic to acknowledge how difficult this can sometimes be.

Challenges in communication, or wanting a reluctant family member to seek medical help, can cause strain in relationships. Supporting with intimate care, including helping an individual change, use the toilet or washing wet or soiled clothing, may cause physical or emotional strain and impact the caregiver’s own well-being or mental health.

Emotional impact of incontinence

Not only can incontinence be distressing for the individual, causing embarrassment, frustration, or anxiety, practical support may be required from family members which can be difficult to accept. This can lead to a decline in self-esteem, a reluctance to engage in social activities and cause difficulties with mental health. If it is happening during the night, it can also affect sleep, which has an impact on daytime functioning and mood for both the individual and those caring for them.

Family members may experience stress and worry about their loved one’s well-being. They may also feel a sense of responsibility and frustration that impacts their own psychological and emotional wellbeing, mental health and feelings of struggling to cope. Adjusting to a new role of carer, particularly when this involves supporting with intimate care tasks, may be difficult.

Financial impact of incontinence 

Money worries can worsen stress when supporting someone struggling with their bladder and/or bowel.  

There is a financial cost to disposable continence products (pads), as well as for toileting aids, additional clothing and washing. There can also be increased expenses related to medical care, such as travel to appointments for assessment and treatment, and the cost of medications that may be recommended to help. Some people may require home modifications to make their living environment more accessible. Some family carers may have to also give up work or reduce their hours to provide required support, adding to financial strain.

Social isolation

Incontinence may impact a person’s confidence to develop new friendships or relationships, or continue existing ones. Fear of leakage, odour, embarrassment, or a lack of accessible toilets in the community may result in the person with incontinence withdrawing from social activities. It may also limit or deter participation in previously enjoyed activities that may exacerbate the incontinence, such as high impact sports, distance running, remote camping, or long country walks. All of these, together with the time it takes to provide practical support, can also impact their life partner or family members.  

Family members might be hesitant to engage in activities that could be challenging for the person with incontinence, or that they previously enjoyed together. Being unable to leave their loved one, or becoming too tired or emotionally drained to continue with their usual activities will also worsen the situation. 

Changes in daily routine

Those providing care may need to adapt their schedules and routines to accommodate an individual who is living with incontinence. This may include assisting with regular bathroom visits, including at night, helping with personal hygiene, changing of pads and being mindful of the availability of suitable toilets in public spaces. These may impact their ability to work, enjoy leisure and maintain social activities and friendships. 

There may be additional washing and cleaning as well as anxiety about controlling odour, avoiding damage to furniture and managing if car seats or wheelchairs need to be cleaned and dried.  

Communication challenges

The misconception that incontinence is always inevitable, along with taboos surrounding bladder and bowel issues, make it difficult to discuss incontinence or know how to access help. These can reinforce feelings of isolation and make it difficult for family members to offer support, search for solutions or improved management options.  

While open communication is key, discussing incontinence can be a sensitive topic that requires empathy and understanding. Challenges may be compounded when there are gender issues, such as a son talking to his mother, or a father to their teenage daughter, or where to do so would breach cultural norms. 

To address these difficulties, it is crucial for the family member to foster open communication, encourage and support those that they care for to ask healthcare professionals for support, and explore available resources. Community support can also be valuable, and connecting with others facing similar challenges can be beneficial for both the individual suffering from incontinence and their caregivers. Seeking medical advice and implementing recommended practical strategies for managing incontinence, can help mitigate the impact on both the individual and the family. Additionally, support groups and counselling may be beneficial for the emotional wellbeing of both the person with incontinence and their caregivers. 

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Definition of sustainability: using resources responsibly so they are available for future generations, while doing as little harm to the environment as possible.

Urinary incontinence is a common problem, thought by the NHS to affect millions of people. If you or someone you care for has a continence problem, it’s important to see a medical professional as there are lots of options which can improve or eliminate the problem. However, this isn’t always possible, so whether we’re talking about the short or long term, using the correct products for incontinence management is vital for physical health, independence, and quality of life. 

So how can we combine greater awareness of sustainability with proper management of the condition?

Disposable products are the norm

‘Sustainable healthcare is a major goal both worldwide and for the NHS, where single-use products are a key contributor to plastic waste.”

Sustainable Development Unit, 2020 (UK Government Body)

Making incontinence products more sustainable

A more sustainable approach to incontinence management includes reducing the amount of single-use products, recycling, and finding longer lasting, multi-use alternatives.  Thankfully, there is innovation happening within this area.

Multi-use options include: 

•  Washable incontinence underwear: these can be washed and re-worn multiple times. 
•  Female bladder support devices: they are inserted into the vagina to support the bladder neck and can reused.  
•  Male urethral control devices: these are wrapped around the penile shaft to restrict urine flow.  
•  Male body worn urinal: they have an inner receptacle lining that drains urine from the penis and direct-connect leg collection bag. 

These options are more sustainable because they result in fewer products being thrown away and fewer products being produced in the first place. They can also be more cost-effective than the disposable products.  

Hygiene, comfort, and quality of life 

For people with continence difficulties, hygiene, comfort and quality of life are the priorities.

Appropriate use of the right product for the right person reduces the likelihood of skin irritation, dermatitis, rashes, skin infections and moisture lesions. It is also important to consider effective containment, lifestyle, maximising independence and personal preference.

Pros & cons of disposable pads 

• Disposable, single-use pads usually need to be changed several times during the day, when the pad reaches its absorbency capacity (some have a wetness indicator to guide changing), or is soiled.  This has a time and cost implication.  

• Disposable pads are often designed to reduce odour and lock urine and moisture away from the skin. Some new generation products have devices that alert an app when the product needs to be changed.  

• They come in many sizes and designs, meaning that there should be a product available for all levels of incontinence and different body shapes.  

• They are widely available.

• They are non-recyclable for hygiene reasons and are often made with non-biodegradable materials. 

Pros & cons of washable products  

• Washable products usually require a larger initial financial outlay.   

• They require individuals to have access to a washing machine, and appropriate facilities to dry them, such as a tumble drier, well-ventilated house, or access to outside drying.  This can be time consuming for the individual or their carers. 

• They have a reduced carbon footprint thanks to their multi-use nature: less production, and less waste. 

• New innovation means that a wider range of washable products are available. Like disposables they come in a range of sizes, designs and absorbencies which are discrete and effective.

• Washable products may be worn throughout the day and night, like disposable products. 

Most washable products are made from soft natural fibres, so are comfortable. 

Support to make the right decision

For the millions of people who are affected by incontinence, management products are an important part of their lives and ensure dignity, self-esteem and allow them to continue with their usual activities. 

There are lots of things to consider when deciding on the best option for anyone managing a continence issue. It is important to be aware that treatment is possible for many conditions.  Where this is not an option, or is not immediately possible, it is helpful to know that there are other products than just the disposable pad that has been available for many years. Happily, research and development continues to explore innovative and increasingly sustainable alternatives. 

Your healthcare professional can provide more advice, information and support

This article is part of the Education Spotlight on Urinary Incontinence, supported by iMedicare. You can also read more about constipation in our information library here.

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Stress urinary incontinence is when you leak from your bladder when coughing, sneezing, laughing, running or jumping, for example. Usually only a small amount of urine is passed. It occurs when the pelvic floor muscles around your bladder and anus (back passage) become weak or stretched.

What causes stress incontinence?

Stress urinary incontinence can happen at any age. It is caused by a weak sphincter (a muscle at the bladder outlet), or by poor support to the bladder outlet from the pelvic floor muscles and ligaments.

This usually happens because the muscles of the pelvic floor are weak or damaged. Pelvic floor muscles may become weakened by pregnancy, childbirth, and delivery, straining to empty the bowel, repeated heavy lifting, menopausal changes, long term coughing, constipation and being overweight, lack of general fitness and high impact sports.

What are the pelvic floor muscles?

The pelvic floor is made up of layers of muscles, stretching like a hammock from your pubic bone to the bottom of your backbone. These muscles help to hold your bladder and bowel in position, as well as the uterus (womb) in women. They prevent leakage from your bladder and bowel, only relaxing when your bladder or bowel is emptying.

What can I do myself to help with stress urinary incontinence?

You can help yourself by making some lifestyle changes in order to reduce pressure on your bladder and pelvic floor muscles.

• Exercise regularly, including pelvic floor muscle exercises. Avoid exercises that increase the pressure on your abdomen such as high impact aerobics, jogging/running.
• Avoid smoking, which can aggravate bladder weakness through coughing.
• Avoid gaining excess weight. If you are overweight, a weight loss diet might help your incontinence.
• Drinking plenty of fluid each day, typically 1.5-2 litres (6 – 8 large cups or glasses, unless otherwise medically directed ). Drinks containing alcohol or caffeine, for example tea, coffee, or sugary fizzy and energy drinks may irritate your bladder and should be avoided. You can have drinks that do not contain caffeine, such as decaffeinated tea or coffee.
• Limit the amount of caffeine and alcohol you drink to prevent bladder irritation and avoid increased urine production.
• Trying not to become constipated by eating a healthy diet with plenty of fruit and vegetables
• Doing pelvic floor exercises. These can improve your muscle tone (strength), your continence and quality of life. Your health care professional will explain these exercises.
• Seeking medical advice if you have a long-term cough

All of these can also be discussed when you attend your consultation with the doctor, physiotherapist or nurse specialist. They will be able to advise and support you make these changes.

When should I seek further treatment for stress incontinence?

Although you may feel embarrassed talking to someone about your symptoms, we would encourage you to have a chat with your GP if you have any type of urinary incontinence. They are used to having these conversations and you should be encouraged to know that this can be the first step towards finding a way to effectively manage the problem.

Many people wrongly think that incontinence is a normal part of ageing, or that it cannot be treated. We would recommend seeking further advice who can assess and guide on treatment and management.

Will I need any tests?

These are some initial tests that you may have as part of your assessment:

• Urinalysis: This test usesa sample of urine to find out if there is any infection or any blood in the urine.
• Bladder diary: You will be given a chart (bladder diary) so that you can keep a record of the amount of fluid you drink and the amount of urine you pass, for a 3 day period. You can also record other information on the chart such as incontinence. ( link to our diary )
• Bladder scan: This is to find out if there is any urine left in your bladder after you have passed urine. The nurse will check the residual urine using an ultrasound machine to scan the bladder.
•  Physical examination: Your health care professional may need to undertake a physical examination to make a further assessment, for example a pelvic/vaginal, rectal or prostate examination.

Some further tests may be required if the cause of your urinary incontinence is not clear. Your health care professional will usually start treating you first and may suggest these tests if treatment is not effective.

Pelvic floor exercises

These are exercises that improve and strengthen the pelvic floor muscles. It is important that you are shown how to do these correctly and you will be referred to the physiotherapist or specialist nurse for this treatment. They will assess your pelvic floor muscle strength and then advise an individual programme of exercises for you to follow.

Are there any other treatments?

If pelvic floor exercises and conservative options do not help, your health care professional will discuss further treatments, for example, you may benefit from a referral to a Bladder and Bowel specialist nurse, physiotherapist or a doctor who specialises in urinary incontinence.

Further treatments can include medication (tablets), nerve stimulation, physiotherapy or surgery.

Download this information as a leaflet (PDF)

This article is part of the Education Spotlight on Urinary Incontinence, supported by iMedicare. You can also read more about constipation in our information library here.

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As the cost of living crisis worsens, we hear that more and more people are unable to afford essential products to manage incontinence. Bladder and bowel continence problems are common. 1 in 10 adults in the UK are affected by faecal incontinence, and the issue is closely associated with advanced age, and it is estimated that 34% of women are living with urinary incontinence. Incontinence poverty is a growing issue where people can not afford to buy the products they need to manage the problem, which can lead to significantly lower quality of life for individuals and their families, as well as other physical and mental health problems.*

The initiative, devised and delivered by Bladder & Bowel UK and NRS Healthcare, is using networks of community pantries, ‘warm banks’, luncheon clubs and community centres to share information about the provision of free essential products. Packs of incontinence products can also be requested over the phone. The items will then be posted free of charge to the individual’s home. †

“It is all-too-common that people don’t have the products they need to stay hygienic and comfortable, and the rising living costs we have seen will only make this true for more people,” says Karen Irwin, Bladder & Bowel UK’s Service Manager and Specialist Nurse. “We know that not having the right products can stop people leaving the house, seriously affect mental health, and also cause a massive strain on relationships.

“Having access to the correct products is essential to manage incontinence, an issue which affects so many people across the UK.”

Matthew Stead, Managing Director at NRS Healthcare says: “As the UK’s leading online living aids retailer we are delighted to partner with Bladder & Bowel UK to raise the issue of incontinence poverty in the UK, As the cost of living crisis continues to bite, some of the most vulnerable in society are hit the hardest. That’s why we and our suppliers have donated over £150,000 worth of products to this extremely important cause. We encourage anybody affected with incontinence who is unable to afford suitable products to get in touch with us.”

Requests for products can be made by phoning NRS Complete Care Shop on 01772 675 048, while stocks last. For guidance on managing bladder and bowel conditions, visit www.bbuk.org.uk.

*Patrick DL, Martin ML, Bushnell DM, Yalcin I, Wagner TH, Buesching DP. Quality of life of women with urinary incontinence: further development of the incontinence quality of life instrument (I-QOL). Urology. 1999 Jan;53(1):71-6

† While stocks last. Maximum two orders per household.

Bladder & Bowel UK support bladder and bowel health for everyone, offering a confidential helpline offering advice from specialist nurses and product experts. Find essential information about preventing and managing bladder and bowel issues for adults, children and professionals at www.bbuk.org.uk. Media enquiries: marketing@bbuk.org.uk

NRS Healthcare was established in 1947 and has developed a strong reputation for innovation in services and products in the area of rehabilitation aids and equipment for the disabled and injured including those to assist in the rehabilitation of servicemen following WW2. NRS has since grown to become a market-leading and award-winning provider of products and services designed to support independent living and is a trusted supplier to the NHS, proudly serving over 10 million people with mobility equipment and disability aids.  It also sells a range of over 4,500 products directly to millions of consumers via online channels. A smaller division provides clinical services to public sector customers.  NRS Healthcare is headquartered in Leicestershire and operates 22 depots across the UK.

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• New research reveals the challenges male incontinence sufferers face, with half (50%) afraid to leave their homes
• Insufficient public washroom facilities preventing male incontinence sufferers from living a normal life
• New partnership between Initial Washroom Hygiene and Bladder & Bowel UK aims to confront the taboo surrounding incontinence
• Organisations call on UK Government to introduce first of its kind legislation to make sanitary bins in male public washrooms mandatory

9 August 2022: New research from Initial Washroom Hygiene today reveals that half of male incontinence sufferers are afraid to leave their homes. For many of these sufferers,   inadequate facilities in public washrooms – including those at places of work – are preventing them from living a normal life.

The research is part of the company’s new nationwide campaign – ‘Stalls for All’ – that aims to deliver ‘washroom dignity’ for everyone and ensure that people have access to the washroom facilities they need. This first phase of the campaign sees the washroom hygiene company partner with charity Bladder & Bowel UK to raise awareness of the challenges male incontinence sufferers – estimated to be around one in three older men – face*.

A wake up call for all businesses

The research reveals that fewer than just a fifth (17%) of men have facilities in their place of work to dispose of sanitary waste in male washrooms, highlighting a severe lack of support from businesses.

This lack of support is felt particularly by those who suffer from continence problems, with just 36% feeling that their sanitary needs are met when using public washrooms. Such is the extent of the challenges that they face, nearly three in ten (29%) have been forced to carry a used incontinence pad in their bag or coat due to a lack of facilities. These hardships are compounded by the stigma that faces incontinence sufferers  –  over half (54%) do not feel comfortable telling their close friends or family, and 44% are too embarrassed to seek medical advice.

Speaking about his experience of bladder incontinence, George** who is in his thirties says: “Incontinence is completely restricting my lifestyle and social activities. My main concern is that people will find out I have a bladder issue, as I don’t feel comfortable speaking about it to those close to me because of the stigma that comes with it. The lack of toilet facilities at my work also means working in the office is an additional cause of anxiety and stress, which I don’t need”.

Peter** is in his sixties and is experiencing bowel leakage: “I’m really struggling to enjoy retirement because of my experience with bowel incontinence, I’ve even had to give up my hobbies which is heartbreaking for me. I’ve been advised on conservative treatment options and containment products, but because disposal bins are only found in women’s and disabled toilets, living a normal life in public is incredibly difficult”.

Jamie Woodhall, UK Technical & Innovation Manager, Initial Washroom Hygiene comments: “Everyone deserves the right to access the washroom facilities they need, when they need them. Today’s research reveals the shocking reality that many men in the UK face, but this is a reality that can be easily avoided if simple changes are made across the country. This should be a wake up call for all businesses or local authorities with a washroom: now is the time to urgently reassess the state of your washrooms and give your visitors, employees and customers the dignity they inherently deserve.”

Initiating change

The partnership between Initial Washroom Hygiene and Bladder & Bowel UK builds upon the organisations’ individual efforts to ensure washroom inclusivity.

Bladder & Bowel UK supports bladder and bowel health for everyone. It improves awareness of and solutions to continence problems across the country, offering a confidential national helpline, a range of resources, professional training and more.

With six in ten (61%) male incontinence sufferers believing that the Government should legislate to ensure the provisions of better disposal facilities in public washrooms to help those who suffer, Initial Washroom Hygiene and Bladder & Bowel UK are together urging the Government to take immediate action.

Karen Irwin, Specialist Nurse and Service Manager, Bladder & Bowel UK says: “Bladder and bowel problems are a common occurrence, but all too often stigmatised and subsequently undiscussed. Many people with incontinence do not seek help due to embarrassment, lack of awareness of treatment options, or consider incontinence to be a normal part of the ageing process. Incontinence can affect anyone at any stage in life and may be related to other medical issues, for example poor general health, physical disabilities, cognitive impairment, stroke, urinary tract infections, prostate problems, diabetes and many more causes. With severe strains on the NHS in a post-pandemic world, fewer men are visiting their GP to get checked. It is therefore crucial that we create an environment in society where men feel comfortable talking openly about their experiences, and receive the support they really need.”

Discussing the partnership’s goals, Woodhall says: “Not only do we want to recognise and support anyone who has ever faced an undignified or uncomfortable experience when using public washroom facilities, but we want real change. The Government must recognise that a nation-wide conversation is long overdue, and new legislation would go a long way in helping this disenfranchised group.”

* https://pubmed.ncbi.nlm.nih.gov/20541241/

** Case studies anonymised.

About the research methodology

The research was undertaken by Opinium on behalf of Initial Washroom Hygiene. The survey sample was over 900 UK male adults. The survey was carried out online between 11th – 12th April 2022.

About the Initial Washroom Hygiene

Initial Hygiene is a global leader in hygiene services operating in over 45 countries across the world including the major economies of Europe, North America, Asia Pacific and Africa. It provides innovative and environmentally responsible washroom services solutions to large and small organisations across a range of business sectors including public administrations and schools, food and drink manufacturing, hospitality and leisure, medical and paramedical, construction, retail, services and transportation.

The range of Initial Hygiene’s services and supplies includes:

• Hand washing and drying products and services
• Feminine hygiene disposal units and services
• Products for washroom, urinal and toilet hygiene and cleaning

About Bladder & Bowel UK

Bladder & Bowel UK support for bladder and bowel health for everyone, offering a confidential helpline offering advice from specialist nurses and product experts. Find essential information about preventing and dealing with bladder and bowel issues for adults, children and professionals at www.bbuk.org.uk. Media enquiries: marketing@bbuk.org.uk

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I love running; the feel of the weather (whatever that may be) on my face, the stunning vistas I am lucky enough to have on my doorstep, and the feeling of freedom I have when I am out there running….on my own…..or in recent years really very early in the morning when I have less chance of bumping in to anyone, just in case I leak. Does this sound familiar?

Urinary Incontinence – an often unspoken story

It turns out the prevalence of female urinary incontinence can be as much as 70%¹. Many of us live with it in silence, believing that it is simply part of growing older or the result of having children, or feel far too ashamed and embarrassed to seek help. The mental health impact can be severe; recent research indicates 66% of women with urinary incontinence are more likely to be diagnosed with depression and low levels of self-worth². And that is just the women who have put up their hands to be counted.

My Story

I remember clearly the first time I experienced bladder leakage. About 6-months after the birth of my second child I started running; it gave me much needed headspace and was a great stress reliever – I have relied on it ever since. I was out running with a friend and towards the end of our run I suddenly leaked and I leaked considerably: I was soaked. I was grateful for the coverage my oversized t-shirt provided but I felt uncomfortable, hideous and was absolutely mortified. I could not wait to get home and hide away. This continued to happen sporadically for a few years but gradually got worse until it happened all the time when I ran; I also lived in fear of sneezing and coughing. None of my friends talked about having the problems I did and, as a consequence, neither did I. I had never read about it happening to women like me who were not in their eighties (I am now 44). My husband was great, but I felt very alone. Worse still, it stopped me doing things I loved – just in case.

After many years of trying (and failing) to find a solution (and yes, I do my pelvic floor exercises), the supportive pessary I had been using when I ran stopped working and my mental wellbeing nosedived. I tried yet again to get help and I was finally referred for urodynamics. Whilst not the most fun to have on an afternoon, the results confirmed I had stress urinary incontinence (AKA the involuntary bladder leakage during physical exertion and effort) and very slight symptoms of an overactive bladder. When it came to the chat about what could be done to help, I thought it would mean major surgery, so I was surprised to learn about urethral bulking, a much less invasive treatment involving an injection of a non-toxic, hydrogel via the urethra to support the bladder neck. I understood it would not cure me, but felt encouraged by the statistics indicating positive symptomatic improvement, some as much as 67%³. However, I wanted to know more about other women’s experiences of this treatment and what things were like afterwards, not just the statistics I was presented with. So I went away to think through my options and find out more about urethral bulking.

During my research, however, I found that whilst first-hand accounts of women’s experiences of stress urinary incontinence exist, as well as the impact that other surgical treatments had on physical symptoms and quality of life, detailed accounts of women’s personal experiences of urethral bulking were lacking and I felt needed. Having an insight into women’s experiences of this procedure would have provided me with an important aide alongside medical information and opinion when making a decision about the best choice of treatment for me in managing my own stress urinary incontinence, so I felt sure it could help other women too. I felt so strongly, I decided to do a research piece for my MSc dissertation – so, here I am.

Can you help?

I am looking to interview women on a one-to-one basis so they can share their experiences of stress urinary incontinence and the difference that having urethral bulking has made for them; it is my hope that other women might benefit from this knowledge in the future when it comes to their own treatment decision-making. Participation is confidential and all data anonymised meaning nobody will be able to identify who took part. So, if like me you have experienced bladder leakage and had urethral bulking, I would love to hear from you.

To find out more and register please visit https://bit.ly/31lOglk

Thank you for reading.

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Many questions are asked about wearing sanitary protection in combination with a continence product. There is little research on the subject. Continence nurse specialists usually advise that it is an individual choice for the person, their carer or family. If sanitary protection is required in conjunction with a continence product, it could be used on days when the menstrual flow is at its heaviest.

If you do decide to use a sanitary product in combination with a continence product, the information below may be useful:

• Sanitary protection may be used inside a continence product, but it is not designed to absorb urine.
• Continence and sanitary protection have odour protection, this helps any reduce the risk of odours. Some sanitary protection may also contain perfume to help mask any odour.
• Continence products have leakage barriers or leg elastics, that repel urine into the core of the product. This helps prevent leakage. Sanitary protection may not have this function.
• If you receive continence products from the NHS, extra products will not be supplied during menstruation, therefore the use of sanitary protection many be beneficial.

Here are some hints and tips to consider if you decide to use sanitary protection inside a continence product:

• Sanitary protection should be positioned securely into the continence product using the adhesive strip to keep it in place. If the sanitary protection has wings ensure that these are secured, however there is no evidence to suggest that product with wings add any benefit for use with a continence product.
• Ensure that sanitary protection does not disrupt the way that the continence product is fitted. It is important to make sure that the continence product is kept close to the body and that leakage barriers and leg elastics are correctly positioned to minimize the risk of leakage (follow manufacturing guidelines)
• Ensure that sanitary protection is changed regularly to help keep the person’s skin clean and dry. The continence product only needs to be changed at the same time intervals as on days when the person does not have a period unless it is soiled, or nearly full. (follow manufacturing guidelines)

Recommended products

• Tampons or menstrual cups may be used in conjunction with continence products, but these may not suit everyone and should only be used by women and girls who can insert and change them independently or if consent is given.
• If tampons or a menstrual cup are not appropriate, a continence product may be used without a sanitary towel
• For some women and girls, hormonal medication to reduce or stop menstruation may be appropriate. Your GP will be able to offer advice on the choices available.

Remember, deciding whether to use sanitary protection inside an incontinence product or not, is an individual choice. Whichever option you choose, it has been Attends intention to provide you with some useful insight on this topic.

Visit Attends UK website: https://www.attends.co.uk/ 

Get in touch with us

Bladder & Bowel UK have information about a wide range of bladder and bowel conditions for children and adults on our website. For free confidential advice and support please contact our helpline via the webform or on phone number 0161 214 4591.

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