All the following products should be used only on medical advice.
A catheter is a fine hollow tube which is inserted into the bladder to drain the urine away. It must be used on a doctor's advice only and is available on prescription. Catheters can be prescribed for temporary use - following an operation for example- and some people use them for life. There are different lengths and sizes for children, men and women, and there are two types.
An intermittent catheter is one which you fit into your bladder and remove several times a day, emptying the contents into the lavatory or a jug. People are usually taught to do this for themselves. Some catheters are lubricated for easy insertion.
An intermittent catheter set with a mirror
An indwelling catheter may be inserted into your bladder through your urethra (urethral catheter), or through your abdomen (suprapubic catheter). Both are simple procedures which do not hurt, but may feel a little uncomfortable the first time. They are usually fitted by a doctor or nurse, though some people are taught to change their own as required, such as after two or three weeks or months. They are connected to a drainage bag which holds the urine. This is emptied as necessary, through a tap. Try different taps to see which suits you best, depending on the nimbleness of your fingers and your eyesight. The bag may be strapped to your leg or worn in a special holder or underwear. You may prefer to have the bag supported in a pouch sewn on to your trousers or skirt.
Urine drainage bag discreetly fitted to the thigh
Leg bag sizes vary to hold between nearly 1/4 pint (125 ml) and 2 1/4 pints (1300 ml). At night the bag can be attached to a night bag containing up to 3 1/2 pints (2 litres), so you do not need to worry about waking up to empty it. The bag has to be compatible with your leg bag attachment. Also it is important to use a night bag holder so that the tap does not touch the floor - to avoid germs on the floor.
An alternative to the bag is a catheter valve. You release this at regular intervals - it is very important not to allow your bladder to become overfull with urine. Again you may need to try several types for easy emptying and neatness under your clothes.
- Most catheter companies have free information booklets on how to care for yourself and your catheter.
- You can still have sexual intercourse with a catheter in your bladder. For further practical information, contact the Spinal Injuries Association (www.spinal.co.uk/) or Promocon. (See helpful organisations).
Many women experience stress incontinence due to weakened pelvic floor muscles. This can be prevented or cured by strengthening the muscles. The simplest treatment is pelvic floor exercises, which you can be taught by a nurse or physiotherapist. Other treatments available include electrical stimulation and biofeedback.
Vaginal cones (above) - available in different weights - can help with pelvic floor exercises. You put the lightest weight cone into the vagina for a short period once or twice a day, gradually building up till you can hold the next heaviest weight. The muscles tighten to hold in the cones and this helps you to identify your correct pelvic muscles. You exercise to strengthen the muscles several times a day. Women of all ages can do the exercises, sitting, lying and standing. A set of cones costs £20 upwards.
A penile sheath - sometimes called a condom or an external catheter - is a soft sleeve which fits over the penis to collect urine and is attached to a leg drainage bag. It may be self-adhesive, or you may need to use a separate adhesive. Sheaths are available in latex or non-latex materials and come in a range of sizes. It is very important that you are measured for the correct size and learn how to apply the sheath. Many companies have a free Helpline and provide a measuring or sizing kit. Most sheaths can be used once only, and most are available on prescription. They can be used during the day, at night or left on for 24 to 48 hours and then changed. Many men prefer this method to wearing pads, especially if they are travelling away from home.
Body-worn urinals come in several designs depending on the type of leakage. Drip and diaphragm urinals are suitable for men with a moderate dribble. Pubic pressure urinals and penis and scrotum urinals are designed for men with a retracted penis. They are normally fitted by an experienced appliance practitioner, who can advise on the best type for you. They can be left on for longer periods and will last for several months if they are washed and stored according to the instructions. Most are available on prescription.
Self-adhesive sheaths attached to leg drainage bag
- Sheaths and urinals need to be the right size, to allow for natural movement of your penis, but not so loose that they might leak or fall off.
- Sheaths with a bulbous outlet are less likely to kink.
- A self-adhesive sheath with an applicator is easier to manage if your fingers are not very nimble.
- A sheath is not suitable if the penis is very small or has become retracted. A larger shaped pad or a body-worn urinal is better.
- It is important to wash and dry your penis and surrounding area thoroughly before putting on a fresh appliance.
- Washing and drying urinals regularly will help to prolong their use.
- No appliance can be guaranteed to be 100% waterproof. Leaks are less likely if you follow the manufacturer's instructions.
The anal plug (below) can be an alternative to pads for people with leaks from the bowel. It is a small foam tampon with a long string for easy removal. You insert it into the back passage and can leave it for up to twelve hours, though you will need to remove it for a bowel movement. The plug is useful when swimming or out on special occasions. Not everyone finds a plug comfortable or effective. It is available on prescription.
An enuresis - bedwetting - alarm is a device that prompts you to wake up when your bladder needs emptying and to hold on until you can get to the lavatory.
There are two types:
- a bedside alarm with a sensor pad that is placed under the bottom sheet, and connected to a control box placed by your bedside.
- a personal or mini alarm with a sensor worn inside a slim pad or in y-fronts by men. It is connected to a control box pinned to your night clothes.
Alarms are available with sound, flashing lights and vibrating signals. Most cost between £30 and £65, but they can be borrowed from local enuresis clinics. For further information, contact the ERIC (see helpful organisations).
A bedside enuresis alarm
A personal mini alarm
If you want to know more about any of the products we have described, and where to get them, contact PromoCon (see helpful organisations).
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