Important points to consider

There are some important things you may consider:

• Developing a good understanding of the nature and pattern of your bladder / bowel leakage can help you to take advantage of potentially "leak-free" periods.

• Although it may be difficult to enjoy intimacy or sex while using some products, there are often alternative products that may be helpful.

• Specific sexual activities vary and you may need to re-think your usual practices and products depending on your symptoms.

• Bladder and bowel symptoms can vary from day to day or month to month and so you may need to change your products to suit your changing needs.

• Most people who have bladder/bowel leakage are scrupulous about hygiene as they fear they smell (usually that is not the case!) and are concerned not to get sore skin. Try to ensure your bladder / bowel is empty before sex and make sure you are feeling clean and fresh.

• Some women experience urinary tract infection after sex and may benefit from a one off dose of antibiotics – this is something to discuss with your family doctor.

Product suggestions

Absorbent products

• Recently, more attractive product designs have become available. If you have very light urine loss washable pants may be suitable. They are available in a range of styles and designs for men and women, and often are designed to resemble regular underwear. Some washable pants for women have lace panels, and are in different styles such as bikini or thong, and for men boxers are available with built-in absorbent pads.

• For heavier urine loss you can now purchase disposable pants in more feminine and masculine designs from supermarkets, pharmacies and online.

• Rustle-proof discreet bed protection is available and can be used under your usual bed sheet to protect the mattress if you leak when not using your usual body-worn protection.

You can read more information about all types of absorbent products in the sections on Absorbent products for women and Absorbent products for men and about bed protection here.

Catheters

• If you need to use some form of catheterisation to empty your bladder, intermittent catheterisation will give you much more freedom for sexual activity.

• If intermittent catheterisation is not suitable for you, you may need an indwelling catheter. If your need for a catheter is more than short-term, a supra-pubic catheter is an option as the catheter enters your bladder between your belly button and pubic bone rather than through the urethra. Some people find that this allows for greater freedom for sexual expression, whilst others are uncomfortable as they feel it has altered their body image.

• There are things you can do to make sexual intercourse slightly easier even with a urethral catheter. Men can fold the catheter back along the shaft of the penis and cover it with a condom.

• For men and women with either a supra-pubic or urethral catheter, you could try using a catheter valve. This allows the collection bag to be disconnected without risk of the urine leaving the catheter. Catheter valves are a relatively discreet product. The catheter can then be taped onto your abdomen so it is less in the way.

• Use plenty of water-based lubricant to reduce the piston effect (in-out movement of the catheter) during penetrative sex, which can increase the risk of bacteria entering the bladder.

You can find more information about catheters here.

Female devices

• An internal vaginal device would only be suitable if vaginal intercourse was not part of your sexual activity.

You can find more information about female devices here.

Male devices

• Most male devices cover the penis and are therefore not an option during penetrative sex.

• A penile clamp can be used for short periods and if you are able to tolerate it without too much discomfort you may find it useful. It will need to be removed to allow full erection and some urine tends to leak on removal so remember to have something absorbent to hand.

You can find more information about male devices here.

Faecal devices

• If you have bowel leakage, try to ensure your bowel is as empty as possible before sex. You may use a bowel washout device for this.

• An anal plug may be useful in reducing the risk of bowel leakage during sexual intercourse. Generally, people who have sensation in their lower body find anal plugs hard to tolerate but you might manage for a short period.

You can find more information about faecal devices here.

Toileting aids

• If you experience urinary urgency and/or incontinence you may find it useful to have a small hand-held urinal nearby so you can quickly empty your bladder.

Follow these links to find more information about toileting aids for women and toileting aids for men.

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