Important points to 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 use some products during sex, the obvious ones being those that cover the genitals such as pads or male devices, there are other 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 (usully 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.

Product suggestions

Pads

• Try to find products which are slightly more aestheically acceptable to you than plain, unisex products e.g. male or female specific disposable or washable pants. Some disposable pants for women have pretty patterns on them and others for men are in more masculine designs. Some washable pants for women have lace panels, and are in different styles e.g. bikini or thong, and for men boxers are available with built-in absorbent pads.

• Ensure you have discreet bed protection e.g. under your usual bed sheet so you are less worried about the mattress if you leak when not using you usual body-worn protection.

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Female devices

• An internal urethral device may be acceptable although should be used with caution during vaginal intercourse as this could result in dislodgement of the device into the bladder and an increased risk of bacteria entering the bladder.

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

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Male devices

• These mainly cover the penis and are therefore not an option during penetrative sex.

• The penile clamp may be useful. It 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 rememb er to have something absorbent to hand.

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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.

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Catheters

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

• If you cannot manage IC, you may need an indwelling catheter. If your need for a catheter is more than short-term, you should consider having a supra-pubic catheter (SPC). The catheter enters your body between your belly button and pubic bone.

• If you are unable to have a SPC, 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, try using a catheter valve as opposed to a drainage bag - 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 pistoning effect (in out movement of the catheter) during penetrative sex. This can increase the risk of bacteria entering the bladder.

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Toielting aids

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

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