Bladder problems typically take the form of urinary incontinence (leaking urine) and urinary retention (inability to empty the bladder) and can arise from neurogenic disorders such as spinal cord injury, multiple sclerosis and spina bifida. Incontinence and retention can also be age related, or result from an underlying physical disease, caused by a dysfunction in the bladder. 

Taking care of your bladder

Bladder problems must be properly managed, if left untreated they could result in serious health issues. 

There are many options available to help manage bladder problems:

• Pelvic floor exercises
• Bladder retraining
• Catheters
• Collecting devices
• Lifestyle changes
• Medication
• Surgery

Pelvic floor exercises

Pelvic floor exercises are designed to strengthen the pelvic floor muscles to help reduce urinary incontinence.

• Slowly contract and lift the pelvic floor muscles and hold the position for five seconds, then release
• Quickly contract and release the pelvic floor muscles

You will need to do the exercises regularly and it may take several months before you see a significant improvement.

Bladder retraining

Bladder retraining to help reduce urinary incontinence aims to gradually stretch the bladder so that it can hold larger volumes of urine.

Catheters

Clean intermittent catheterisation (CIC) is an effective bladder management technique based on the regular and complete emptying of the bladder by using a catheter. People who catheterise to empty their bladder typically need to do so 4-6 times a day.  

Collecting systems (for men)

For men who leak urine (male incontinence), urisheaths are an effective and comfortable solution. The urisheath is worn over the penis and is connected to a urine bag fastened to the leg. 

Lifestyle changes

For some people managing symptoms may include lifestyle changes, such as modifying the diet to reduce constipation and reducing the consumption of caffeinated beverages. Timing fluid intake at certain times can also be helpful so the need to urinate is more convenient and doesn’t coincide with excursions in public or sleeping at night.

Medication

Drugs are prescribed for all types of incontinence, but they are generally most useful for urge incontinence, particularly when combined with pelvic floor exercises and bladder training. Stress incontinence is usually managed without medication.

Surgery

A variety of surgical procedures are available for the treatment of bladder problems. Deciding which procedure, if any, you use depends on the type and cause of incontinence.

If your bowel does not work effectively, you may experience bowel leakage and/or constipation.

Bowel leakage

Bowel leakage is the involuntary passage of stool e.g. you cannot control when your bowel opens, often resulting in bowel accidents.

Constipation

There is no exact science to what constitutes constipation as the symptoms vary from person to person. It is often characterised by decreased bowel movements and straining at defaecation. 

Neurogenic bowel

Neurogenic bowel is a lack of nervous control which prevents the bowel from functioning effectively and is caused by a neurogenic disorder like spinal cord injury, multiple sclerosis and spina bifida.

Why is bowel care so important?

Having a good bowel care routine will improve your physical and emotional well-being and help you to:

• Have regular and pain-free bowel movements
• Prevent bowel leakage and constipation
• Improve your quality of life

Options available to help manage bowel problems

To manage both bowel leakage and constipation, there are a number of treatment options available in increasing order of invasiveness:

• Conservative treatment
• Digital stimulation
• Trans anal irrigation, also known as bowel irrigation e.g Peristeen^®
• Sacral nerve stimulation
• Antegrade colonic irrigation (ACE)
• Sacral anterior root stimulation
• Stoma

It is most likely that you will be offered conservative treatments first, such as moderating diet and fluid intake and/or taking medication, such as bulking agents, laxatives and enemas. 

Bowel irrigation

If your bowel problems are not solved using conservative methods, and you are still experiencing bowel accidents or having difficult emptying your bowel, then bowel irrigation may help. Bowel irrigation can prevent bowel leakage and constipation by making sure that bowel movements are regular and predictable.