Incontinence and Other Issues

If you are suffering from incontinence of any sort, rest assured you are certainly are not alone and you can join a family of others. You will join literally millions around the world who also suffer. People suffer from incontinence for all kinds of different reasons, from genetic, neurological damage from accidents that have affected the lower back/spine, old age, childbirth or prostate problems, there are many reasons.


It has to be said that we at Down-Undercare cannot offer ‘professional’ advice, however we can provide feedback on what other people have suffered from and the way they dealt with it and some of it is general knowledge.


We must also remind ourselves that people who are hunting for information on incontinence are not only those that suffer themselves and never had to deal with the problem. There are many others who have suddenly become carers who are flung into the situation on a daily basis where they are caring for loved ones. Many people never thought they would have to deal with the situation! It is a complete wilderness, with little guidance or information from anyone.


To assist with those who have not had to deal with previously we have included a page on how to apply a nappy, which may be helpful to some.


I am or have a relative who is suffering with Incontinence, where can I get help?

Suffering from incontinence is never good news, and we suggest you speak to your own doctor to discuss the issues and the possible cause. From our experience we have found that some medical professionals will offer plenty of guidance about the cause, but have little knowledge of what is available in the way of protection because they have never had to deal with it.


Some physiotherapists specialise in continence issues and may be able to rehabilitate a variety of muscles and offer their own advice. The Australian Physiotherapist Association will identify a Physio who works in this field for you. You can contact them on 1300 306 622. Historically they have had a website that you can use – however at the time of writing this function is not available but may be when you read this. Use your search engine to look for “Find a Physio”.


You may have already discussed your issues with your medical professional and need to think about Protection and wearing a garment of some description.


Below we have provided some information about the types of product and styles that are available.


Depending on the severity of the problem this will indicate which product is suitable for you, from a simple pantie type liner – and similar products which increase in capacity and cost. You can then step up to a pull on pant type product and then step up again typical ‘nappy’ or Diaper / Brief style product, should you require the extra protection – so these are your options.


Minimising cost is an important factor as incontinence aids are expensive and it is often an ongoing cost. There is no need to use a large capacity (expensive) product if you do not require it. You will find that most types of product will be available in different capacities. So again, depending on your day to day circumstances, you will be able to use a lower capacity product (and lower price) during the day, and then at night you may require a larger or different type of product. Pull up pants are of limited use as they are unable to hold a great deal – and thus the requirement to go to the nappy style product.


For males, instead of a pantie liner style product you can use an anatomically designed absorbent ‘cricket box’ style product which sits comfortably in the jocks. These hold a surprising amount and are comfortable to wear and are unobtrusive, they are quick and easy to change and relatively inexpensive to purchase.


If leakage occurs – which it frequently does (more especially at night) you may like to consider some waterproof over pants. These can be hard to get hold of, however we stock a high quality pant in 5 different colours and 11 different sizes from 3xs – which would probably fit a 4yr old – to 5 XL. These pants provide an useful ‘insurance’ from leaks which allows people to go out and lead an normal life without having a worry of soiled clothes. We also have a good selection of ‘plastic pants’ which some people prefer. There is of course bed and furniture protection too, which we also stock should it be required.


Stress Incontinence in General

Stress incontinence is the leaking of small amounts of urine during activities that increase pressure inside the abdomen and push down on the bladder. This occurs mainly in women and sometimes in men (most often as a result of prostate surgery).


Stress incontinence is most common with activities such as coughing, sneezing, laughing, walking, lifting, or playing sport. Other factors contributing to stress incontinence include diabetes, chronic cough (linked with asthma, smoking or bronchitis), constipation and obesity.


Stress Incontinence in Women

Stress incontinence in women is often caused by pregnancy, childbirth and menopause. Pregnancy and childbirth can stretch and weaken the pelvic floor muscles that support the urethra causing stress incontinence during activities that push down on the bladder.


During menopause, oestrogen (a female hormone) is produced in lower quantities. Oestrogen helps to maintain the thickness of the urethra lining to keep the urethra sealed after passing urine (much like a washer seals water from leaking in a tap). As a result of this loss of oestrogen, some women experience stress incontinence during menopause.


Stress Incontinence in Men

Many men develop stress incontinence after prostate surgery. This can take 6 to 12 months to resolve and it is recommended that men seek help from a health professional to address the issue.



Urge Incontinence

Urge incontinence is a sudden and strong need to urinate. You may also hear it referred to as an unstable or overactive bladder, or detrusor instability.


In a properly functioning bladder, the bladder muscle (detrusor) remains relaxed as the bladder gradually fills up. As the bladder gradually stretches, we get a feeling of wanting to pass urine when the bladder is about half full. Most people can hold on after this initial feeling until a convenient time to go to the toilet arises. However, if you are experiencing an overactive bladder and urge incontinence, the bladder may feel fuller than it actually is. This means that the bladder contracts too early when it is not very full, and not when you want it to. This can make you suddenly need the toilet and perhaps leak some urine before you get there.


Often, if you experience urge incontinence you will also have the need to frequently pass urine and may wake several times a night to do so (nocturia).



What causes Urge Incontinence?

The cause of urge incontinence is not fully understood however it seems to become more common as we age. Symptoms may get worse at times of stress and may also be made worse by caffeine in tea, coffee and fizzy drinks or by alcohol.


Urge incontinence can be linked to stroke, Parkinson’s disease, multiple sclerosis and other health conditions which interfere with the brain’s ability to send messages to the bladder via the spinal cord. These conditions can affect a person’s ability to hold and store urine.


Urge incontinence may also occur as a result of constipation (not being able to empty the bowel or having difficulty doing so), an enlarged prostate gland or simply the result of a long history of poor bladder habits. In some cases the cause of an over-active bladder is unknown.


Incontinence associated with chronic retention, and functional incontinence.

Incontinence associated with chronic retention is when the bladder is unable to empty properly and frequent leakage of small amounts of urine occurs as a result.


Signs that your bladder is not completely emptying include:


feeling that you need to strain to pass urine

a weak or slow urine stream

feeling as if your bladder is not empty just after going to the toilet

little or no warning when you need to pass urine

passing urine while asleep

frequent urinary tract infections or cystitis, and

‘dribbling’ more urine after visiting the toilet.


What causes incontinence associated with chronic retention?

There are several possible causes for this type of incontinence. These include:


a urethra blockage caused by a full bladder (the full bladder can put pressure on the urethra, making it difficult to pass urine)

an enlarged prostate

a prolapse of pelvic organs which can block the urethra

damage to the nerves that control the bladder, urethral sphincter or pelvic floor muscles

diabetes, multiple sclerosis, stroke or Parkinson’s disease (these conditions can interfere with the sensation of a full bladder and with bladder emptying), and

some medications (which can interfere with bladder function) including over the counter medications and herbal products.

Urinary incontinence can be caused by many things, but can be treated, better managed and in many cases cured. For this reason, it is important to talk to your doctor or a continence advisor about your symptoms, in order to get on top of them.


We thank the Continence Foundation for the above comprehensive information about Urinary Incontinence.


Bed Wetting

If you suffer from Bed wetting – What ever your age – you again are not alone!


It is a fact that every baby will be incontinent, for the simple reason that the brain and the bladder are not yet working effectively together and the bladder is not sending signals to the brain to hold the contents of the bladder and or bowel until a convenient time. Children become ‘continent’ at different ages, some at 15months or maybe earlier, and others remain ‘untrained, wet or incontinent’ until much later. Most children will be dry by the age of around 3-4 years as the child develops. Normally day times can remain dry, where as night time remain a problem.


After the age of years 5+ some parents are getting concerned as their child is still wetting the bed at night. As the child develops, they too recognise that they should be dry at night as they talk about it at school, and very often they will gradually grow out of it. Tension often mounts within the household as the child gets older, because of the daily routine of washing sheets and re making the bed and night clothes. There is also increased pressure as the child gets older and school camps and sleepover’s with friends become more frequent, and it is only then that the real pressure is put on both the child and the parent to do something about it.


One method to save the washing is for the child to wear disposable pullups to negate the washing. We suggest that these are not used routinely as the child can become lazy or complacent about not needing to get out of bed to go to the toilet and it hides the background problem and delays the ‘training’. It is not unheard of as the child gets older for them to enjoy wearing and wetting – be it either in a pullup or just wetting the bed and sometimes do it out of defiance to purposely upset the carer or parent.


Most of the times unless the child has other issues, bed wetting is caused by the need to urinate during the early stages of deep sleep (REM), and the child just sleeps through it and may even wet several times more – often waking up a long time after the first occurrence. There are other reasons why the child might bed wet as they get older and this can be caused by stress and anxiety – and this can happen during adult life also – after a traumatic event. There are of course many causes for anxiety and stress, and this could be friction between parents/carers etc and the child is affected by this, it could be pressure or bullying at school as well as maybe suffering from Special Needs and other related problems.


Treatment for Bedwetting.

Although you maybe at your wits end with coping with all the washing etc, it is generally thought that treatment is not worthwhile/ effective until the child reaches the age of 5 years.


The main treatment or ‘cure’ for bedwetting is a battery-operated alarm, and there are a number of these on the market. We retail the Dri Sleeper model which is made in New Zealand and has great results. There are two models, the Eclipse, and the Excel. The more expensive device is a wireless unit, with a small ‘electrode’ that sits in the pants, and the Alarm unit sits remotely on a table top nearby. The other unit is a wired ‘electrode’ that has a cord that plugs into the alarm unit which is attached to the shoulder of the pyjamas. Both are equally as effective. The alarm units have a 90% cure rate. Treatments using these devices normally take from a few weeks to a couple of months. Some of the success stories that we have heard are amazing – with parents wishing they had purchased these years previously!


It is very necessary for both the child and the parent need to work together (without causing too much stress to the child) to ensure an effective treatment.


There are other similar types of devices, which include a bed Mat attached to an alarm system – and some medical professionals prescribe drugs.


Bed wetting affects approximately 19% of children between the ages of five and twelve years of age. 1 in 100 adolescents still wet the bed at night. Boys are more likely to wet the bed than girls. Girls will normally be dry at night earlier in age than boys.


If the child you care for still wets the bed during adolescence, if you have not done so already you should speak to your medical professional with the child.


Bed wetting for children is still quite common, so you as a parent should not feel alone or embarrassed that your child is still wetting – the child is probably in many cased will be equally as embarrassed. There will be other parents in the same class that also have this problem – so dont be afraid of having a chat within your social group.


It is never too late to start a treatment (using an alarm mentioned above) but we would recommend seeing your medical professional if the problem persists for further investigation.


Wet Dreams.

This is a bit of a strange subject within a site that deals with incontinence, however in our defence we have been asked by concerned parents about Wet Dreams, and we must remember that our page is also viewed by concerned children about nocturnal emissions – so we have decided to include some basic information on the subject.


It is perfectly normal for an adolescent child, whether male or female to have Wet Dreams. There is absolutely nothing to be concerned about if this happens. Wet Dreams occur through adolescence and into adulthood, though they are more common during the teenage years.


The Dreams occur during the early part of the sleep process and during deep sleep (REM) and it is unusual for the person concerned to remember much if any of the dream, however the dream will include some sexual context. During the dream, the body ejaculates without any stimulation or masturbation, and all that will remain is the ejaculate or product of the ejaculation.


Some children become concerned about what has occurred because it is ‘abnormal’ for them , whilst some will be concerned that their pajama’s/pants and or bedding are stained and are concerned as to what the parents will say if they do see it.


So just to reiterate, It is perfectly normal to have night time emissions (Wet Dreams). It is unusual though that they would occur too frequently, but some people have them more than others but both the child or parent should not be concerned at all.