Coping with changes

After pelvic radiotherapy, changes to the bladder and bowel often cause the same day-to-day issues. So we have covered them together in this section.

Protect your skin

If you have problems with leaking (incontinence) from your bladder or bowel control problems, it can make the skin in that area sore.

You can protect your skin by keeping it clean and dry. There are lots of products available to help you. Your continence adviser can give you more information.

Here are some suggestions to help keep your skin clean and dry:

  • use a skin cleanser instead of soap and water
  • unperfumed baby wipes are more gentle on your skin than toilet paper
  • absorbent pads and a non-oil barrier cream or film can help protect your skin
  • cotton underwear lets your skin breathe more than other materials.

Plan ahead when you go out

If you have problems with bowel or bladder control, you may feel worried about going out, especially to somewhere new. Planning ahead so that you are prepared can help you feel more confident.

Access to toilets

If you are going somewhere new, it is a good idea to find out where the nearest toilets are before you go.

Macmillan has a free toilet card you can use. It may help you access a toilet more quickly when you are out.

We have more information about using public toilets.

Take a bag with supplies

Pack a bag of the things you may need when you go out. This will help you feel more confident. You may want to include:

  • wet wipes or baby wipes
  • a non-oil barrier cream
  • pads and pants
  • a change of clothes
  • a sealable bag
  • anti-diarrhoea tablets – if you have problems with diarrhoea
  • your Macmillan toilet card.

Specialist products for leakage or soiling

If you have problems with leakage or soiling (incontinence), there are different products you can wear. These can help you feel more confident and protect your clothes. A continence adviser can help you choose products that suit your needs.

You can buy pads for mild to moderate incontinence in most supermarkets and pharmacies and online. If these are not absorbent enough, you can get different pads from your continence adviser. They can also explain what is available to you on the NHS. This can vary from region to region. The Bladder and Bowel Community also has information about different products.

Problems with leakage or soiling can mean you have extra expenses. Call Macmillan on 0808 808 00 00 to find out more about ways to help cover the cost.

Products for bladder incontinence

Pads and pull-ups have a layer that draws urine away from the surface and absorbs it, so your skin stays dry. There are different types available. You can wear some inside your underwear and others as a replacement for underwear. You can also buy pads to cover your bed.

For men

Having a urine bottle near your bed may help you get a better night’s sleep. You won’t have to walk to the toilet every time you need to go. If you are worried about getting to the toilet in time during the day, keep the bottle nearby. You may want to keep one in your car.

If you don’t want to use pads, you may prefer to wear a sheath and leg bag. The sheath fits over your penis (like a condom), and urine is held in a bag that you strap to your leg. You can buy underwear with a built-in pocket to hold the bag.

Products for bowel incontinence

There are different types of pad you can wear during the day and at night. Pads and pants with charcoal linings may help to reduce smell from leakage or wind. There are also different types of pad you can use to cover your bed or chairs.

Anal plugs and inserts

Peristeen® Anal plugs are made from soft foam and stop bowel leakage for up to 12 hours. There is a cord attached to the plug, which allows you to remove it when you are ready. Some people find anal plugs uncomfortable to begin with. But most people get used to them after using them a few times.

Renew® Anal inserts are made from soft silicone and are placed in the anus. They stop any leakage until they are pushed out of the bowel when you have a bowel movement. You can also remove them before a bowel movement.

Your continence adviser can show you how to use them.

Keep to a healthy weight

Being overweight puts pressure on your pelvic floor muscles. It is important to keep to a healthy weight if you have bladder or bowel late effects. Your GP can advise you on the ideal weight for your height.

Keep physically active

Keeping active will help you manage your weight and avoid getting constipated. This is important to help look after your pelvic floor muscles. Exercise also helps you feel better and can reduce stress.

If you have stress incontinence, it is best to avoid anything that involves running or jumping. Walking and swimming are lower-impact and are less likely to cause problems. When your symptoms are under control, you may want to gradually try other types of exercise.

If you have a stoma, there is no restriction on the sports that you can play apart from contact sports, such as rugby and football. Ask your stoma nurse if you are not sure what you can do.

Avoid constipation

Avoiding constipation will help protect your pelvic floor muscles.

To avoid constipation, you can try the following things:

  • choose foods that reduce constipation
  • check you are sitting in the correct position to empty your bowels
  • drink plenty of fluids
  • keep active.

Manage stress

Anxiety and stressful situations can make bladder and bowel symptoms worse.

Learning to relax may help improve some of your symptoms. Some continence clinics and support groups teach stress management. Your doctor or specialist nurse can tell you about relaxation classes in your area.

Relaxation CDs are available from bookshops and some health shops. You can also download relaxation podcasts from the internet.

Some people find that complementary therapies such as massage or yoga help them feel less stressed.

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