Mythbusters: Incontinence

by | Urinary Health

Like taxes and money, incontinence is one of those topics we don’t always feel comfortable discussing. But with one in four Australians being affected by incontinence, it’s a condition we need to talk about more freely. Social stigma and a lack of education around incontinence means many people choose the wrong products – especially incontinence pads and skin care – and suffer in silence from issues like incontinence associated dermatitis (IAD).

While incontinence impacts people of all ages, mid to later life stages can increase its likelihood among both women and men. For women, it can be linked to hormonal changes: particularly a drop in oestrogen in the lead up to and after menopause, when tissue in the urinary tract becomes thinner and prone to irritation, making leakage more likely. For men, incontinence can be associated with prostate enlargement putting pressure on the bladder or a weakened pelvic floor from straining on the toilet or a chronic cough.

Here, we dispel some of the most common myths about incontinence.

Myth: Incontinence is normal

Fact: Around 25 per cent of Australians live with incontinence, according to the Continence Foundation of Australia.1 For some people, it’s occasional drips, dribbles and leaks while others experience total loss of bladder and bowel control. 

While incontinence is common, it’s not a normal part of ageing. Instead, think of it as a sign you may have a health condition that requires investigation. With the right care, incontinence can often be treated or improved so you don’t have to just “put up with it”.

Incontinence affects both men and women, and can be temporary, such as after childbirth or surgery, during a bladder infection or while taking certain medications.2-3 It may also be ongoing and associated with health conditions such as diabetes, stroke, Parkinson’s disease, dementia and multiple sclerosis.

Regardless of cause, incontinence doesn’t discriminate. Which is why we’re setting aside the stigma and sharing the knowledge on how to find the most appropriate solutions for your needs so you can better manage incontinence and live the life you love.

Myth: Incontinence only affects older people

Fact: While incontinence affects people of all age groups, you might be surprised to discover the group most likely to report current or previous experience with incontinence are under 50. According to the Continence Foundation of Australia’s 2023 National Consumer Survey, the group most likely to report they currently or previously experienced incontinence are between 30-49 (36%). In the 50-69 age group, 31% respondents had experienced incontinence, while 17% for respondents both respondents in the 70+ and 18-29 age groups had also experienced incontinence.4 

Whatever your age, all incontinence is worth discussing with a trusted healthcare provider such as your GP or pharmacist as soon as you notice changes in your toilet habits. With the right expert advice and quality continence care products, you’ll have all you need to keep doing the things you love.

Myth: All urinary incontinence is the same

Fact: There are actually four main types of urinary incontinence:1

 *Urge incontinence is associated with a powerful need to urinate urgently that can sometimes lead to wetting yourself before you reach the toilet. While its likelihood increases with age, other factors such as consuming caffeine, carbonated drinks and alcohol can also be triggers. Your GP may recommend pelvic floor physiotherapy to improve bladder control. In some instances, physio may be supplemented by a medication to help relax the bladder muscles. Avoiding alcohol, caffeine and fizzy drinks can also help.

*Stress incontinence causes small amounts of urine to leak from the bladder when it’s subjected to extra physical force from coughing, laughing, lifting or walking. Pelvic floor exercises under the guidance of a GP or Physiotherapist can strengthen the muscles which support the bladder to reduce chances of involuntary urine loss. If you’re living with obesity, losing weight can improve or in some instances completely cure symptoms.

*Urinary retention occurs when the bladder doesn’t completely empty while using the toilet and what remains may later leak out. Sometimes it’s associated with acute illness, constipation or health conditions affecting the abdomen; other times it may be to do with taking certain medications. All urinary retention should be promptly assessed by a GP, while not being able to urinate at all is a medical emergency.

*Functional incontinence is also known as disability associated incontinence, highlighting its link to physical or intellectual conditions that make it difficult to use the toilet. Maintaining a clear pathway to the toilet at home and knowing where to find accessible toilets while out and about can be useful.

Whatever type of incontinence you are experiencing, there are products and support to help.

Myth: All incontinence pads are the same

Fact: Not all pads are created equally. Some are specifically designed for a woman’s anatomy; others are just for men. But that’s not the only difference. Some also help manage incontinence and support skin health.

Your skin is your body’s first line of defence, which is why protecting your skin’s natural pH levels is essential to remaining comfortable and healthy when living with incontinence. Extended exposure to urine and faeces (which are highly acidic) disrupt your skin’s natural pH level. This impacts your skin’s ability to maintain a healthy moisture barrier which can often result in dermatitis. Using a range of products especially designed to taking care of your skin and preserve its natural pH levels is your best defence against dermatitis, and a proactive step to maximising your comfort and confidence.

MoliCare products are discreet and trustworthy, with a recent study in the British Journal of Nursing finding 84 per cent of nurses preferred MoliCare products for their ability to meet performance expectations and avoid compromising on the wearer’s quality of life.5

Plus, they all contain evidence based MoliCare SkinGuard® technology to maintain the natural pH of the skin. This helps prevent irritation that can cause incontinence associated dermatitis (IAD). IAD is the raw, red appearance of skin caused by an increase in the skin’s pH-level around the genitals and/or anus. There are many different possible causes for a pH-change, using harsh soaps or heavily fragranced wipes, over-moisturising, prolonged exposure to damp pads or pull-ups, or exposure to urine and faeces. IAD can be painful and extremely distressing if not managed carefully.

Myth: A pad is all you need to manage incontinence

Fact: Yes, absorbent incontinence products are the first step in staying dry and comfortable. But the next essential step is not so obvious until you consider each change of pad or pants requires thorough cleansing to maintain hygiene and eliminate odour.

For some people, that can be upwards of eight times per day. A lot of changes mean a lot of cleansing, but cleansing can be tough on skin – especially in delicate areas. Using fragranced wipes and/or soaps can irritate your skin and change your skin’s pH-level which can lead to dermatitis. This can lead to a range of skin conditions, such as IAD, causing pain, discomfort and reduced mobility

That’s why preventative skin care specially formulated for repeated use on some of the body’s most sensitive skin is crucial to keeping skin healthy and strong at every change.6-7
In addition to choosing the right cleansing products, a barrier cream formulated to protect the skin against the acidic properties in urine and faeces, is also essential to help minimise irritation. Incorporating a barrier cream into your change routine after cleansing helps protect the skin and reduce the risk of irritation and discomfort.

Myth: Skin care is just for your face

Fact: You may be used to investing in skin care for your face, but your whole body deserves the same care and attention – especially in delicate areas. Incontinence-appropriate preventative skin care products can improve overall skin health while safely cleansing skin of urine and faeces and provide ongoing protection.6-7 While traditional bar soaps and liquid body washes are highly alkaline and can strip the skin of its natural barrier, the MoliCare Skin range is dermatologically tested to clean, protect and care for sensitive areas. Each product soothes your skin from first application and ongoing use helps prevent further damage. There are even extra soft cleansing wipes and cleansing foam for no-rinse cleaning that’s quick and convenient when you’re on the go.

Myth: Any barrier cream improves sensitive areas

Fact: A barrier cream is designed to help protect the skin against the irritating effects of urine and faeces. Applied after cleansing at each change, barrier creams are an essential step in your skincare routine to help protect your skin and minimise irritation. But not all barrier creams are created equal. Some barrier creams contain ingredients which block the absorbency of an incontinence pad. It might feel ok when you apply it, but your skin can become irritated and damaged when urine cannot be properly absorbed by your pad.

That’s why using the right skin care actually helps you stay dry, comfortable and properly protected. MoliCare Skin also offers specially formulated barrier creams to create a protective layer that preserves skin integrity without compromising the absorbency of your pad. They’re also free from zinc oxide and petroleum which may lessen absorbency of continence aids and increase exposure to skin irritants.

By using the right preventative skin care products designed to manage incontinence-related conditions, you can keep skin healthy, which reduces the risk of developing IAD.6-8 And skin breakdown and infection can lead to hospital admission, so it’s worth taking the best possible care you can of your skin.6-8

Myth: There’s no way to improve continence 

Fact: Whether incontinence is new for you or part of a long-term health condition, it always warrants a conversation with your trusted GP. Depending on the cause, there are plenty of evidence-based strategies to improve symptoms of incontinence. From suggesting dietary changes to starting a pelvic floor exercise program or making medication adjustments, know that your doctor is ready to help.

MoliCare continence products and MoliCare Skin products are available throughout Australia at leading pharmacies, medical distributors and online at MoliCare.au

References:

  1. The Continence Foundation of Australia. Understanding incontinence. 2021. Accessed May 3, 2024. https://www.continence.org.au/incontinence/understanding-incontinence
  2. Pregnancy birth and baby. Bladder weakness after birth. September 2022. Accessed May 3, 2024. https://www.pregnancybirthbaby.org.au/bladder-weakness-after-birth#:~:text=Leaking%20urine%20(called%20’urinary%20incontinence,is%20known%20as%20stress%20incontinence.
  3. National institute of diabetes and digestive and kidney diseases. Symptoms & causes of bladder control problems (Urinary Incontinence). July 2021. Accessed May 3, 2024.
    https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems/symptoms-causes#:~:text=Temporary%20incontinence%20is%20usually%20a,including%20using%20alcohol%20or%20caffeine.
  4. Continence Foundation of Australia. 2023 National consumer survey analysis. 2024. Accessed May 3, 2023. https://www.continence.org.au/sites/default/files/2024-03/National%20Consumer%20Survey%20Analysis%20Report%202023_External_18032024_LR.pdf
  5. Sanaeifar N, Limam D, Zettl S, Vechter O, Porsch S, Kesselmeier R. Nurses’ perspectives and preferences on MoliCare Premium Elastic products for incontinence management. British Journal of Nursing. 2023 Dec 7;32(22):1078-1085. doi: 10.12968/bjon.2023.32.22.1078.
  6. Beeckman D, et al. Best practice recommendations for holistic strategies to promote and maintain skin integrity. Wounds International. 2020. Accessed May 3, 2024.
    https://woundsinternational.com/best-practice-statements/best-practice-recommendations-holistic-strategies-promote-and-maintain-skin-integrity/
  7. Ousey K, O’Connor L, Doughty D, Hill R, Woo K. Incontinence-associated dermatitis made Easy. Wounds International 2017; 8(2). Accessed May 3, 2024. https://woundsinternational.com/made-easy/iad-made-easy/
  8. Kayser SA, Koloms K, Murray A, Khawar W, Gray M. Incontinence and incontinence-associated dermatitis in acute care: a retrospective analysis of total cost of care and patient outcomes from the Premier Healthcare Database. Journal of Wound, Ostomy and Continence Nursing 48(6): p 545-552, November/December 2021. doi:10.1097/WON.0000000000000818