Problems with bladder and bowel control (incontinence)

Incontinence means poor bladder or bowel control and may also involve increased frequency and urgency without leakage from the bladder or bowel. Incontinence can be caused by weak pelvic floor muscles. It can also affect your confidence in having sex.

For many people, incontinence and the impacts this has on sexuality is an embarrassing problem for which it may be difficult to seek help. You may wish to talk confidentially to one of our staff on the Cancer Information Helpline 0800 CANCER (226 237), or speak to a continence nurse or a pelvic health physiotherapist. You can also phone the Continence NZ helpline (0800 650 659) or see www.continence.org.nz. These services can help by teaching you how to exercise your pelvic floor muscles correctly and give advice on managing bowel and bladder problems. 

Incontinence may be a short- or long-term problem. People may leak urine when coughing, sneezing or laughing. This is known as stress incontinence. Needing to go to the toilet without being able to hold on is called “urge incontinence”. It’s one possible side effect of treatment for cancer of the prostate, bladder, bowel, penis, vagina, vulva, cervix or uterus. People may find they dribble after they urinate or after an orgasm.

Men with an indwelling catheter should fold the catheter down the length of their erect penis then place a condom over the penis. Always use plenty of water-based soluble lubricant when having intercourse with someone with an indwelling catheter in place.

If you have an indwelling or supra-pubic catheter you may find it possible to tape the tubing to your skin, remove the bag and insert a specially designed valve or stopper (FLIP-FLOW is one trade name). Talk to your doctor or nurse to see if this is an option for you, and where to get one.

Finding your pelvic floor muscles

To correctly identify the pelvic floor muscles:
  1. Sit on a chair, leaning forward with your knees slightly apart.
  2. Now imagine that you are trying to stop yourself from passing wind. You should be aware of the skin around your anus tightening, and being pulled up and away from the chair. Your buttocks and legs should not move at all.
  3. Now imagine that you are sitting on a toilet passing urine. Try to stop your stream of urine. This will help you to identify the right muscle. Again, you should feel a lifting and tightening.

Practising your pelvic floor exercises

  1. Sit, stand or lie with your knees slightly apart. Slowly tighten and draw up around the anus and urethra (and vagina for women) all at once, lifting them up inside. Try to hold strongly for a count of three, then release and relax. You should feel in control of the whole contraction with a definite “letting go” sensation at the end.
  2. Rest for ten seconds.
  3. Repeat and squeeze and lift and relax. If you find holding for three seconds easy, aim to progressively hold for longer – up to ten seconds.
  4. Repeat this combination of contractions and rest periods as many times as possible – up to ten times.
  5. Now do five to ten short, quick but strong contractions.
  6. Aim to do this whole exercise routine several times each day.
  7. Tighten the pelvic floor muscles just before you lift something, cough, sneeze, laugh, lean forwards etc.
(Adapted from the Continence Foundation of Australia’s publications: The Continence Guide: Bladder and bowel control explained, and Sexuality and Incontinence.)