The leaking of America: Can sanitary bins help restore some much-needed dignity?
Putting sanitary bins in loos for dah boys
By Howard Wolinsky
It’s happened to me. How about you?
Right after surgery for a kidney stone earlier this year, I felt I had to pee. But I couldn’t control it.
I ended up standing in a pool of piss. It was embarrassing. I felt powerless. I felt I was two years old again. I was powerless, in a hospital gown, with urine running down my legs.
I tried to mop up my “accident,” and finally, sheepishly, I asked the nurse if she could find someone to finish the job.
The doctors and nurses didn’t warn me that I might have this problem.
I wasn’t prepared, nor were the health professionals. They put me in a pair of disposable underpants with a sanitary napkin. They improvised. It seemed like it was the first time it ever happened. I know this couldn’t have been the case.
When I got home, I ordered adult diapers from Amazon. In a few days, my incontinence resolved. I was lucky. I was also sensitized to the indignities of urinary incontinence (UI).
In our little corner of the world, we usually think of UI—urinary incontience—in men who have undergone prostatectomies, or in men with enlarged prostates, or benign prostatic hyperplasia (BPH). About 50% of these men who have undergone surgery experience UI on a temporary or permanent basis.
UI, or urinary leakage, is a far bigger issue than just prostate cancer. Young men experience it. Women also experience UI during pregnancy, after childbirth, and during menopause.
UI is not a disease, but a symptom of something getting scrambled in the brain or in the urinary tract. It can be associated with neurological problems, such as multiple sclerosis and Parkinson’s disease, Alzheimer’s disease, and strokes; urinary tract infections; obesity; surgical side effects, as in my case, but also from prostate operations, back surgery, and bowel surgery; and lifestyle issues, such as consuming too much caffeine or alcohol (both diuretic in nature), using narcotics or certain medications, and drinking too much fluid at once.
A side effect and indignity of UI is you always have an eye on where the nearest public bathroom might be. Because of UI, some patients limit trips outside their homes.
And then: What to do about disposing of used diapers?
Some people travel with large plastic bags. Some men ask their wives to place their used adult pads—contained in plastic bags, I hope—in their handbags. Some flush pads and nappies down the toilet—bad for the environment and good for plumbers.
Prostate Cancer UK and phs, Britain’s hygiene services provider (Big Piss?), conducted a survey on UI. They polled 500 men, half of whom had prostate cancer, on UI-related attitudes. Researchers were shocked to find that UI is an issue not only for older men but also for young men, in their teens and 20s.
UI takes an emotional toll.
Researchers said: “Overall, one in four men feel depressed about the impact involuntary urinary leakages have on their lives, with that figure soaring to 100% for men aged 16-25.”
PC UK said the problem has been more publicly addressed in women than men. Public toilets for women in UK are required to have sanitary bins, but there is no requirement for male loos.
Chiara De Biase, director of Support and Influencing at Prostate Cancer UK, said, “Men can leak, too. Four simple words, but when spoken, have the power to tackle a taboo that impacts the lives of hundreds of thousands of men across the UK every year. One in three men over 65 are estimated to have an incontinence problem, and one in 25 men over the age of 40 experience incontinence issues each year.”
In a white paper, the researchers said: “We found that anxiety and isolation are prevalent for men with UI. Of those who had experienced poor facilities: two in five (44%) said they now feel anxious about using public toilets. Over a third (38%) leave the house less often. Almost eight in 10 (78%) stated they feel anxious about a lack of suitable facilities when leaving home.”
Researchers said over a third (34%) of the men found it hard to locate a bin in a public toilet to throw away used incontinence pads, while almost one in five (19%) reported having a bad day-to-day experience when out because they were rarely able to find bins of any kind in public toilets to dispose of their incontinence products.
Prostate Cancer UK and phs have been campaigning for installation of sanitary bins in men’s bathrooms to dispose of incontinence pads. They have a letter-writing campaign—dubbed Boys Need Bins—to MPs (Members of Parliament) urging that funding be earmarked for purchase of sanitary bins for public bathrooms. Some talk of free sanitary products being made available in men’s loos. (This would mirror campaigns for “period equality” in the UK.)
(A bin for men.)
Seems like an idea we could benefit from this approach in the States. Give bins a chance. As actor Wilford Brimley used to say in a different context: It’s the right thing to do.
What can cause urinary incontinence?
By Howard Wolinsky
Incontinence is the inability to completely control the bladder or bowels. Any type of incontinence will occur by degrees from mild to severe and will have an array of causes. Urinary incontinence, though most common among women, occurs in men and manifests in different ways, as well. The National Association for Continence indicates that in the U.S. alone there are more than 20 million people dealing with some sort of incontinence, and this explains the huge array of incontinence products available.
What are the causes?
Prostate issues – Enlarged prostate glands can be benign or due to cancer. The enlargement blocks the urethra and cues the bladder to work harder, building up the walls of the bladder and causing great difficulty in fully emptying it over time. Those who have been treated for prostate cancer may also find that nerve damage leads to incontinence.
Disease – Neurological diseases such as MS, Parkinson’s, Alzheimer’s and even stroke can cause malfunctions in the nerves, leading to urinary incontinence in men and women alike. Allergies, though not a disease, may lead to behaviors like chronic bouts of coughing that can also weaken pelvic floor muscles and lead to urinary leakage. Urinary tract infections can also be a cause.
Obesity – A general lack of exercise may contribute to urinary incontinence in men but paired with obesity or too much extra body weight and it creates an amount of pressure on the bladder that can lead to urgency, an inability to hold urine, and urine leakage. Lack of exercise may lead to constipation, which itself can be a cause of urinary incontinence due to pressure on the urinary tract.
Surgery – An array of surgical procedures, in addition to prostate surgery, may lead to urinary incontinence in men. Back surgery, bowel surgery and other procedures might be a cause.
Lifestyle – It is known that consuming too much caffeine or alcohol (both diuretic in nature) may lead to incontinence, using narcotics or certain medications, and drinking too much fluid at once can also lead to leakage.
Catch some webinars
—Want to learn about focal therapy? Listen to AS pioneer Dr. Laurence Klotz: https://ancan.org/webinar-is-focal-therapy-right-for-your-prostate-cancer/
—Lifestyle? Catch ASPI’s webinar with Dr. Stacy Loeb, of NYU, on lifestyle factors, such as diet, exercise, and sleep in AS: https://aspatients.org/meeting/as-101-program-on-diet-and-nutritional-lifestyle/
What are your thought about Ivermectin for cancer treatments?
Kathleen
Who would have thought? Bins were removed from woman's stalls after 9/11 and have not fully returned. We need them back for the same reason, among others.