Bladder weakness affects more than nine million people in the UK, yet many don’t seek medical advice. It’s a growing pharmacy category, especially as the population ages. However, it’s not only older people who experience problems with bladder control.
Bladder weakness can affect people of all ages, and may be associated with some long-term medical conditions, such as neurological problems and prostate trouble in men. It can also be associated with lifestyle factors such as diet, fluid intake and medication. So what should the pharmacy team know about bladder weakness and which products should they stock?
When advising customers on bladder weakness, it helps to be aware that there are various types, with the two main types being urge incontinence and stress incontinence.
Certain lifestyle factors can exacerbate or even cause bladder weakness, but there are a range of ways in which people can manage or prevent symptoms:
Customers with bladder weakness will want to make sure they stay dry at all times and are prepared for leakage. Many women use sanitary pads rather than specialist bladder weakness products because they’re cheaper and more familiar, but these stay damp and can make the skin sore.
Thorrun Govind, community pharmacist at Sykes Chemist in Bolton, says the bladder weakness ﬁxture can be very confusing, which is why people often use sanitary towels instead. “Pharmacists and pharmacy staff should discuss whether customers are using the right products,” she says. “It’s important to advise that speciﬁc incontinence products are much more absorbent and feel more secure. These lock in the odour and moisture, which is why they need to be recommended over sanitary protection.”
One of the most popular products are pads and liners, which are worn inside underwear. There are various absorbencies, shapes and sizes, with separate products aimed at men and women. Liners and thin pads are ideal for minor leakage, whereas more absorbent pads and pants, which are worn instead of underwear, are more suitable for signiﬁcant wetness, offering security while remaining discreet. These products use the same technology as nappies, with a ‘hydrophobic’ layer that draws urine away from the skin, and are available for both men and women.
Customers may need to change their product choice according to their activity, using higher absorbency pads when they are doing sports and exercise. For more severe urine loss, customers can use sheaths and drainage systems for men and urinals (urine collection devices) for men and women.
For customers who experience problems at night, you can recommend washable bed pads, which sit on top of a mattress to soak up any urine. Clothing and swimwear brands for people with bladder weakness are available online, and pharmacy staff may wish to direct customers to suitable companies.
If customers experience bladder weakness, they can develop sore skin – just as babies can develop nappy rash. Products formulated for nappy rash should relieve the symptoms, but customers may prefer to use adult-speciﬁc brands and pharmacy staff are ideally placed to offer advice on suitable products, such as barrier creams and moisturisers.
Pelvic ﬂoor muscles control the ﬂow of urine. If they are weak or damaged, for example during pregnancy or childbirth or after prostate surgery, this can cause urine leakage.
Dr Ruth Maher, physiotherapist, pelvic ﬂoor expert and co-inventor of Innovo, comments: “Crucially, it is important that women understand that there is no such thing as a ‘weak bladder’. What we really mean is a ‘weak pelvic ﬂoor’. There are common misconceptions surrounding bladder weakness, and these make it more difﬁcult for women to understand the issue and therefore ﬁnd an effective solution.”
Pelvic ﬂoor exercises can help strengthen the pelvic ﬂoor and reduce incontinence episodes. These exercises involve contracting the pelvic ﬂoor muscles at least three times a day, for at least three months. Ideally, customers should visit a specialist continence physiotherapist to make sure they’re doing the exercises properly.
Pelvic ﬂoor strengthening aids may help men and women if bladder weakness is caused by a weak pelvic ﬂoor. Some devices provide a visual way for customers to see if they’re doing the exercises properly. Weighted vaginal cones provide resistance, like weighted tampons, but aren’t suitable for women after a signiﬁcant prolapse. It’s important to speak to a specialist continence physiotherapist before stocking these types of products, as even those available on prescription may not be effective or may not work for everyone.
The bladder weakness fixture can be very confusing, which is why people often use sanitary towels instead