Intimate sexual relationships are an important part of most people's lives but, although difficult to manage or even contemplate with bladder and bowel leakage, are not impossible!

Developing a good understanding of the nature and pattern of your bladder / bowel symptoms can help you to take advantage of potentially leak free periods.

Although it may be difficult to use some products during sex, the obvious ones being those that cover the genitals such as pads, male devices or or a urethral catheter, there are other products that be helpful.

Specific sexual activities vary and you may need to re-think your usual practices and products depending on your symptoms. Bladder and bowel symptoms can vary from day to day or month to month and so you may need to change your products also.

Pads Try to find products which are slightly more aestheically acceptable to you than plain, unisex products e.g. male or female specific disposable or washable pants

Ensure you have discreet bed protection, e.g. under your usual bed sheet so you are less worried about the mattress if you leak when not using you usual body-worn protection.

Female devices An internal urethral device may be acceptable although should be used with caution during vaginal intercourse as this could result in dislodgement of the device into the bladder and an increased risk of bacteria entering the bladder. An internal vaginal device would only be suitable if vaginal intercourse was not part of your sexual activity.

Male devices These mainly cover the penis and are therefore not an option during penetrative sex. The penile clamp may be useful. It can be used for short periods and if you are able to tolerate it without too much discomfort you may find it useful. It will need to be removed to allow full erection and some urine tends to leak on removal so rememb er to have something absorbent to hand.

Faecal devices An anal plug may useful in reducing the risk of bowel leakage during sexual intercourse. Generally, people who have sensation in their lower body find anal plugs hard to tolerate but you might manage for a short period.

Catheters If you need to use some form of catheterisation to empty your bladder, Intermittent catheterisation (IC) will give you much more freedom for sexual acitivity.

If you cannot manage IC, you may need an indwelling catheter. If your need for a catheter is more than short-term, you should consider having a supra-pubic catheter. The catheter enters your body between your belly button and pubic bone.

If you are unable to have a supra-pubic catheter, there are things you can do to make sexual intercourse slightly easier even with a urethral catheter. For example, use a catheter valve as opposed to a drainage bag - catheter valves are a relatively discreet product. the catheter can then betaped into your abdomen so less in the way. Men can fold the catheter back along the shaft of the penis and cover it with a condom.

Use plenty of ater-based lubricant to reduce the pistoning effect (in out movemen t of the catheter) during penetrative sex. This can increase the risk of bacteria entering the bladder.

Toielting aids If you get urgency and urge urinary incontinence you may find it useful to have a small hand-held uirnal nearby so you can quickly empty your baldder.