The men that public toilets forgot

Incontinence does not always mean a man wets his pants without a nappy. Sometimes it is the last few drops of pee that refuse to exit at the urinal, only to appear once everything is zipped up. It affects far more men than most people imagine, and for many guys, continence pads have become a part of everyday life. Public toilets are not helping.

There are examples around the world, and a recent Finnish study of more than 4 000 men aged between 30 and 80 found that 58% experienced dribbling, or after-pee, after urinating. More than 40% of men in their thirties reported the problem, along with two-thirds of those aged between 60 and 80. Among older men, about one in four said the wee ended up in their pants.

South African men do not seem particularly keen to learn more about it, at least based on what they search online. Google searches for pelvic floor health have increased by about 40% over the past year, while prostate health attracts considerably more interest. Searches specifically about dribbling after urination barely register on Google Trends, and that says a lot. Men don’t talk about these things, not even to the web.

Dribbling after zipping up

So what do you do when so many guys are affected by the challenge, yet a man needs to change a continence pad in a public toilet and has nowhere to put it? Women’s bathrooms have sanitary disposal bins inside cubicles.

Charl Broodryk of Nuwkem Hygiene said men’s hygiene requirements had received little attention in public toilet design. “There is often nowhere appropriate to dispose of these products, and that can be embarrassing and undignified,” Broodryk said.

Medical doctor and psychologist Dr Jonathan Redelinghuys said men could experience urinary problems for several reasons, including prostate conditions, neurological illness and complications following surgery. Weakened pelvic floor muscles were not necessarily responsible.

“The prostate is frequently responsible for urinary problems in men. An enlarged prostate can prevent the bladder from emptying completely, while prostate surgery can sometimes damage the nerves involved in bladder control,” Redelinghuys said.

He said urine remaining in the bladder could cause dribbling after urination. Damage to the urinary sphincter or its nerve supply could cause more significant leakage.

A simple pad disposal facility can change men’s lives. Picture iStock

Men who undergo prostate surgery can also find themselves using continence pads well after recovering from the operation. An American study of men who had their prostates removed found that 11% were still using more than one pad daily a year later. A Swedish study of more than 4 600 men found that 14% were incontinent a year after prostate surgery. It’s not Mickey Mouse numbers.

“These are medical conditions, not simply an inconvenience. Men can experience considerable embarrassment, particularly when they have to manage continence products away from home,” Dr Redelinghuys said.

Women’s toilets have sanitary disposals – not guys’

Currently, a used continence pad can be flushed, risking a plumbing blockage, or carried out of the cubicle and discarded in a communal bin, often in full view of other men using the facilities.

“Nobody would question the need for sanitary disposal facilities in women’s bathrooms. Yet men who need exactly the same level of hygiene and privacy are often overlooked,” Broodryk said. He said installing discreet disposal bins inside men’s cubicles would not require extensive changes to existing bathrooms.

Many men continue living with incontinence without seeking further medical assistance. Among men in the American study who were still incontinent a year after prostate surgery, only 1.4% underwent a procedure to correct the problem within ten years. Redelinghuys said embarrassment was one reason men avoided discussing bladder problems with their doctors.

“Men are often reluctant to discuss bladder problems, and some delay seeking medical help. Providing appropriate facilities acknowledges that these conditions exist and that the people living with them deserve dignity,” he said.

Broodryk said shopping centres, airports, hospitals, workplaces and other public facilities should reconsider the equipment provided in men’s bathrooms.

“Proper hygiene facilities should accommodate the people who actually use them. Male continence care has been overlooked for far too long.”