THE SEXUAL NEEDS OF PEOPLE WITH DISABILITIES – PHYSICAL/PRACTICAL NEEDS (INCONTINENCE)
An area of particular stress is incontinence. As a symptom it causes great distress as it is demeaning and often seen as immature, a flashback to being a naughty child. It is a matter for shame and secrecy. Bedwetting or faecal incontinence are not matters that are easy to talk about. People seem to think that having incontinence and being sexually mature cannot go together. Anxieties and fears of leakage of urine or faeces during lovemaking tend to result in avoidance or diversion of feelings so that enjoyment is reduced. These problems need to be addressed by the doctor so as to allow the anxieties to be shared. The relief of a young woman, telling how her new relationship was so much better because, when they slept together he wet the bed too so it did not matter that she did, was tangible.
A myth exists, even among staff, that it is impossible to have intercourse with a catheter in situ and this needs to be diffused. If the person wishes to use this myth as an excuse for not having intercourse then that is another problem, but a catheter does not need to be a bar. Women need informing that the catheter is not in the vagina but in the urethra, and body fantasies must be explored. Again, there may be a need for addressing practicalities like position and whether the catheter can be spigotted, or whether continuous drainage should not be interrupted, in which case it is important that neither partner lies on the tubing. For men, advice on folding back the catheter, if necessary taping it, and using a condom over it may be needed. In any event, these areas of anxiety need addressing as there is great potential for emotional and practical difficulties (Mooney, Cole and Chilgren, 1975).
*203/197/1*
