Virginia Ironside's Dilemmas: Where to wee?

Radiation therapy has left this reader with incontinence problems that severely affect her quality of life. Doctors say she must "learn to live with it", but how can she?

A woman checks the condition of a portable toilet at the Glastonbury Festival site at Worthy Farm, Pilton on June 22, 2011 in Glastonbury, England. (Getty Images)

Dear Virginia,

I’m 35 and I’ve had radiation therapy for cancer and the resulting scarring means that I find it very difficult to stop leaking urine at times during the day. I really need to be near a loo all the time and as a result my life has been severely hampered. I’ve tried pads, but I’m always worried about the smell. Because I can’t go out very far my kids have to stay indoors all the time and it’s not good for them. I’ve tried every doctor, but no one can help and they just say I must “live with it”. But I can’t. Do you have any suggestions?

Yours sincerely,

Maggie

Virginia says...

Let’s get the medical stuff out of the way first. You say you’ve “tried every doctor”. But have you attended any of the numerous Incontinence Clinics there are around the country? Have you rung the National Association for Continence (nafc.org)? Have you been in touch with Pelvic Radiation Disease Association – set up specifically to help people like you, (prda.org.uk)?

Now if the answer to all these questions is “yes” then let’s look at the the advice you find so unsatisfactory – the recommendation to “live with it.” Honestly, it’s not such bad advice, but it does require great courage and a huge psychological shift.

You have become – and quite understandably I may add – a victim in this scenario. You are being bullied by your bladder. And my advice for how to deal with bullies is the same, whether they’re thugs in the playground or bladders. Stand up to them.

If you monitor your weeing patterns, and perhaps ask your doctor for a pill that would make you wee less on certain occasions, you could probably manage an hour or two at least without this problem occurring. Give it a trial run. Next, before you go out anywhere, get a map with all the nearest lavatories, so that you are quite secure that if you do need to rush to one, at least you know where it is.

Finally give up trousers, take up skirts, and wear pads at all times. Healthy urine shouldn’t smell much, anyway, and if you go fully kitted out, you can change the pads every time you find a lavatory nearby.

Be bold about your problem. If you’re visiting friends, tell them in advance that this is a horrible side-effect of your radiation treatment and you hope they’ll understand. If you find yourself unable to get to a loo in time, be open about it. Explain you’ve had an “accident”. People are more sympathetic than you’d think.

But you must not be dominated by the problem, not just for your own sake but your children’s. You don’t want them growing up having never had a run-around childhood, never able to go on trips with you.

A bit of leaked wee is, to be quite honest, not the end of the world. It’s not as if you’re occasionally vomiting uncontrollably, or becoming hopelessly drunk, or suffering attacks of temper and lashing out. It’s just a little bit of water. Get help. And be brave.

Readers say...

Try some physio

Urinary urgency and incontinence can be caused by a number of factors. In this case it sounds like the scarring caused by the radiation. However bladder retraining, fluid advice and pelvic floor muscle exercises might help. Simple measures such as cutting out caffeine/fizzy drinks can reduce bladder over-activity. Women’s health physiotherapists use a frequency/volume chart to determine fluid input and output. This can be a very useful exercise to show bladder capacities and habits. The website acpwh.org.uk can put you in touch with a women’s physiotherapist in your area.

Philippa Irvine, by email

Help is out there

Macmillan Cancer Support (macmillan.org.uk) has a booklet called “Managing the Late Effects of Pelvic Radiotherapy in Women”, which gives advice and possible remedies for these problems. And there’s the Bladder and Bowel Foundation (bladderandbowelfoundation.org). These organisations have a lot of experience in this field and can offer much more than the “just live with it” advice.

S Parnell, by email

Next week’s dilemma

Dear Virginia,

I’m 23, and ever since I was young I have suspected I was adopted. I have a younger sister who not only looks nothing like me, but is completely different in personality. And I don’t seem to share any physical characteristics with my parents. I love them, but I’ve never felt I belonged in our family. And now I want my birth certificate for a passport, my mother became very odd and said she’d lost it. I asked my dad if I was adopted, when I was 18, but he just avoided the question. How can I find out?

Yours sincerely,

Stacey

What would you advise Stacey to do?

Email your dilemmas and comments to dilemmas@independent.co.uk. Anyone whose advice is quoted or whose dilemma is published will receive a £25 voucher from the wine website Fine Wine Sellers