HOW DO YOU FIGHT URINE LEAKAGE?

Spontaneous leakage of urine or stool is a condition where we do not control our emptying. In the Czech Republic, even every 4th man over the age of 40 has difficulty leaking urine. Incontinence even affects their lives so much that they give up their favorite activities and limit contact with the environment. They most often restrict sports, sex, or travel by public transport. They are afraid they will see or feel it. The most common causes of incontinence in men include swelling or surgery of the prostate, the consequences of surgery or injury, or overactive bladder. 

In what situations do you have problems?

In order to work together to find the most comfortable solution to your urinary incontinence problem and to recommend appropriate incontinence aids, we must first find out what the circumstances of the urine leakage are in your case. Choose the most appropriate situation where problems occur. We will recommend further steps and aids to help you live a normal life.

How about trying herbs and tools?

1.  Feminhelp tablets, which contain a combination of pumpkin and soybean seed extracts, nettle extract, cranberry juice powder, and vitamins D and B12, are excellent as food supplements for this type of problem. The well-known Austrian herbalist Marie Treben advised strengthening the bladder sphincter by drinking tea from a coconut pasture capsule. Studies also confirm the effectiveness of the pumpkin seed extract (Cucurbita Pepo). Together with other natural substances (horsetail, flax, magnesium, and vitamins D, C), you will find it in the first non-hormonal tablet Incovenal comfort. Reduces the number of incontinence episodes by up to 80%!
2.  My mother told us from an early age that we should follow a proper drinking regime. Even in old age, when there are problems with incontinence, it is necessary to replenish fluids regularly and in no case retain urine. 
3. Try to eliminate alcohol and coffee from your diet. Fluids that contain caffeine or alcohol irritate the bladder and can unnecessarily worsen incontinence. 
4. Don't be afraid to rely on comfortable incontinence aids, such as Seni Lady Normal pads, which are anatomically shaped and, thanks to their special structure, have a much higher absorbency than classic sanitary pads. New - TENA Slip diapers with ConfioAirTM are characterized by exceptional breathability.

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Exercise 1-2 times a day for 5 minutes exactly as instructed and the results will come soon

EXERCISE 1 - BREATHING

Position: Take a basic position. Lie on your back, knees bent, hands on the side of your stomach.

Exercise: 

• Tighten the muscles around the rectum as you would with a wind, pull the lower abdomen slightly towards the spine, pull the urethral sphincter, and strengthen the lower abdominal muscles. 
• The hips remain pressed to the mat. 
• In the active position, we recommend gradually extending the endurance for 3.5 to 7 seconds. Exhale gradually relax all muscles. The relaxation phase should be 2 times longer than the active part of the exercises.

CVIK 2 - MOST

Position: Lie on your back, knees bent, hands resting freely along the body with palms to the ground.

Exercise: 

• Tighten the muscles around the rectum, tighten the urethral sphincter, gently pull the lower abdomen toward the spine, and strengthen the lower abdominal muscles. 
• Lift the pan slightly and hold in the active position for 3, 5, 7 seconds. 
• Then slowly place the pelvis back on the mat and relax the rectal sphincter and abdominal muscles. The relaxation phase should be 2 times longer than the active part of the exercise.

CVIK 3 - ON THE ABDOMEN

Position: Lie on your stomach, fold your arms under your foreheads with your palms down, place your outstretched legs slightly apart.

Exercise: 

• During exhalation, straighten the spine, turn on the rectal sphincter and urethra, gently pull in the lower abdomen, and strengthen the lower abdominal muscles. 
• Gently push the insteps and hips into the pad and extend the endurance for 3, 5, and 7 seconds in the active position. 
• Slowly release tension in the muscles of the limbs, sphincters, and abdominal muscles. The relaxation phase should be 2 times longer than the active part of the exercise.

CVIK 4 - CAT'S BACK

Location: Kneel on all fours. With your palms, rest on the width of the shoulders, the knees are the width of the hips under the hips, the space between the shoulder blades does not fall to the base, the head is in the extension of the body.

Exercise: 

• With a breath, gently flex and at the same time fasten the muscles around the rectum, tighten the urethral sphincter, gently pull in the lower abdomen and strengthen the muscles in the lower abdomen. 
• In the active position, gradually increase the duration of 3, 5, 7 to 10 seconds. 
• With an exhalation, release the tension of all muscles and straighten your back to the starting position. Do not tilt your head. The relaxation phase should be 2 times longer than the active part of the exercise.

CVIK 5 - SEAT ON THE SHOES

Position: Sit on your heels, place your hands loosely on your thighs palms down.

Exercise:

• Tighten the muscles around the rectum, tighten the urethral sphincter, gently pull in the lower abdomen, and strengthen the muscles in the lower abdomen. 
• Push the insteps into the pad and gently push the hips and pelvis forward. Hold in the active position for 3, 5, and 7 seconds. 
• Slowly release the tension in the muscles of the lower limbs, sphincters, and abdominal muscles. The relaxation phase should be 2 times longer than the active part of the exercise.

CVIK 6 - Slightly SUPPORT

Position: Spread across the shoulders, bend your knees slightly, and put your hands on your hips, or you can rest your hands on your thighs above your knees.

Exercise: 

• Tighten the rectal sphincters and urethra, gently pull in the lower abdomen and strengthen the muscles in the lower abdomen. 
• With a breath, gently push your hips and pelvis forward. 
• Hold in the active position for 3, 5, 7, and 10 seconds. Exhale, relieve tension in all muscles, and straighten the pelvis to the starting position.

Repeat each exercise 3-5 times, exercising on a suitable mat and in a ventilated room. Do not eat at least 1 hour before exercise and always exercise with your bladder empty. 

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Can very young women suffer from incontinence?​

After several years of using contraception, the ligament becomes laxative - this means that the ligament is loose throughout the body, losing its original strength and flexibility. It is not yet known whether it will return to its original state after planting and how many years it will take. The pelvic floor can be imagined as a trampoline, where the springs on the trampoline correspond to the ligaments and muscles. So the muscles are weak from lack of movement and a sedentary lifestyle and the ligaments are loose. So very young women should play more sports and postpone the beginning of their sex life.

Urine leakage at a young age - what can be the cause?

Do you imagine a woman who suffers from urinary incontinence as a lady of years? Many women with incontinence are much younger than you might guess. The most common cause of urinary incontinence is the relaxed pelvic floor muscles. This quite naturally relaxes, along with other muscles, with increasing age. But what causes incontinence in young women, girls and sometimes even children , whom their muscles still do not allow with age?

What about young men?

Young men, with rare exceptions, do not suffer from incontinence. However, obesity at a young age also has many negative effects on them.

And what about incontinence after prostate surgery - will the problem go away on its own over time?

In the past, open operations were performed, the prostate was peeled out, as if you were peeling an apricot stone, and sometimes the sphincter broke. Then incontinence was irreversible. Today, operations are done more gently, the difficulty in retaining urine lasts only a few days and then resolves.

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Incontinence in young people is no exception

Involuntary leakage of urine is associated with most people with old age, various chronic diseases and in women with repeated births. This is far from always the case. Australian doctors have looked at incontinence in young people aged 16 to 30 and found that one in eight women in this age group reported problems with urinary incontinence.

The authors of this study state that incontinence also affects people without the usual risk factors, such as overweight, pregnancy, diabetes or previous gynecological operations. At the same time, women who are sexually active are more likely to have urinary incontinence problems than those who do not have a sexual partner. According to doctors, a possible explanation is a change in the bacterial population of the urinary and genital tract in sexually active women.

However, the exact causes of incontinence in young, otherwise healthy people are not entirely clear, according to Australian experts. According to them, the body structure or genetic factors could be to blame. However, to clarify the possible context, it would be necessary to monitor young patients for several decades.

Types and symptoms of incontinence (leakage of urine)

Stress incontinence is urination during coughing, sneezing, exertion and is caused by the reduced closing force of the sphincters at the mouth of the urethra. This weakening of the sphincters is often caused by damage during childbirth, menopause and old age. This type affects only women. Weak muscles can be strengthened again with appropriate exercise.

To urge incontinence is urinary urgency characteristic which is caused by excessive vzruchovostí muscle wall of the bladder and the inability to control the bladder, if the arriving urge to urinate even when a lower filling degree. The causes are spinal cord injury, diabetes, urinary tract infections or stones in the bladder. 

Periodontal incontinence when the bladder is overfilled, when the urine then drips or drains "over the threshold". In men, the most common cause of these problems is an enlarged prostate.

Neurogenic incontinence is in neurological diseases (multiple sclerosis or other neurological disorders). Urinary incontinence can also occur in children. A visit to the doctor is necessary when detecting incontinence, it is necessary to find out its cause, not to delay the visit to the doctor for incontinence newly developed in children.

INCONTINENCE TREATMENT

Treatment of urine leakage in men is available from tablets through exercise to laser. Here it depends on the causes of the leak. Drugs in tablet form can be prescribed for overactive bladder , which can successfully suppress the constant contraction of the bladder muscle, which leads to an increase in its functional capacity.

After prostate surgery and injuries, rehabilitation, including bladder training, comes first. You will learn to empty correctly, on the contrary, to keep urine and also not to empty.

For people with a milder form of urine leakage in men, insurance companies pay for special pads and other aids. It is also important to change eating habits and drinking regime , which includes restrictions on drinking coffee, carbonated drinks and spicy foods.

URINE LEAKAGE AND SURGERY

If incontinence occurs after prostate surgery, especially after removal of the tumor, and severe urinary leaks persist, after a thorough examination, surgical management of these leaks is also considered.

These are various modifications of the tapes, which have the task of compressing your urethra in a suitable place. Another possibility is the application of a gel substance directly into the area of ​​the urethral sphincter, which, thanks to its properties, will at least partially help to compensate for its currently impaired function.

If the cause of incontinence in men is benign hyperplasia , ie enlargement of the prostate, then it is time for mini-invasive laser treatment. Due to the economic complexity, implantation of an artificial sphincter is not a very used method in our country .

The doctor introduces 3 different types of implants to the patients, which prevent the leakage of urine, various pumps and reservoirs. It is not a cheap affair, it costs around 200,000 crowns and the operation is performed only in 2 places in the country.

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Most people are ashamed of their incontinence problems. What are the appropriate ways to treat it?

Incontinence or spontaneous leakage of urine bothers about a tenth of the population. It is often considered a problem for older women, but it is also not avoided by men and children. The cause may be a weakening of the pelvic floor after childbirth or during a sedentary job, in men, it signals, for example, prostate problems. Most patients are ashamed of their incontinence and do not want to admit it to their doctor. However, thanks to early diagnosis and appropriate treatment, problems with urine leakage can be successfully solved.

What are the degrees and symptoms of incontinence?

The manifestations of this disease may vary according to the degree of incontinence. If it is a mild form, urine leaks in drops once or twice a day. When urine leaks in the range of 100-200 ml in 4 hours, doctors talk about moderate incontinence.

We consider urinary leakage to be a severe degree of incontinence that bothers the person practically constantly. It typically occurs in seniors who leak more than 200 ml of urine in 4 hours. Also, this problem persists during the night.

Other possible manifestations of incontinence:

• Burning and cutting when urinating
• Frequent nocturnal urination
• Odor
• Irritated skin and sores
• Inflammation

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What causes incontinence?

The causes of incontinence can be different, usually, more than one factor is involved in the development of this disease. Very often urine infection or weakening of the pelvic floor muscles is responsible for the leakage of urine.

Other causes are;

• Genetic predispositions and congenital malformations
• Birth trauma
• Radical gynecological procedures (eg removal of the uterus )
• Long-term strenuous physical work
• Injuries associated with spinal cord injury
• Chronic cough due to asthma or smoking
• Obesity and lack of exercise
• Prostate enlargement in men
• Diabetes

The pelvic floor descent, which is also often responsible for problems with urine leakage or bowel movements, can be manifested by a feeling of pressure, or a small lump can be felt, which descends from the vagina. For a woman, it can mean, among other things, difficulty walking or having sex.

See what helps with incontinence

In addition to a variety of herbs, some dietary supplements or aids will help solve the problem or make your situation easier. So what to choose? Talk to your doctor about which remedies are best for you. 

• Herbs -

for normal urinary tract function, for example, nettles, coconut shepherd capsules, horsetail, or dandelion are suitable, also, pumpkin seeds are good.

• Food supplements  -

If you are not one of those who like to make herbal decoctions and teas, choose food supplements. Usually, you will find a combination of extracts from several herbs.

• Incontinence drugs -

There are not many of them, they are used exceptionally and their use must be consulted with a doctor. These are mostly parasympatholytics or hormonal treatment.

• Incontinence aids -

The most common aids include incontinence pads, which are manufactured in many sizes and shapes (for men and women) so that they are completely discreet and at the same time maximally functional. Incontinence briefs are just as practical.

• Cosmetics for incontinence - leakage of urine is also associated with frequent and recurrent skin problems in the genital area. To solve them or prevent their formation, it is suitable to use cleansing foams, which on the one hand remove impurities from the skin, at the same time have a pH of 5.5 and, also, neutralize odors.

HOW DO YOU PREVENT URINARY INCONTINENCE?

Incontinence can be prevented, for example, by the above-mentioned exercises to strengthen the pelvic floor, but also by maintaining a healthy lifestyle. Regular gynecological examinations and consultations with a doctor in case of any problems are also important.

How do you treat incontinence?

The treatment of incontinence depends mainly on its type and degree. It also depends on the timely and correct diagnosis. Slight urine leakage is usually solved with the help of special exercises, which focus on strengthening the pelvic floor muscles. The non-hormonal supplement I've InkontinStop is also suitable for women during menopause, which helps to reduce urine leakage.

How do you treat stress incontinence?

Regarding stress incontinence, milder stages are often treated with conservative procedures, including rehabilitation, low-frequency pulse electrical stimulation, pressotherapy, or pharmacological therapy. If this treatment is not effective enough, surgery will be started. If the cause is a violation of the urethral sphincter, for example, an artificial one can be implanted.

A standard procedure in the treatment of stress incontinence is also the introduction of a "tape" around the urethra, where it provides support in increasing intra-abdominal pressure. There are several different types of tapes, such as TOT, TVT, TVT-O, Monarc, or others.

In the case of a mild or moderate form, laser incontinence treatment is also applied. In this case, no anesthesia or anesthesia is necessary, the advantage is a reduction in the burden on the body and faster healing.

How do you treat urge incontinence?

In the case of urge incontinence, conservative treatment consists mainly of adjusting the lifestyle and physiotherapy of the pelvic floor muscles, but it also includes a micturition drill or "urination according to the watch". Your doctor may also prescribe parasympatholytics, which are used to loosen the bladder wall and reduce the frequency of urination.

If neither method is successful, applying Botulinum toxin to the bladder wall can help the patient. Sometimes, however, even this treatment is not enough, and in such a case it is possible to proceed to an operative solution. These are operations that increase the capacity of the bladder (myectomy) or the complete diversion of urine from the lower urinary tract. However, these procedures are irreversible.

EXERCISE FOR INCONTINENCE

To strengthen the pelvic floor muscles, it is advisable to try Kegel exercises. They help prevent problems with urine leakage, but they are also suitable for improving the quality of sexual life and for women before and after childbirth. Regular and long-term exercise is important because the results often come after a few weeks.

HERBS FOR INCONTINENCE

For example, pumpkin seeds, which you can get in the form of tablets at the pharmacy, can support the proper function of the bladder. Other recommended remedies include cranberries in any form, coconut tea, pasture capsules, or licorice.

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WHAT IS URINARY INCONTINENCE?

Urinary incontinence is an involuntary loss of urine,  which generates a profound discomfort and a worsening of the person's quality of life with effects also on the economic and psychosocial sphere. It is, in fact, the cause of psychological, occupational, relational, physical, and sexual problems.

SEE THE CAUSES 

L ' urinary incontinence female can be caused by several factors, because of the many anatomical and physiological mechanisms that contribute to the maintenance of continence in women and the multiple physiological conditions (pregnancy, childbirth, menopause) that can act on these mechanisms. The causes can, therefore, be borne by various districts: the bladder, the pelvic floor, or the structural stability of the ligament system of the urethra and bladder.

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WHAT ARE THE RISK FACTORS?

The main risk factors are age, the number of pregnancies and vaginal parts, a high baby weight, the presence of vaginal prolapse, obesity,  chronic cough in patients with chronic bronchitis, cigarette smoking, cystic fibrosis, the intensive practice of sports that require jumps or strong abdominal thrusts (some form of dance, jumps in athletics, trampoline), heavy work activities, menopause.

- Advancing age is associated with an increase in the prevalence of urinary incontinence

- The limitations of mobility, as patients with movement difficulties, will inevitably have difficulty reaching the bathroom in time

- The female sex, relating to cases of stress incontinence in women who have had a vaginal delivery

- Acute hospitalization

- Hygienic deficiencies accompanied by urine retention and urinary tract infections

- Neurological and especially dementia diseases

WHAT DO YOU THINK ARE THE SYMPTOMS OF URINARY INCONTINENCE?

Symptoms are directly related to the type of incontinence: 

• Stress incontinence: occurs when there is an increase in abdominal pressure (coughing, sneezing, weight lifting, jumping, physical exercises) and urinary loss varies from very slight to severe. This type of incontinence is particularly related to pregnancy, obstetric trauma, and pelvic changes associated with menopause and senile age. 

• Urge incontinence:  consists of one loss of urine following a strong and uncontrollable urination urgency as a consequence of involuntary contractions. The loss of urine occurs due to an imperious urination need that does not allow to get to the bathroom before the urine leak. The causes of contractions can be neurological (multiple sclerosis, stroke outcomes, spinal cord injuries), or they can derive from infectious pathologies, stones, or bladder tumors, foreign bodies. In many cases, this hyperactivity does not have a precisely identifiable cause.

• Mixed incontinence: the symptoms of stress incontinence and urge incontinence are associated.

DIAGNOSIS 

The diagnostic process is based on a very accurate, structured, and finalized anamnesis, highlighting all possible risk factors and obtaining a detailed description of the symptoms (urination frequency, circumstances in which loss occurs, impact on the quality of life).

A useful diagnostic tool is the urination diary, that is, the recording of the patient's urination habits over 24 hours, repeated for 4-5 days.

The urogynaecological physical examination assesses the tropism of the genital mucous membranes, the results of obstetric traumatism and/or previous surgery, the possible presence of genital prolapse, the state of the internal genitalia, the degree of urethral mobility and other parameters.

The diagnostic imaging makes use of ultrasound examinations, useful information both anatomical and functional, and urodynamic examination, which aims to provide a pathophysiological diagnosis of the condition of the patient.

Often the first level diagnostic approach, based on the clinical framework, may already be sufficient for diagnosis and therefore for a first therapeutic approach.

The use of second-level investigations should be reserved for more complex cases, relapses, and cases that deserve surgical treatment.

HOW DIFFUSED IS IT?

It is a predominantly female condition that affects:

• 20-30% of young women
• 30-40% of adult women
• 30-50% of older women
• 23-67% of pregnant and postpartum women.

HOW IS INCONTINENCE TREATED?

The first therapeutic approach consists in correcting or eliminating the risk factors identified with the anamnesis (for example, reduction of body weight, chronic cough, etc.) or of the factors that can worsen incontinence (genital atrophy, infections of the urinary tract).

The therapy must be personalized to the individual patient as much as possible and can count on pharmacological resources (for forms of urge incontinence) such as antimuscarinic drugs, or on perineal (for all forms) and surgical (for forms) rehabilitation therapies stress incontinence).

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What is incontinence all about?

Incontinence, ie spontaneous leakage of urine, simply the loss of control over the bladder, bothers a large number of Slovaks. Nevertheless, for most of them, it is a big social taboo, which they often do not want to reveal even to their doctor. In many cases, this can be solved.

Incontinence affects women much more than men, and although it is much more common in the elderly, it is not a necessary consequence of aging. We call incontinence any will-uncontrollable leakage of urine, with the proviso that this leakage can have a number of causes and according to their findings then falls either under the care of a urologist (stressful, urgent, mixed, flushing) or neurologist (reflexive, paradoxical, psychogenic).

Why does urinary incontinence occur?

Incontinence is not a disease, it is a symptom that can have a variety of causes, whether it is a medical condition, disposition, or common habits. Risk factors for incontinence include:

• Gender (women have a higher risk of developing stress incontinence, mainly due to pregnancy, childbirth, menopause and also due to the natural female anatomy, men are at higher risk of paradoxical and hot flush incontinence)
• Age (the higher the age, the higher the risk of incontinence)
• Overweight (excess kilograms increase pressure on the bladder)
• Smoking (the effects of tobacco on the body increase the risk of spontaneous leakage of urine)
• Family history (if any of your parents has incontinence, you also have an increased risk of developing it)
• Diseases (incontinence often occurs due to some degenerative diseases or diabetes)

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What are the types of spontaneous urine leakage?

• Stress incontinence is typical for women after childbirth or after menopause. It is caused by excessive pressure in the abdomen, for example when coughing, sneezing, lifting heavy loads, or also when laughing.
• Urgent incontinence is manifested by a sudden and very intense need, followed by urination. It occurs very often in sleep. In addition to being caused by multiple sclerosis and other degenerative diseases, diabetes, surgery, or injury, it can also be the result of a urinary tract infection.
• Mixed incontinence is a combination of stress and urgent leakage of urine.
• Paradoxical incontinence affects men more often and may be caused by weakened bladder muscles or a blocked urethra. It manifests itself in such a way that the bladder is still overcrowded and only flows. It occurs, for example, due to urinary stones, diabetes, after difficult operations, or also due to an enlarged prostate. Elderly men also experience flushing in connection with an enlarged prostate, which prevents the excretion of urine.
• Psychogenic incontinence may occur, especially in elderly patients, due to fear, anxiety, or stress. 

Incontinence treatment, then surgery

The use of drugs is one of the most common forms of treatment for spontaneous urination, in the case of older women, in the case of stress incontinence, hormonal preparations introduced directly into the vagina are used. In case of urgent incontinence, patients have usually prescribed drugs that can suppress excessive bladder activity. If the pills do not work, the doctor will order surgery, the specific procedure depends on the cause of the problem. Sometimes the patient undergoes implantation of an artificial animal, but more often the introduction of special synthetic tapes under the urethra is used.

Incontinence during pregnancy and after childbirth

It is not unusual for spontaneous leakage of urine to occur in pregnant women, especially in the advanced stages of pregnancy. Incontinence occurs during this period because of enormous pressure on the pelvic floor. Postpartum incontinence can then be caused by swelling of the tissues in the vaginal area. As soon as the body heals, the spontaneous leakage of urine should also subside. If this does not happen within half a year of birth, it is advisable to see a doctor.

The natural treatment of urinary incontinence 

The treatment of urinary incontinence depends entirely on the diagnosis and the degree of incontinence. For example, milder stages of stress incontinence are treated with exercise, electrostimulation, laser, pressotherapy, or pharmacological therapy. In the more advanced stages, a mini-invasive procedure is usually performed, in which the urethra is supported by a special vaginal tape, which prevents the leakage of urine when the pressure in the abdomen increases. Another possibility is the surgical implementation of an artificial urethral sphincter.

Other treatment options for incontinence include:

• Lifestyle change, especially weight reduction, reduction of physical activity, and adherence to a regular drinking regime (restriction of drinking coffee, and other diuretic drinks).
• Kegel exercises, ie strengthening the pelvic floor

• Micturition drill, ie bladder training, ie urination according to a predetermined plan determined by the doctor

• Parasympatholytics, drugs to relax the bladder wall, which reduces the frequency of urination
• Hormonal treatment
• Acupuncture
• Herbs

How do you fight incontinence?

• The first step is a proper lifestyle - stress, irregular diet, smoking or alcohol will not help you to solve the leakage of urine, on the contrary.

• Regular exercises to strengthen the pelvic floor muscles are recommended by doctors, but also by the patients themselves, who strengthen the pelvic floor muscles. Try special Kegel exercises. You can train them at home, at work and on the street - just anywhere, anytime!

• Try Venus's balls - there are different types that can help you with weakened pelvic floor muscles. Don't be afraid to try them.

• Use the right medical devices - hygiene and comfort, you should think about them especially when incontinence. Appropriate incontinence aids will help you feel comfortable and do what you enjoy without limits. 

If you have a urine leak, try medical incontinence aids. Talk to your doctor or pharmacist and choose a product that will help you feel comfortable and dry in any situation.

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