Navigating Travel with Bladder Issues

Urinary incontinence commonly found among people who use wheelchairs can be troublesome, especially while traveling. These helpful tips take the worry out of your next trip

Urinary incontinence (UI) — the inability to control bladder function — is common in the vast majority of men who use wheelchairs as a result of an SCI making bladder issues an everyday inconvenience for many wheelchair warriors. Being on the road or in the air comes with extra complications. The thought of being away from a familiar routine and surroundings can be downright daunting. So for those with UI, it means preparing and planning ahead to avoid potentially embarrassing situations.

It’s the extras — extra preparation and extra supplies — that can help take the anxiety out of travel. Anticipating those unplanned snags beyond one’s control (weather, traffic and mechanical delays, overbooked flights, etc.) can make the difference between a travel experience that’s pleasurable or stressful.

Supplies: Understand Your Options

Understanding the pros and cons of traveling with various bladder management options is the first step in making an informed selection. It’s important to note that some options require more frequent changes than others. In addition, it may be helpful to find out which products are covered by insurance.

Absorbents

Highly absorbent disposable pads and undergarments do exactly what they are meant to — absorb moisture and prevent leaks. However, since these products allow urine to be in constant contact with the skin, rashes, irritation and skin breakdown are common complaints.  As a result, absorbents need to be changed fairly frequently.

For longer trips, such as a cruise or transcontinental flight, absorbents should be used with caution. In as few as five days of continuous use, incontinence-associated dermatitis can occur, with an increased risk of pressure ulcers.

Intermittent catheterization

Intermittent Catheterization Program (ICP) is a method in which you insert a catheter into the bladder and empty it completely every four to six hours. ICP is an option for patients who have enough hand function to perform it independently and who can remember to cath on schedule. Complications of ICP can occur, such as narrowing of the urethra, inflammation of the epididymis (a duct that stores sperm), hydronephrosis (enlargement of the urine collection section of the kidney) and reflux (backup of urine into kidney). 

Indwelling catheters

An indwelling catheter can be left in place for 2–4 weeks at a time. However, it carries the highest risk of a catheter-associated urinary tract infection (CAUTI), which can be dangerous and even life threatening. The risk of developing a CAUTI increases five% each day a catheter is in place, with a 100% infection rate for long-term use.

External catheters

Unlike absorbent products, which require multiple daily changes, external catheters have the benefit of longer wear-times, which is certainly more convenient for traveling. Condom catheters have been shown to reduce the risk of CAUTI when compared to indwelling catheters, however, they are known to frequently dislodge, causing embarrassing accidents. Condom catheters seal to the shaft of the penis using an aggressive adhesive. As a result, up to 15% of users will experience skin breakdown and 40% of long-term users will get a urinary tract infection (UTI).

The latest generation of external male catheters defeats the rashes, skin sores and UTIs associated with absorbents, as well as the CAUTI accompanying indwelling and condom catheters. Rather than enveloping the shaft, these “urine collection devices” attach to just the tip of the penis to maintain a dry anatomy and greatly reduce the risk of skin irritation and CAUTI. In addition, advancements in hydrocolloid manufacturing are resulting in more reliable and comfortable adhesive properties and less skin irritation and dislodgement.

Preparation Saves Time and Embarrassment

Here are some planning-ahead tips that could save you, your traveling companions and/or your caregiver unnecessary time and embarrassment.

1. When traveling by car, map your route on paper or a GPS and use freeway exit guides to plan regular stops at rest areas. Google Maps can highlight each rest stop on your trip so you know when and where you can go.
2. When traveling by air, make the flight attendant your confidante by alerting him or her about your UI before the plane door closes. Confirm that the flight attendant has an aisle chair available should you need to use the lavatory. This can be helpful should the plane get stuck on the tarmac or have to be de-iced a second time.
3. Manage your liquid intake by avoiding beverages two hours before boarding. Changes in cabin pressure and tight seat belts can put extra pressure on your bladder, especially if it’s full.
4. While complimentary beverages may be appealing, it’s prudent to eye the beverage cart with caution. Avoid diuretics like soda or coffee and stick to plain old water to wet your whistle.
5. When booking air travel, know the airline’s wheelchair storage policy, including size and weight restrictions for the aircraft.
6. If you’re flying with an airline that offers a limited number of aisle seats at no charge, be sure to make reservations far in advance to avoid extra fees. If you book with an airline that doesn’t assign seats, consider investing in Early Bird Check-In, which guarantees you a spot at the front of the line to ensure you get that aisle seat.
7. No matter what mode of travel you choose, an easily accessible “Plan B” bag can be a lifesaver should the airline lose your checked baggage or a long wait for the restroom causes an accident. Pack extra supplies, a change of clothing and a plastic bag for soiled clothing.
8. Well in advance of your trip, talk to your doctor about medication in the case of an overactive bladder; this type of medication needs two weeks to take effect.
9. When traveling to a foreign country, learn how to ask, “Where is the restroom?” in the native language. Be prepared to find that not all foreign locations may be wheelchair-friendly.

Talk to your doctor or healthcare team before you confirm your travel plans. Knowing your options when traveling with UI can make or break your trip. Products that are safe, healthy, and don't require multiple changes throughout the day provide more freedom and flexibility. And products with longer wear-times will take up less space in your suitcase. Adept planning can make a huge difference in ensuring a more enjoyable and less worrisome travel experience. Bon voyage!