1. INTRODUCTION
Male urinary incontinence (UI) is common and may cause discomfort, embarrassment and disruption to everyday activities. For further information on the management of urinary incontinence, please refer to the EAU Guidelines on Urinary Incontinence and the 5th International Consultation on Incontinence (PDF). UI is defined as “the complaint of any involuntary leakage of urine”. [1] The epidemiology of UI in men has not been investigated to the same extent as in women. The prevalence of UI ranges from 1 to 39%, depending on how UI is defined and which population has been included in the study. [2]
Clear risk factors have not been scientifically documented, but several medical correlates have been reported. Established risk factors predisposing men to UI include increasing age, presence of lower urinary tract symptoms, urinary tract infections (UTIs), functional and cognitive impairment, diabetes, neurological disorders, and prostatectomy. [2]
Containment products
Containment is important for people with UI when active treatment does not cure the problem, or when it is not available or possible. Some individuals may prefer to choose containment rather than undergo active treatment with its associated risks. This includes the use of absorbent pads, urinary catheters, external collection devices and urinal collection devices for men. A useful resource for healthcare professionals and patients can be found at: www.continenceproductadvisor.org [3]
Male external catheters
Some men who cannot benefit from active treatment of urinary incontinence may benefit from the use of a male external catheter (MEC). Recognising that few nurses have had education and training in the use of MECs, the EAUN decided to update the Male External Catheter guidelines.
MECs are well known in the field of urological, neurological and geriatric nursing, but knowledge about them varies greatly among regions, and it is the impression of the Working Group that more patients could benefit from their use if the assessment and instructions were correct and individualised for each patient.
Nurse education
The use of MECs is hardly taught to nurses, which paves the way for underuse and avoidable problems. To support safe, effective practice, it is vital that appropriate education and training are provided to ensure that practitioners have a clear understanding of urinary tract anatomy, assessment, correct procedures and the potential problems and complications that may be encountered.
In Europe, there is great variation in the level of education and practical training of nurses in urology, with the roles and responsibilities of nurses differing among countries. It is therefore difficult for any guidelines to fulfil all the requirements or expectations of individual practitioners. However, the EAUN Guidelines Group aims to ensure that every nurse and allied healthcare professional will gain some benefit from using these guidelines.