Ask the nurse

Any type of indwelling catheter can cause irritation to the inside of the bladder, resulting in the leakage of urine around the catheter.

As your aunt had a tube via the bladder outlet (urethra) this may have caused problems with the closure mechanism of the bladder. This can lead to constant leakage, despite having the tube through her tummy (suprapubic).

Indwelling catheters also cause infections of the urine which can cause irritation and leakage.

We would suggest that the catheter be removed and her incontinence managed with pads for the moment. This will allow her bladder to settle down and she can be reassessed by her specialist.

Try contacting ERIC (Education and Resources for Improving Childhood Continence) via their helpline: 0845 370 8008. They are a really useful source of information for young people with continence problems.

You should also go back to your GP. There are specialist centres for people with bowel problems around the UK and you may be able to have your daughter referred for indepth assessment and possibly treatment.

Urinary tract infections are common amongst the elderly mainly due to lack of mobility and a poor fluid intake. These infections can increase confusion and it would be worth discussing with your mother's GP the advisability of sending a urine sample to the laboratory to ensure she is being given the necessary and appropriate antibiotics. You should try and encourage her to drink more, especially water.

As far as hygiene is concerned, some wipes you can buy have alcohol in them and this can irritate on already fragile skin. Unperfumed soap and water is the best once any excess faeces has been removed with tissue or a disposable cloth.

You should always deal with the vaginal area and bowel separately when cleaning to avoid transfer of bacteria. Wash the vaginal area from front to back and never apply talcum powder or unprescribed creams.

TENA has a range of support products, which include wipes, washes and barrier creams. Visit the Product Range to find out more.