Hesperian Health Guides

Hesperian Health Guides

When You Have Problems Passing Stool or Urine

HealthWiki > Where Women Have No Doctor > Chapter 23: Problems of the Urine System > When You Have Problems Passing Stool or Urine

Many women (and men) do not have normal control over when they pass stool or urine (especially persons who are near death, or who have a spinal cord injury, or a disability that affects the muscles of the lower body). This can be inconvenient and embarrassing. It can also cause skin problems and dangerous infections, so it is important to stay clean, dry, and healthy.

Bowel control

This information will help those persons who have hard stools (constipation) or who have difficulty passing stool. You can learn to help the stool come out when it is easiest for you. The bowels work best when you are sitting rather than lying, so try to remove the stool when you are sitting on a toilet or pot. If you cannot sit, try to do it lying on your left side.

a woman lying on her side to remove stool, using a mirror
If possible,
lie on your left side.
To keep your finger clean, use a thin rubber glove, or 'fingercot’, or a plastic bag.

How to remove stool:

  1. Cover your hand with a plastic or rubber glove, or a plastic bag. Put oil on your pointing (index) finger (vegetable or mineral oil both work well).
  2. Put your oiled finger into the anus about 2 cm (1 inch). Gently move the finger in circles for about 1 minute, until the muscle relaxes and the stool pushes out.
  3. If the stool does not come out by itself, remove as much as you can with your finger.
  4. Clean the anus and the skin around it well, and wash your hands.
To prevent hard stools:
  • drink lots of water every day.
  • eat foods that are high in fiber.
  • keep a regular bowel program.
  • exercise or move your body every day.

Bladder control

catheter

Sometimes it is necessary to remove urine from the bladder by using a rubber or plastic tube called a catheter. Never use a catheter unless it is absolutely necessary. Even careful use of a catheter can cause infection of the bladder and kidneys. So it should be used only if someone has a:

  • very full, painful bladder and cannot past urine.
  • fistula.
  • disability or injury, and cannot feel the muscles that control passing urine.


How to put in a catheter

1. Wash the catheter well with clean, warm water and mild soap. Rinse well with clean, warm water.
a pot of water on a fire
2. Wash well with mild soap and clean water the skin around the genitals. Take care to clean the area where urine (pee) comes out and the folds of skin around it (the vulva). If you do not have mild soap, use only clean water. Strong soap can harm your skin.
3. Wash your hands. After washing, only touch things that are sterile or very clean.
4. Sit where your genitals are not touching anything, like on the front of a chair or on a clean toilet seat. If you sit on the ground or another solid surface, put clean cloths under and around the genitals.
5. Wash your hands again with alcohol or with mild soap and clean water, or put on sterile gloves.
6. Cover the catheter with a sterile lubricant (slippery cream) that dissolves in water (not oil or petroleum gel). It helps to protect the soft skin of the genitals and urine tube (urethra). If you do not have any lubricant, make sure the catheter is still wet from the boiled water, and be extra gentle when you put it in.
7. If you put the catheter in by yourself, use a mirror to help you see where the urinary opening is, and use your pointing (index) finger and third finger to hold the skin around the vagina open. The urinary opening is below the clitoris almost at the opening to the vagina. After you have done this a few times, you will be able to feel where the opening is and you will not need to use a mirror.
8. Then, with your middle finger, touch below your clitoris. You will feel a sort of small dent or dimple, and right below that is the urinary opening. Keep your middle finger on that spot, and with your other hand, hold the clean catheter 4 to 5 inches from the end, touch the tip to the end of your middle finger, and gently guide the catheter into the opening until urine starts to come out.
Make sure the catheter is in a downward position so that the urine can come out.
You will know if the catheter goes into the vagina instead of the urinary opening because it will go in easily, but no urine will come out. Also, when you remove it, the catheter will have discharge (mucus from the vagina) in it. Rinse the catheter in very clean water, and try again.
IMPORTANT! To avoid infection when using a catheter, it is important for you to be very clean, and to use only a catheter that is very clean. If you do get a bladder or kidney infection, talk with a health worker. You may have an infection in your vagina.


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