This simple addition to men’s toilets would help over 2.4 million Aussies

When Paul Guest, 51, developed incontinence following surgery for prostate cancer, he knew recovery would take time. A keen rep footballer, one challenge was learning to control his bladder while running and jumping – something aided massively by the help of a specialist physio.

But he wasn’t prepared for a barrier many don’t spare a thought for: finding somewhere to throw out his incontinence pads.

An estimated 2.4 million Australian men and boys live with incontinence, 40 per cent of which are under the age of 50. But most men’s bathrooms lack bins that allow for incontinence products to be disposed of privately, hygienically – and with dignity.

While incontinence is most commonly associated with prostate cancer (it is a common side effect of radical prostatectomies), it can also be caused by other pelvic floor issues or injury, and is associated with ageing and disability.

A proud Wiradjuri man and environmental health and safety co-ordinator at construction company Lendlease in Canberra, Guest decided to bring the issue to his manager, who was receptive to his concerns. Guest has led the rollout out of bins at three construction sites and at Lendlease national head offices in Sydney, Melbourne and Brisbane.

In being an advocate for change, Guest became a beacon for colleagues, who felt comfortable asking questions or opening up to him about their own experiences with incontinence.

“It was really emotional talking about it with the guys and I think I got a lot of people to learn what they didn’t know, because you don’t know what you don’t know,” says Guest.

“That was a really, really exciting part of the whole process. And it was good for my own healing too.”

In 2021, Continence Health Australia launched BINS4Blokes, a national advocacy and awareness campaign to promote the installation of incontinence product disposal bins in male public toilets and encourage men to seek help for incontinence.

In addition to the millions of men with incontinence, continence bins also benefit those living with Crohn’s or Colitis who wear stoma bags, and trans men who need to dispose of sanitary products.

BINS4Blokes project officer Vicky Pentney says unlike women’s bathrooms, men’s bathrooms often lack any kind of bin – even outside cubicles. The fact that hand dryers are increasingly common have further reduced their availability. Urinals also often mean fewer cubicles to dispose of pads privately.

But a lack of proper disposal facilities can contribute to poor mental health.

“Some men might leave the workforce prematurely because of lack facilities. Sometimes they don’t go out into the community [because of this] and experience social isolation,” she says.

Indeed, men with incontinence are more likely to experience depression and a lower quality of life.

“We’re advocating for more bins in male public toilets, to help men get out and live normal lives freely and fully,” says Pentney. “The prevalence of incontinence is often under-reported because of the stigma attached to it – many people don’t talk about it.”

Dr Shan Morrison, director of Women’s and Men’s Health Physiotherapy in Melbourne, says lack of bins is one of many reasons men with incontinence might withdraw into themselves.

“There’s so many barriers to them leaving the house,” she says adding that even using a handbag to carry pads is something many men need to adjust to.

As a physio, she says her biggest priority is getting patients out socialising and exercising – the latter of which plays an important role in improving continence health. But she says many clients are discouraged from doing so due to a lack of facilities at sporting grounds.

“The most important thing is that it doesn’t get in the way of them living their life, and their relationships, socialising, exercising, whatever it is that they enjoy doing.”

In 2011, Alan White was diagnosed with aggressive prostate cancer. When his catheter was removed following surgery, he developed incontinence.

He recalls going to a café with his wife to celebrate being cancer-free, only to find he had leaked through a pad onto a pair of light-coloured pants he was wearing.

The experience fundamentally changed how he went about his daily life (from what he wore, to how much fluid he consumed, and when), and how he saw public spaces.

“It was a wake-up call to that. Just having no control of one’s body for a period of some months.”

White has now been a passionate men’s health advocate for more than a decade, including working with BINS4Blokes.

Since 2021, the campaign has successfully advocated for the placement of a number of continence bins in public toilets around Australia, including at major hubs like Melbourne Cricket Ground and Perth Airport, and through partnerships with local councils. But there is still a way to go.

White wants to see more sporting organisations in particular come on board, and says golf clubs have been especially resistant to change. Some organisations are put off by the financial cost of adding and maintaining bins, says Pentney.

She says larger 42 litre bins cost between $20 to $40 per bin per service, with estimated yearly costs for servicing sitting around $1000.

To this argument, White says: “Well, if you put one [a continence bin] here and you promote it, then you might get more members back here to spend money, so there’s long-term financial gain for you.”

For others, it simply comes down to a lack of awareness and education.

White says the long-term goal is to have more all gender bathrooms available, which would solve the problem of a lack of continence bins, but until then, getting bins into men’s bathrooms is the priority. Signage on cubicles indicating continence bins is also important.

He would also like to see greater education and awareness in culturally and linguistically diverse (CALD) communities, where conversations around men’s health are often quite stigmatised.

For free and confidential help, call the National Continence Helpline, 1800 33 00 66

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