managing incontinence with undergarments and pads
Absorbent incontinence products are very useful for managing urinary and bowel incontinence and include disposable or reusable pads and garments, shields, guards, briefs and underpads, all of which absorb and contain urine and stool. These products offer protection from the embarrassment of urine and stool leakage. Many new incontinence treatments are available and people who are having problems with urine and stool leakage should seek treatment information from their physicians and nurses in addition to using these products.
Absorbent incontinence products are designed to "soak up" urine and stool. They protect clothing, furniture and bedding and can help people with incontinence maintain their dignity, self esteem, comfort and, sometimes, even their independence. They are made with various degrees of absorbency and range from thin panty liners to bed pads.
Types of incontinence pads
- Perineal pads (called panty liners) are designed with an adhesive strip that allows them to be firmly fixed to underwear.
- Many incontinence undergarments have elasticized legs and use a belt attached to the garment with buttons or Velcro that holds the pad in place.
- A very popular product that is often seen in the most active older adult patient is protective underwear that is pulled on like cloth underwear and has a "natural feel." A nice addition to this product is refastenable tabs that allow changing without removal of outer clothing.
- Briefs or diaper-like products come with elasticized legs and self-adhesive tabs that secure the brief.
Absorbencies
Manufacturers design absorbent products for light, moderate or heavy leakage;
but because there are so many brands, it's difficult to compare one with another.
Many women use sanitary napkins (perhaps as much as 30 percent of sanitary or
feminine hygiene pads are purchased for incontinence), especially young women
with minimal leakage or leakage that occurs only with physical stress.
Photo: Courtesy of Coloplast/Conveen
Sock-like
drip-collecting pouches (left) are available for men and most find that they
are both comfortable and discreet. Pouches and drip collectors are typically
held in place by adhesive strips inside underwear briefs and offer protection
for men with moderate incontinence such as occurs after a prostatectomy. 
afex (right) is an innovative breakthrough for male incontinence management. Designed by those who have incontinence and tested by urologists, afex provides comfort, convenience, and confidence, while being very cost effective.Its receptacle is latex-free and ergonomically shaped for a loose fit and ventilation. It has a soft double-walled liner with drain holes to reduce skin exposure to residual urine and prevent backflow onto the body.
The afex collection bag doesn't require tubes or leg straps.The "turn-n-click" design makes attaching simple and quick, plus two convenient stability tabs allow you to secure the bag as needed. The bag is double-sealed to contain odor and can handle up to 16 ounces. Our "one-touch" horizontal port makes draining the contents easy and efficient. For more information, See: Managing Male Incontinence with afex.
| Types of Products | Amount Absorbed |
| Perineal and sanitary pads | Light urine leakage up to 3/4 cup, 4 to 6 ounces |
| Pouches, drip collectors and guards | Moderate urine leakage up to 1 3/4 cups, 10 ounces |
| Undergarments, protective underwear | Moderate to heavy urine leakage up to 2 ½ cups, 17 ounces |
One of the side effects of using absorbent products can be persistent feelings of loss of independence and self-respect. Not too many people are comfortable with the idea that they use adult "diapers." Some people who are chronically ill or bedridden truly need diaper-like products even though their bulky, "childlike" design may appear undignified or primitive. "Diapers are for babies, not me, and I don't like being treated like a baby," is a refrain I hear from many of my patients. Fortunately, newer absorbent products fit the body better and can't be detected under clothes. These adult undergarments with special pockets for disposable pads allow a person to manage their wetting problems and still maintain their dignity.
Disposables:
Disposable products are more expensive than washable products, in general,
and can cost anywhere from $200 to $400 per month, depending on the amount of
bladder loss. This is a large expense for a person on a fixed income. Some people
are forced to make their own pads from tissue paper, towels and other materials.
Unfortunately, Medicare, HMOs and insurance companies don't tend to cover the
cost of absorbent products and their disposal adds to environmental pollution.
However reusable products may not be as "skin friendly" as disposable
ones.
Reusable Garments:
Garments that are washable usually have an outer layer of plastic, rubber
or synthetic material for protection and can be pulled up, snapped on the side
or open down the front. They are usually less expensive to use over time than
disposable garments. Because of their waterproof outer layer, many women find
washable garments uncomfortable because they don't "breathe". Such
women often prefer cotton underwear with a perineal pad in the crotch to collect
urine leakage.
Courtesy of Kimberly Clark makers of Depend and Poise products
During
treatment for urinary and bowel incontinence, absorbent products may be very
helpful; but they can also be a deterrent to continence by giving the wearer
false confidence and allowing an attitude of acceptance. People who use absorbent
products over a long period of time may lose their determination to seek evaluation
and treatment for incontinence. Further, if these products aren't used properly
over a time, they can contribute to breakdown of skin and infections. Diapers
and pads should be changed frequently to avoid the skin's exposure to urine
and to eliminate the buildup of odors.
Sometimes, a person's weight and resulting pressure on the absorbent material can cause fluids to leak out the sides of garments (side-seepage.) Accordingly, a person's sitting position may help avoid side-seepage.
Underpads/Bedpads:
Special underpads or drawsheets can make a huge difference for caregivers
who are dealing with bed-wetting by keeping the mattress dry. Both disposable
and washable pads are available in supermarkets and they can be ordered through
catalogs or online. Various large chain stores such as JC Penney and Sears sell
their own brands.
Many of my patients or their caregivers have asked me to recommend the best type of product for them. There is no simple answer that works for everyone because factors such as the type and severity of incontinence, personal preferences, product quality and cost, availability of caregivers to help with changing the product and the person's skin condition should all be considered when making this choice. The absorbent capacity of products also varies and is not standardized. Furthermore, there is little research available that compares one product to another. Ultimately, most consumers make their choices based on trial and error, budgetary considerations, and whether or not a product is available in the care setting.
Most new products contain a super absorbent polymer that turns
urine into a gel, which prevents leaking or the escape of odor. Other products
are designed to wick away moisture so the skin stays dry and free of irritation.
This type of product will have a significantly positive impact on skin problems
for people who are managing incontinence but consumers should be aware that
not all products use this new technology.
There are books on urinary incontinence that can be good resources as they discuss these conditions in more detail: The Urinary Incontinence Sourcebook and Managing and Treating Urinary Incontinence by Diane Newman, CRNP.
Last updated September 2004
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