Managing Urinary Incontinence

Anyone who is experiencing involuntary loss of urine should consult a physician. Although not in itself a disease, urinary incontinence is never normal and is sometimes a symptom of a serious problem that requires attention. In addition, your doctor will be able to recommend treatments that may eliminate or reduce the severity of your incontinence.

However, even for those whose incontinence will ultimately be cured, there is likely to be a period of time before the cure is attained when management with products is an important interim strategy. For some people, lack of proper management can cause them to hide at home in fear of an embarrassing accident. Some people quit their jobs, give up their volunteer work, shy away from social engagements and even give up necessary routine activities such as grocery shopping. Fortunately, none of these restrictions is necessary. With the proper use of the right products, you can live a full and active life despite urinary incontinence.

This section will help you learn about the kinds of products that are out there, make wise choices about which products are most likely to work for you. To some extent, the kind of product you need will depend on the kind of incontinence you are experiencing and the amount of leakage that you have. Other important considerations are the cost of the products and their appearance and whether you are a woman or a man. Most people want to find the least expensive and most discrete product that will handle their problem effectively.

Wearable Pads and Guards A number of pads and guards are designed especially for women whose stress incontinence causes them to experience the loss of small to moderate amounts of urine during physical activities such as coughing, sneezing, lifting, or working out at the gym. These pads generally have a waterproof back, a pad containing a gel-forming polymer to absorb fluid more effectively, and an adhesive strip that is designed to hold the product securely inside your panties. Most are contoured to fit comfortably between your legs and have elasticized sides to provide a cupping form. They come in several sizes and levels of absorbency. These products resemble sanitary napkins that are designed for use during menstruation, but the padding and absorbent gel are different in the two kinds of products. The padding and gel in sanitary napkins is designed to absorb blood, while those in the incontinence products are designed to absorb urine. The chemistry of blood and urine is different enough to require different products for best performance.

Pads and guards especially designed for men with mild incontinence are also available. Like the pads designed for women, the products for men have an adhesive strip to anchor the product inside snug knitted underwear, a waterproof backing to prevent leakage, and a pad containing gel-forming polymer.

Belted UndergarmentsDesigned to be worn instead of ordinary underpants, this category of product consists of a belt worn around the waist with buttons or Velcro attachments in the front and back to which a pad that fits between the legs is attached. The pads have a plastic or fibrous waterproof backing and contain gel-forming polymer.

Some manufacturers produce pads with different levels of absorbency. These products are useful for both women and men whose incontinence results in the loss of small to moderate amounts of urine. Because the belt to which the pad is attached is elastic, the product can be pulled up and down easily to facilitate using the toilet; and the pads can be changed easily without needing to remove your trousers or slacks.

Disposable UnderwearThese are one-piece, absorbent underpants that have a fibrous “cloth-like” waterproof backing and a built-in absorbent pad containing gel-forming polymer. They resemble ordinary underwear more than any other incontinence product. Some manufacturers produce products with different levels of absorbency, but all these products are designed mild to moderate levels of incontinence. The distribution of the padding in most of these products makes them more appropriate for women than for men. A characteristic of these products is that you have to take off your trousers or slacks in order to put on a new pair of these underpants. This is a major disadvantage if you ever need to change in a public washroom.

Disposable Briefs (Adult Diapers)These products which are designed for moderate to heavy urinary and/or bowel incontinence closely resemble baby diapers, except that they have two or three tape closures on each side instead of just one. The current products have either a plastic or fibrous “cloth-like” waterproof padding and absorbent padding that contains gel-forming polymer. Disposable briefs differ in quality in many ways; and the adage “you get what you pay for” is especially appropriate with these products. Cheap briefs often have a noisy, fragile plastic backing that tears easily and unreliable tape closures that may come loose if you are active and that cannot be adjusted without damaging the plastic backing. Better briefs have a less noisy and more robust plastic or a noiseless “cloth-like” covering and tapes that hold reliably and can be fastened and unfastened repeatedly to facilitate using the toilet. Inexpensive briefs also absorb less urine than their more expensive competitors and thus must be changed more often. The capacity difference between products is often great enough to make a higher-priced brief less expensive to use because you don’t use as many of them. Disposable briefs work equally well for men and women and have the advantage of not requiring you to remove your trousers or slacks when changing in a public washroom.

Many people have a strong psychological resistance about wearing diapers; and this fact is a reason why these products are called “disposable briefs” instead of “diapers.” That resistance is also the reason why belted undergarments and disposable underwear, which look less like a diaper, were invented. However, if your incontinence is great enough to require something more than a pad or shield worn inside your regular underwear, a high-quality disposable brief will provide more reliable protection for a longer period of time and during a greater range of activity than any other kind of product. If you want to get out into the community and lead a normal life, you will find that it’s better to have more protection than you need than to need more protection than you have; and a disposable brief is the most reliable way to get that protection.

Reusable ProductsAlthough most people prefer to use disposable products, reusable washable products are available in almost every category for which disposable products are made. Factors which make these products less popular are the need to do extra laundry and the difficulty of temporarily storing and transporting wet products when you are away from home. One major reason why some people prefer to use a reusable product is the belief that disposable products place a heavier burden on the environment. Conclusive data are not available about whether this belief is correct when all factors are considered. Disposable products certainly produce more waste that has to be handled in some way; and recycling of disposable incontinent products is not available in most communities. However, reusable products also stress the environment by requiring additional detergent and additional power for laundering and drying. Another reason why some people use reusable products is that they believe that reusable products produce fewer skin irritations than disposables. Other people believe the opposite.

External CathetersAnother option available to men is an external catheter consisting of an adhesive sheath that is attached to the penis and connected to a collection bag via a tube. Adhesive sheaths made of either latex or silicon are available. Collection bags are worn either attached to the leg or around the waist. Judging from what one reads in internet discussion forums, these systems are preferred by men who feel that they offer more dignity than wearing a “diaper” or who believe that they produce less skin irritation than an absorbent product. Some physicians also feel that these appliances are more appropriate than absorbent products and thus recommend them to their male patients.

Nevertheless, using an external catheter is associated with its own problems. The fact that the sheath is attached to the penis means that it isn’t practical to urinate in the toilet. Thus, the system is impractical for anyone who is partially continent and wants to use the toilet when he can. Second, there is the potential for the tube to come loose from either the sheath or the bag and cause a leak; and this is likely to happen when a man is doing something that requires a substantial amount of movement. Finally, a full collection bag may rupture and cause a major mess if it is bumped roughly. These considerations make the system most appropriate for men who lead sedentary lives.

Internal Catheters People who are unable to empty their bladders may need to use an internal catheter. These come in two major varieties. Intermittent catheters are essentially rubber or latex tubes that one inserts into the bladder and then removes after the bladder has drained. An indwelling catheter is a latex or silicon tube with a small balloon that can be inflated once the catheter has been inserted in order to hold it in place. Both kinds of catheters have the potential to cause dangerous urinary tract infections. They should be used only upon the advice of a physician and only if you are able to take the precautions needed to reduce the danger of infection.