Urinary Incontinence Products:

Many products are available to help patients avoid embarrassment and prevent leakage.

Absorbent Pads and Protective Undergarments

A variety of absorbent pads and undergarments are quite effective in catching spills and leaks. With recent improvements in paper technology, pads are now thin enough to be worn undetected, and a spare can be hidden in a purse or pocket. Many undergarments developed for incontinence are almost indistinguishable from regular briefs and underpants.

For men, drip collectors are available which can be worn under briefs and are not noticeable under normal clothing. Lined with absorbent material, the pouch-like collector surrounds the penis or scrotum and is fastened with a belt or pins.

All absorbent undergarments should be changed when wet to limit problems of chafing or infection.

External Devices

Self-Adhesive Foam Pads. Foam pads with an adhesive coating are available for women with stress incontinence. They work as follows:

• The pad is placed over the opening of the urethra where it creates a seal, preventing leakage.
• It is removed before urinating and replaced with a new one afterwards.
• The pad can be worn up to 5 hours a day and through the night.
• It can be used during physical activity, although it may change position during vigorous exercise.
• It should not be worn during sexual intercourse.

Adhesive pads should not be used by women with the following conditions:

• Urinary tract or vaginal infections
• Urge or other forms of nonstress incontinence
• A history of surgery for incontinence

Urethral Caps. Small silicone caps that use suction to adhere to the urethral opening are also an option for women. These caps may be uncomfortable for some women, and side effects can include irritation and urinary tract infections.

Penile Clamps. The penile clamp is a hinged V-shaped external device that has two foam rubber pads which fit over the penis. When it is locked in place, it helps prevent dribbling. To urinate, the man releases the clamp.

Internal Devices

Vaginal Pessaries. Vaginal pessaries are devices inserted into the vagina that support the inside of the vaginal walls. Pessaries are usually made of silicon and come in various forms, including donut or cube-shapes. They must be fitted by a health professional and are effective for vaginal prolapse or other vaginal structural problems. Serious complications are rare but can occur if the pessary is not replaced periodically.

Tampons. Mild stress incontinence in women, particularly when induced by exercise, may be managed by using a tampon. Specially designed tampons are available, but even simple menstrual super tampons may be helpful. (Keep in mind that tampons can only be worn for a few hours.) Studies have indicated that both tampons and pessaries are equally effective.

Urethral Tubes. Silicone tubes or sleeves that fit into the urethral opening are also available, although they are rarely recommended. When the tube is inserted into the urethra, the sleeve conforms to its shape and creates a seal at the bladder neck, preventing leakage. It is intended for one-time use and is replaced after voiding

Catheters and Collection Devices

A catheter is a slim flexible tube inserted into the urethra. They are mainly used for cases of severe urge incontinence.

A catheter (a hollow tube) may be inserted into the urinary bladder when there is a urinary obstruction, following surgical procedures to the urethra, in unconscious patients (due to surgical anesthesia or coma), or for any other problem in which the bladder needs to be kept empty (decompressed) and urinary flow assured.

Temporary Catheterization. For people who are still active, catheterization is often very distressing. If possible, temporary, also called intermittent, catheterization is usually the best choice. Patients insert the catheter tube into their urethras, generally every 3 - 4 hours. This type of catheterization carries few risks and empties the bladder completely. Some patients report that they can maintain an active life with no significantly increased risk for infection with some simple precautions:

• Sterilize catheters at home.
• Use a zip lock plastic bag for carrying them when leaving home.
• Use another plastic bag for antiseptic cleansing solution.
• When using public bathrooms, wash before and after catheterization. Touch as few places in the bathroom as possible.

Permanent Catheterization. People who are mentally or physically incapable of self-catheterization may need permanent catheterization.

• The permanent catheter is inserted by a doctor or nurse into the opening of the bladder and a cuff is inflated to hold the tube in place. (A suprapubic tube may be recommended for long-term use. It is an indwelling catheter that is surgically placed directly into the bladder through the abdomen. The catheter is inserted above the pubic bone.)
• Urine drains to an external collection device, which is generally strapped to the leg and must be emptied periodically.

Nonsurgical catheterization procedures are generally not painful, but there is a substantial increased risk of infection. Many doctors feel that the catheter is overused, especially in the elderly.

External Collection Devices. External catheter and collection devices include:

• Condom catheters. Condom catheters are much more satisfactory than standard catheters for many male patients, although there is more spillage. The condom is worn all day and at night it is removed and washed for reuse the next day.
• Collection devices attached to the leg. For chronic or severe incontinence, collective devices drain urine into a bag that is attached to the lower leg and emptied periodically. These are generally more successful for men than women. Urine can be funneled into the tube by a pouch surrounding the penis. The positioning of the collecting device is difficult for women, and more accidents occur. For both men and women, irritation of the area around the urethral opening is a problem, since urine is in contact with the area for long periods.