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Incontinence (cont.)

Anti-Incontinence Products and Catheters

Anti-Incontinence Products

Anti-incontinence products, such as pads, are not a cure for urinary incontinence; however, using these pads and other devices to contain urine loss and maintain skin integrity are extremely useful in selected cases. Available in both disposable and reusable forms, absorbent products are a temporary way to stay dry until a more permanent solution becomes available.

  • One should not use absorbent products instead of treating the underlying cause of incontinence. It is important to work with the doctor to decrease or eliminate urinary incontinence. Also, improper use of absorbent products may lead to skin injury (breakdown) and UTIs.
  • Absorbent products used include underpads, pant liners (shields and guards), adult diapers (briefs), a variety of washable pants, and disposable pad systems, or combinations of these products.
  • Unlike sanitary napkins, these absorbent products are specially designed to trap urine, minimize odor, and keep an individual dry. There are different types of products with varying degrees of absorbency.
  • For occasional minimal urine loss, panty shields (small absorbent inserts) may be used. For light incontinence, guards (close-fitting pads) may be more appropriate. Absorbent guards are attached to the underwear and can be worn under usual clothing. Adult undergarments (full-length pads) are bulkier and more absorbent than guards. They may be held in place by waist straps or snug underwear. Adult briefs are the bulkiest type of protection, they offer the highest level of absorbency, and they are secured in place with self-adhesive tape. Absorbent bed pads also are available to protect the bed sheets and mattresses at night. They are available in different sizes and absorbencies.

Urethral Occlusive Devices

Urethral occlusive devices are different for males and females. Female devices are artificial implements that may be inserted into the urethra or placed over the urethral opening to prevent urine from leaking out. Inserts include the Reliance Urinary Control Insert device, while patches include the CapSure and Impress Softpatch devices. Urethral occlusive devices tend to keep people drier; however, they may be more difficult and expensive to use than pads and those who use them need to understand their potential problems if not used correctly. Urethral occlusive devices must be removed after several hours or after each voiding. Unlike pads, these devices may be more difficult to change and to insert correctly.

Male devices are usually clamps that constrict the penis and decrease the amount of urine leakage. They are usually used in severe incontinence that is resistant to other treatments and are variably effective. Males using these devices should not have mental disabilities that would allow them to "forget" and leave a clamp on for extended times as this may cause penile damage.

Urinary Incontinence Catheters

A catheter is a long, thin tube inserted up the urethra or through a hole in the abdominal wall into the bladder to drain urine (suprapubic catheter). Draining the bladder this way has been used to treat incontinence for many years. Bladder catheterization may be a temporary or a permanent solution for urinary incontinence.

In cases of overflow incontinence resulting from obstruction, some people respond well to temporary continuous Foley catheter drainage. Their bladder capacity returns to normal, and the strength of their bladder (detrusor) muscle improves. This treatment is more likely to benefit people without neurologic injury. It usually takes at least one week of catheter drainage depending on the degree of bladder muscle injury to see the benefits. If the incontinence has not resolved after four weeks, then the bladder is unlikely to recover using catheter drainage alone.

If the underlying cause of the overflow problem is bladder outlet obstruction, normal voiding may return after the obstruction is relieved. If the obstruction cannot be relieved, periodic catheterization is usually the best long-term treatment, although surgery may be required. Sometimes, a permanent catheter may need to be considered.

Different types of bladder catheterization include indwelling (left inside the bladder) urethral catheters, suprapubic tubes, and intermittent self-catheterization.

Medically Reviewed by a Doctor on 9/18/2014

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