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Anti-Incontinence Products and Catheters
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.
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® and the FemSoft® device, while patches include the CapSure® and Re/Stor® 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.
Male devices are usually clamps that constrict the penis and decrease the amount of urine leakage. They are usually used in severe incontinence which are 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 (subrapubic 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.
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