You laugh and then leak. Or you sneeze and then dribble. Maybe you just lose it all.
"Urinary incontinence" describes the broad range of bladder control problems that affect more than 12 million people. If you’re one of them, you should see a doctor. Treatments can improve or stop the problem. But over-the-counter "hygiene products" can help you manage it. There are dozens of items to help you manage mild, moderate, and even severe symptoms. There’s a lot to consider when choosing products.
Liners, pads, disposable underwear, and reusable underwear absorb moisture. Products made for incontinence control "catch" the leaks and pull moisture away from your skin. That allows you to go longer between changes.
All incontinence protection products have a "saturation" point -- they can hold only so much liquid -- but the products don’t absorb at the same rate. Sometimes the difference can be dramatic. There’s no standard for terms such as "plus" or "ultra plus," so try different brands to find what works best for you.
Many disposable pads, liners, and undergarments have a waterproof backing. This helps prevent overflow from reaching your clothes. The newest waterproof system uses a "breathable" plastic film that helps reduce skin irritation associated with some waterproof linings.
Choosing Your Product Style
Pads and liners come in a variety of shapes and sizes. That makes it easier to find the right fit for your body shape and lifestyle.
Liners are generally wider and longer than pads and offer better "front-to-back" protection. Pads are usually curved. They're disposable and designed for women and men. Adhesive strips hold them inside your underwear. They trap 8 or more ounces of urine and keep it away from your skin. They also block odor and can be changed throughout the day. Many contain elastic on the sides to cradle your body and help keep leaks from rolling over the edge.
There's also a range of disposable undergarments with built-in protection -- not just in the crotch, but throughout the entire garment. Styles range from pull-ons with elasticized legs and waists resembling a traditional cloth panty to underwear that slips on with Velcro or adhesive tabs for a customized fit. You can also find open-sided "thong style" panties held together by straps in the front and back that rest on top of the hip bone. They are reusable, washable, and typically available in a range of colors. You can get day styles as well as overnight ones, which are designed to hold more urine. Like pads, this underwear is designed to be absorbent, to keep moisture from your skin, and to control odor.
Guards are pads designed around a man's anatomy and worn inside regular underwear. They're held in place by adhesive tabs pressed against fabric. With a variation known as a "drip collector," the penis is placed inside a protective, absorbent sack that absorbs urine flow.
Condom catheters fit around the penis. They end in a tube that leads to a collection bag strapped to your body.
A portable toilet is another option. If you have trouble walking, talk to your health care clinician. You may benefit from a portable toilet that can be placed close to your bed or living area. In addition, move electrical cords, throw rugs, or furniture out of hallways and walkways so that you do not trip or fall on the way to the bathroom.
Disposable protection is the most costly, but it can be the most sanitary and the easiest to use, especially when you're not at home. When at home, many people use washable and reusable pads, liners, and garments. They’re less expensive, and the garments feel more like typical underwear.
Protective underpads are disposable or reusable flat pads with an absorbent layer on one side and a moisture barrier on the other. They protect mattresses, chairs, or other furniture from urine leaks. Some have antibacterial and antifungal finishes and adhesive strips to keep them in place. They also come in a range of absorbencies.
Plastic pants fit over your regular undergarments and help protect against mild to moderate leaks.
Whatever you wear, you’ll need to maintain a schedule for changing it based on your urinary habits. You don't have to change products as soon as you leak. But you should change them if your skin feels wet.
Urinary Incontinence and Odor Control
Most incontinence pads, liners, and disposable underwear feature some type of odor control. Often, the materials are treated with a natural odor-absorbing compound such as baking soda. Sometimes, though, manufacturers add fragrance to the pad, liner, or garment. Some people find this pleasant, but for others it causes skin irritation. If you have sensitive skin, odor control compounds may cause you problems. If so, look for products that are fragrance-free and contain no chemicals for odor control.
If you accidentally leak urine onto clothing or furniture, there are several products -- sprays and special detergents -- that remove urine stains and odors. Most are sold in pharmacies. Some can be found in mail order health catalogs or online.
Barrier Devices for Urinary Incontinence
Some devices control the flow of urine.
Women can choose devices that go inside the vagina, like tampons or vaginal sponges. They provide temporary control by putting pressure on the tissues of the bladder. This helps keep urine from escaping and is particularly good for stress incontinence, where exercise, laughing, and sneezing causes urine to leak.
For 24-hour protection, many women find a pessary helpful. This is a plastic device that's inserted into the vagina. It comes in an array of sizes and shapes. It increases pressure on the urethra muscles and adds support to the pelvic region. These devices are fitted to your pelvis size, so you’ll need to visit your doctor. You can remove them for cleaning. (Many women are advised to remove it overnight once every week or two.) They should be replaced each year -- and that means another trip to the doctor. Ask your doctor if a pessary is a good option for you. In some cases, they can make urinary incontinence worse.
A vaginal guard is another option. They’re disposable devices that come in three sizes. The guard is inserted into the vagina using an applicator. It prevents leaks by adding support to the pelvic structures and muscles.
For men, the primary device is a penile compression clamp. It squeezes the penis to keep the urethra closed for mild to moderate leaks. This can be used only for a certain amount of time.
Because there are few studies on how well they work, their safety, or comfort, and because of the potential for circulation problems, many doctors advise that they be used with extreme caution.
Pelvic Muscle Training Devices
You can use these products when you do Kegel exercises, which help strengthen and control the muscles you clench when you try to hold in urine. Although you don't need external devices to do Kegels, you may find they help enhance your workout.
There are different kinds of Kegel training devices. Some are aimed at men and women, including appliances you squeeze between your thighs. Vaginal weights, rods, and cones of various sizes are intended for women.
It’s hard to tell at a glance which items might help you -- or how some of them work. So do research and talk to your doctor before you buy any of them. Your doctor can help you narrow down the choices.
Skin Care Treatments
No matter how well your incontinence products work, when urine continually touches your skin, you can get rashes and even infections.
Most experts agree that changing pads or underwear whenever you feel wet can help. So can rinsing the genital area with warm water and drying it thoroughly each time you change pads.