The Choice of Incontinence Aids Matters − But How Not to Get Lost Among Them?
Despite significant advances in medicine, a large number of patients still struggle with incontinence, which limits their comfort and reduces their quality of life. If treatment options have been exhausted, these patients rely on the use of incontinence aids, and therefore every urologist and general practitioner should be familiar with the current offerings and their applications.
Collecting Aids
From a functionality perspective, aids are divided into collecting, obstructive, and absorbent categories. The function of collecting aids is to direct urine into a container or bag. In addition to bedpans and urinals, collecting aids also include permanent urinary catheters or urinal condoms. The advantage of the latter two aids is primarily in limiting contact between urine and the skin, thereby reducing the risk of skin damage. Conversely, permanent urinary catheters increase the risk of urinary infections and bladder atony.
Obstructive Aids
Male obstructive aids compress the penis, preventing involuntary urine leakage. Primarily, clamps are used, which have the advantages of being easy to handle and low in cost. A disadvantage can be skin damage and ischemia in the penile area with improper handling, so clamps should be used with great caution.
For women, these devices are classified as intraurethral, extraurethral, and intravaginal, but they are used less frequently in clinical practice.
Absorbent Aids
A significant portion of the population uses absorbent aids, which include pads, insert pads, diaper pants, fixation pants, and absorbent sheets. Their purpose is to absorb fluid, control odor, provide discretion, and protect the skin from reactions. It is necessary to differentiate products by size, absorbency, and gender. It is also essential to consider the individual's activity level.
Patients with mild incontinence typically suffice with products of low absorbency, primarily provided by panty liners. Conversely, for severe urine leakage, aids with higher absorbency are preferable. Insert pads or diaper pants are suitable, benefiting less mobile or bedridden patients while also serving well for involuntary leaks during sleep. Active individuals are recommended incontinence pads, which, unlike menstrual pads, have a special composition to provide sufficient protection during sports.
When to Change an Aid?
Aids should be changed at least 3 times a day; some manufacturers recommend an optimal interval between 4 and 8 hours and always after each bowel movement. Additionally, some aids come with a moisture indicator. During changes, it is advisable to allow the skin to air properly, wash it, and treat it with appropriate cosmetic products.
In caring for an incontinent patient, a physician should not only initiate adequate treatment for incontinence but also assist in choosing suitable incontinence aids. Each patient must be approached individually because only then can they continue to live a full and unrestricted life.
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Sources:
1. Cottenden A. et al. Management with continence products. In: Abrams P., Cardozo L., Khoury S., Wein A. (eds.). Incontinence. 5th International Consultation on Incontinence. Health Publications Ltd., 2013.
2. Seni booklet CZ. Seni.cz, 2018.
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