Incontinence: Pads, Shields, Undergarments, and “Adult Diapers” Offer Choices

From discreet pads to absorbent underwear to “adult diaper”-type products, there’s no shortage of products to help you manage that most inconvenient of symptoms: incontinence.

adult diapers

Absorbent products from shields and pads to undergarments (including what some refer to as "adult diapers") help keep daily living as normal as possible for those who experience incontinence.

Illustration: Dreamstime.com

Urinary incontinence (UI) is a common, embarrassing, and inconvenient problem that has a significant impact on our social, physical, and emotional well-being. In the United States, it affects up to 1 in 2 women and 1 in 6 men. Absorbent products make life bearable by soaking up urine, protecting clothing, reducing odor, protecting delicate skin, and maintaining dignity. Absorbent products have come a long way in a few years and are now less bulky, more comfortable, and more reliable than ever before. They range from panty liners for tiny leaks through to to incontinence pads to more absorbent undergarments for more significant incontinence. (Per the latter category, many use the phrase “adult diapers,” while others use the words “Depends” or “Depend underwear,” citing one of the major manufacturers of such products.)

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Risk Factors for Urinary Incontinence

What causes urinary incontinence? It depends on whether it’s acute or chronic incontinence.

  • Acute temporary incontinence may be brought on by a urinary tract infection (UTI), constipation, alcohol intoxication, and certain medicines, such as water tablets for heart disease, sedatives, opioid pain relievers, and muscle relaxants.
  • Chronic urinary incontinence may be brought on by many conditions, including: obesity, diabetes, pregnancy, the postpartum period, aging, menopause, uterine prolapse, post-hysterectomy, enlarged prostate, prostate cancer, prostatitis, and bladder outlet obstruction. Such neurological disorders as cerebral palsy, stroke, multiple sclerosis, and Parkinson’s disease also can cause incontinence.

Treating Incontinence: The Medical Approach

Many people put off going to their doctor when incontinence strikes, as they are embarrassed or worried, but this is not a wise approach. It’s always better to get diagnosed early as outcomes are improved, no matter the cause. You may have an underlying condition that is easily treated or one that needs further medical treatment.

Treatment will depend on the underlying cause and may include the following: antibiotics, anti-incontinence devices (for bladder retraining), medication, physical therapy, dietary change, behavioral modification, pelvic-floor exercises, internal or external catheter, penile clamps, or, as a last resort, surgery.

Despite all of these treatments, there may be times when you suffer with incontinence–while you’re waiting to see your doctor or for treatment to take effect, for example, or when treatment is not fully effective. It also may occur when you choose not to opt for medical or surgical treatment, due to concerns or personal reasons, or when you’re recovering from surgery. Incontinence also can be common after having a baby.

For these situations, there’s a wide range of products that can help contain leaks, protect skin, and reduce odor to make life more bearable.

  • Incontinence products. For dealing with incontinence on an infrequent or day-to-day basis, these types of products will help you manage your symptoms.
  • Wearable products. Look for these widely available items in stores and also from such online sources as Amazon.
    • Incontinence pads: These are worn inside normal underwear and vary in absorbency, size, and bulkiness. They range from panty shields for small leaks to bulkier absorbent pads.
    • Drip collector: These are for men with light incontinence and are in the form of an absorbent sheath or pad that fits around the penis.
    • Absorbent panties or briefs (or adult diapers): These are shaped like normal underwear but are designed with inbuilt absorbency. They vary in shape, appearance, bulkiness, outside material, and the volume they can absorb. Newer designs are better fitting, more comfortable, and discreet than earlier examples. (Popular brands include Depend for Men and Depend for Women.) More substantial products are available if there is a risk of considerable night-time incontinence.
    • Absorbent guards for men: Like a pad but shaped like a protective cup worn in sports.
    • Belted undergarments: These are longer, wider, and thicker than a standard pad, are worn under the underwear, and are suitable for heavier leaks. They are held in place by a belt that fits around the hips.
    • Boosters pads: These are designed to be used with another product to increase absorbency.
  • Products for the bed. If nighttime incontinence is a problem, several options are available to protect the bed and bedding. These include waterproof mattress, pillow and duvet cover underpads, or protective-covers.
  • Personal care products. Incontinence can be tough on the delicate perineal skin, so it’s vital to keep the skin clean and moisturised to prevent irritation, urinary tract infection, or skin infection. Products include skin care lotions, washcloths, and disposable wipes. If incontinence is frequent, and disposal bags or units may be helpful to ensure hygiene.
  • Odor control. Air fresheners, odor antagonist spray for fabrics (e.g., Febreze and Hex-On), and scented disposal bags are available. If urine has a strong odor, it is important to see your doctor, as you may have an infection.
  • Cleaning products. Laundry detergent and stain removers are available for removing urine odors and stains from reusable absorbent products, clothing, or furniture.

Choosing an Absorbent Product

Choosing the right incontinence product will depend on several factors:

  • Your level of incontinence: Light incontinence involves “dribbling” and occasional release of up to 20 percent of the bladder capacity. Moderate incontinence is a large release of urine, but not the full bladder. Heavy incontinence is the release of the full bladder in the daytime (400 to 600ml). Overnight is the release of urine throughout the night. Products are usually labeled to indicate the level of incontinence they are designed for.
  • Resources
    For more information on incontinence and absorbent products, visit these websites.

    • National Association for Continence: https://www.nafc.org/
      This not-for-profit organization provides education, collaboration, and advocacy for people suffering from incontinence.
    • The Continence Products Advisor: www.continenceproductadvisor.org
      The Continence Products Advisor, also a non-profit venture, is a collaboration between the International Consultation on Incontinence (ICI) and the International Continence Society (ICS).
    • National Incontinence: www.nationalincontinence.com
      This commercial site offers an extensive selection of products.
  • Your preference for a disposable or reusable product. The once unpopular reusable products have made a resurgence due to concerns about the environment and as more high-tech reusable products have emerged. Disposable products have the advantage of being no-fuss: They minimize odor and you don’t have to clean them… just throw them away. But they are expensive and can be bulky, unsightly, and uncomfortable, especially when in full-diaper form. Some reusables are also bulky, unsightly, and uncomfortable but recently there has been a flood of new slimline, comfortable options, which are great for mild to moderate incontinence.
  • How you’ll pay. Medicare does not cover incontinence products, but some other health insurance policies do cover some of the cost. Disposable products work out more expensive in the long run: Prices range from around 20 cents for a lightweight disposable pad for light leaks to $2 for a disposable adult diaper. Reusables are more expensive and may cost up to $5 for a pad and $20 for one pair of briefs or panties.
  • Your current lifestyle will determine the type of products you may wish to consider.

Please note: Absorbent products should not be used in place of medical treatment. If you’re suffering from incontinence, it’s essential that you see your doctor for evaluation and treatment. Incontinence is not to be ignored at any age.

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