The Continence Foundation - Protecting Yourself and Your Clothes

Absorbent products that protect you from leaks of urine have been developed to a high standard over recent years. There is a wide choice of types and qualities, including both pads to wear under ordinary clothes and special absorbent underpants. In each case you have a choice between disposable and washable (re-usable) products. You can go to our descriptions of all the different types of product you can now obtain, or you can read below our general introduction to pads.

This introduction includes tips about disposable pads - how to choose them and use them - and a detailed examination of the advantages and disadvantages of washable pads, including points about laundry. It suggests five key questions to ask before opting for washables.

Pads

Pads are the most popular product worn to protect against leaks. They can be disposable or washable and reusable, and they come in a variety of shapes and sizes for children, men and women.

They can be slim and unobtrusive, slipped inside your ordinary pants (or inside special stretch or waterproof pants or special pants with a built-in pouch), while others take the form of wrap-around all-in-one nappies.

Pads have a surface layer worn next to the skin, usually made of a "feel-dry" material, which allows urine to pass through to a soaker layer of absorbent materials. This means they are designed to be worn even after they have absorbed a quantity of urine. Most have a waterproof backing or underlayer to minimise leaks. Those without a waterproof backing can be used as an extra booster pad.

Some people mix and match their pads - for example, choosing a smaller pad during the day and changing to a more absorbent pad at night; or using a disposable pad for short term use or when travelling, and a washable pad if needed for a longer time.

Tips about Disposable Pads

Pads: Disposable Versus Washable

NOTE: Most of these points apply also to the choice between disposable and washable absorbent pants.

Clearly one of the basic choices is between using disposable products and washable ones. Washable, reusable products are often a sensible choice and if you are paying for them can be more economical in the long run. But they are definitely not the right choice for some people and in some circumstances.

To help you make the choice, have a look at the pros and cons and then at the five key questions you should ask yourself before opting for washables - including the important matter of laundry.

Five Key Questions...

Ask yourself these questions before opting for washables...

1: Is it worth the outlay?

Unlike disposables, it is difficult to get hold of samples to test how well a reusable product performs and how well it suits you, because the cost of each item is so much more. It may not be worth the outlay for washable products if the pattern of incontinence is likely to change with treatment

2: How many products will I need?

This depends on how many you need to use each day and how quickly they will be laundered ready for re-use. The absolute minimum would be three products - one in use, one being laundered and one ready to use - but you will feel safer with seven or more to allow for delays in laundry etc.

3: How will I choose which size?

The size of washable insert pads is determined by the level of protection needed, either slight, light, moderate or heavy. The level of incontinence determines the style of reusable garments, and the size is determined by hip measurements for women or waist measurements for men. Some products have a wider range of sizes than others, and some have more options within the size range. When in doubt, it may be best to choose a slightly smaller rather than slightly larger size, as a close fit helps to prevent leakage. Some of the companies which manufacture in Britain have the flexibility to make one-off garments to cater for special needs, such as irregular sizes.

4: How long will products last?

Most companies claim products can be used and laundered between 100 and 200 times, some guarantee even more washes. It is the washing and drying which cause most wear and tear, so it pays to take care with laundering (see below). Products tend to absorb less urine when they are old, and when you notice this it is time to think about replacing them. You may also notice that the materials have begun to break up slightly.

5: How will I wash them?

Reusables can be washed either by hand or in a washing machine. They can be drip-dried or put into a tumble dryer.

Washing pads can be quite a chore, depending on how many are used and whether they are included in a general household wash or washed separately. You need to be sure you have the facilities and the energy to launder reusables and to work out a system that will suit you.

Either way, it is best to rinse used products as soon after use as possible and then store them in a bucket with a lid, or other sealed container, until they can be washed. This should prevent any smell.

Some people dislike the idea of washing incontinence products, especially if they have been soiled with faeces or used during a menstrual period.

If you are not washing them by hand, you may want to wash them along with your household wash, or to wait until a wash load of used products has accumulated. But avoid overloading a washing machine as this can impede washing and drying performance, while increasing wear on the product. Loading to a maximum of three-quarters of capacity is advised.

Each product comes with maximum temperature guidelines for laundering and some can be subjected to higher temperatures than others. It is important to keep to the manufacturer's instructions on this, because the materials, especially the waterproof-backing, can be damaged by high temperatures. Manufacturers usually suggest that certain substances, such as bleach or conditioner, are avoided when washing. These too can damage the materials the products are made from.

The few reusable products which can withstand high temperature washing are said by the manufacturers to be suitable for faecal or double incontinence. However, in general, disposable products are better suited for this, unless the faecal incontinence is slight or very occasional.

Thorough rinsing is important, as traces of detergent can affect absorbency and, therefore, the efficiency of the products. In a similar way traces of chemicals used in manufacture can affect the absorbency of products when they are new. It is best to wash new products at least once before first use. You may notice that several washes are needed before optimum performance is reached, and you will probably notice that products become softer once they have been washed.

Thorough drying is also important. Sometimes products with a synthetic "stay dry" surface can feel dry when the absorbent layer inside is still damp. Products should be well aired before being put away and stored with the absorbent layer facing outwards. The heavier products take longer to dry, and this can be costly if a tumble dryer is used.

Some local authorities provide an incontinence laundering service which you may wish to use. However, they probably won't be able to offer quite the same care with laundering as can be achieved at home.

You may want to keep some disposable pads in reserve in case you ever run out of laundered reusables for some reason.

Pads and Pants: the range of choice

ALL-IN-ONE DISPOSABLES

These are suitable for heavy urinary or faecal incontinence, especially for people confined to bed or a wheelchair. It is important to get the right size, which relates to the measurement round the hips. Note that use of this sort of product may make toileting difficult.

The closures of disposables have the advantage that they can be secured at any point on the plastic surface, thus ensuring a good fit. Most have re-sealable side tapes and elasticated legs. However, sometimes disposable products are discarded unused because of tabs failing to stick or re-stick during a difficult fitting, or after a toilet visit or a check to see if the product needed changing.

ALL-IN-ONE WASHABLE GARMENTS

These are side-opening garments which, when in position, wrap right round the hips. They are similar in shape to disposable baby nappies. They are usually elasticated around the leg openings and, at least in part, around the waistband. They are fastened by press-studs or Velcro. The fastenings are usually down the sides and sometimes across the waistband, and are adjustable. Nappy-style products are unisex items, generally for heavy urinary incontinence.

All-in-one washable garments are liked by some because they are fully enclosed. The Velcro or snap closures are generally more secure than the adhesive tabs on similar disposable products, so that they are better to use for people who are inclined to tear at or remove their pads. The nappy-style garment can be positioned when the user is standing up, or rolled into position with the user lying down. Some users prefer to sit down onto an opened-out product to position it.

DISPOSABLE INSERT PADS

Insert pads have to be held in place in some way, usually by close fitting underpants, the alternatives being net or stretch pants, or pants with a pouch. Insert pads are available to cater for slight, light, moderate or heavy urinary incontinence. There is one design specifically for men with light incontinence, made in the form of a pouch.

Insert pads may be shaped or rectangular and may include superabsorbent polymers, elastication, adhesive strips, a quilted surface or wetness indicators. Designs are constantly improving and products are rapidly superseded. A wide variety of sizes and absorbencies is available. Most insert pads have waterproof backing. Those without waterproof backing are suitable for use with waterproof pants or (in the smaller sizes) with pants with a waterproof pouch or as a `booster' pad.

WASHABLE INSERT PADS

These come in a wide range of sizes and vary in thickness. They are either rectangular or narrowed in the centre to form shaped pads. Shaped pads are usually symmetrically shaped but some are asymmetrical, with the widest end being positioned to the rear for women and to the front for men. Some of the small insert pads have rounded ends to make it easier to thread them into pouch pants.

Insert pads usually have a waterproof backing. Those with no waterproof backing are for use in conjunction with a waterproof backed product, such as waterproof pants or pants with a waterproof pouch. They can also be used as a booster pad inside another absorbent product to give additional protection. Several of the slim unbacked pads can be used stacked together to give the desired thickness.

Small insert pads are, for many people, convenient to slip in and out of position. However, unlike some small disposable pads, they have no adhesive strip to secure them to conventional underwear, and can be liable to slip unless underwear is sufficiently close-fitting. Large insert pads are less enclosing than nappy-style garments: they are less bulky and leave the hips free. When used inside side-opening pocket pants they have the same options for positioning as nappy-style garments.

MALE POUCHES

These can be disposable or washable and are suitable for men with a slight or dribbling incontinence. They have an adhesive strip to keep them in position and can be worn with close-fitting underpants. Pouches with superabsorbent are thinner and thus easier to disguise under trousers.

ABSORBENT DISPOSABLE PANTS

These may be particularly helpful in situations where laundry is difficult (e.g. when travelling). They are available by mail order or over the counter in some pharmacies: a multi-pack of five packs of three (fifteen pants) will cost about £10 (about 67p each), a much more economical multi-pack of eight packs of 50 will cost about £76 (about 19p each).

ABSORBENT WASHABLE PANTS

These are ordinary-looking pants for men, women and children with an absorbent waterproof backed pad sewn into them, and often extending up beyond the gusset area. This sewn-in pad varies in length, width, thickness and shape with different products. Occasionally the whole garment is lined with absorbent material. They can be washed and re-used many times, are available in different styles and colours and generally cost between £6 and £13 a pair. Most are suitable for only a slight leak or dribble of urine or slight staining from the bowel. However, a few cater for moderate or severe urinary incontinence. In another design the pad area is extended to give rear cover for light faecal incontinence. Pant styles vary. There are Y-front versions for men; full pants, high cut, bikini styles, floral and lace versions for women; and small sizes for children. Some versions have a front panel secured by Velcro, which can be dropped down for people who use intermittent self-catheterisation. These are useful also for women who have difficulty dressing and undressing. Pant materials are polyester, cotton polyester or nylon. Be sure to get the right size: women should measure their hips, men and children their waist.

Pad-pants offer several advantages. They are more like conventional underwear, and because of this they can be used to help in toilet-training and teaching to dress independently. There is no need to position a loose pad, which can be a struggle for some people, and, of course, the sewn-in pad will stay in place. The pad can't be taken out inappropriately (for example, by a confused user), which sometimes happens with loose insert pads. Pad-pants can be used over an insert pad for extra absorbency and more security. The main disadvantage of pad-pants is that every pad change means a change of underwear, and this can be a nuisance if it happens too often or when outside the home. Changing underwear is more difficult for some people than for others and it is important to think through how many changes will be needed before opting for this design. Pad-pants can be particularly suitable if leakage is neither too frequent nor too great. In one design the sewn-in pad has been left open at the ends for quicker drying. Some people slip an insert pad in here and change this instead of the pad-pants. This works because the surface of the pad-pant gusset has a "stay-dry" feel.

POUCH PANTS

There are many ways of holding a disposable or washable absorbent pad in place. One is to wear specially made pants with an internal or external pouch with a waterproof backing (illustration above left). The pad is worn in the pouch, leaving a layer of fabric between your skin and the pad. As the fabric is "hydrophobic" (does not absorb fluid into itself) it can form a relatively dry layer next to the skin. You will need reasonable manual dexterity to manipulate the pad into the pouch. Pouch pants will cope with a light to moderate amount of urine but are not suitable for faecal incontinence. An extra pad can be used if necessary. Pouch pants are available in standard unisex designs, as well as male and drop-front versions. The latter may be of use to people with a disability so that a toilet, urinal or intermittent catheter may be used without completely removing the pants (illustration above right).

STRETCH PANTS

Simple stretch pants may be used to hold a pad in place. This may be an open-mesh weave, closer knit mesh pants (rather like tights fabric) or a more substantial pair of fashion pants. Some have a waterproof gusset. They come in a wide range of qualities: some are intended to be used once only or a few times, others will last a considerable time. Prices therefore run from 25p to £5 or more.

WATERPROOF PANTS

These may be completely made of waterproof material (e.g. plastic pants, some of which are lined with terry towelling or other fabric), or have a waterproof gusset. The latter tend to be less hot and uncomfortable. Prices vary with the quality and material from under £5 up to £20.

Protecting Yourself and Your Clothes

Introduction