Management

Much can be done to prevent and minimize incontinence – even for elderly people with major physical or mental limitations. For some people, the problem may not be eliminated, but most of its hygienic and socially disruptive aspects can be managed.

When incontinence cannot be fully reversed, commercial absorbent products can be used. These products allow normal activity to continue and can provide a “safety net” when an individual is keen to avoid embarrassment. Progress in non-woven materials technology has reduced odor and bulk, while reusables continue to satisfy personal preference stemming from concerns about comfort, cost effectiveness, and environmental issues.  

Various sizes for proper fit are also available. Manufactures are even conscious of sound so that “quietness” has been designed into the construction of the product. Advances in both cost and construction continue to evolve. There are numerous choices due to the variety of national brands, store brands, and discrete mail-order delivery services.

In many cases, individuals with UI need to manage their urine leakage by using certain specially-designed products. The most extensive directory of products and services for incontinence is published by the National Association for Continence. Its Resource Guide contains objective, helpful information for identifying absorbent product options with respect to design and other key purchasing characteristics.

For those people whose incontinence cannot be cured or for those who are awaiting treatment, there are a number of devices to help manage incontinence. Read more about different types of products in the Find a Product section.

Tips for Management of Bladder and Bowel Control Problems

Products for Management

  • Adult briefs are generally considered for heavy incontinence. Briefs gather at the leg and should be soft to avoid irritation or cause ulceration to the leg.
  • Disposable products should have at least two sets of tape tabs to help fit the garment close to the body to avoid leakage and discomfort.
  • Caregivers should receive instruction on how to remove and replace briefs used on bedridden adults in order to be efficient and gentle in moving the individual and to protect their own back from injury.
  • Protective underwear is a pull-on, one-piece design for ease in pulling up and down. Some newer designs have tear-away sides. Available in different absorbency levels, most are manufactured today with cloth-like material and soft elastics.
  • Shields, drip collectors, guards, and pads are the smallest of incontinence products. They are usually held in place by a person's own underwear, specially-made incontinence pants, or a loosely woven stretch brief. Drip collectors are helpful for men with minimal leakage after prostate surgery.
  • Condom catheters may be used with a leg bag worn on the thigh or ankle, which requires tubing for connection, or a bedside drainage bag. These sheaths should be sized to the individual for optimal satisfaction. Men require instruction from their healthcare provider to attain satisfactory comfort and economy.
  • External drainage systems and collection devices for men include an increasing variety of designs that may incorporate supporters or briefs in lieu of an adhesive. All aim to route urine immediately away from the surface of the penis to avoid irritation and maximize comfort.
  • Compression clamps compress the penis to help close off the urethra. Clamps used over long periods may cause ulceration and impair circulation to the tip of the penis. Clamps should be loosened and temporarily removed frequently to avoid penile injury. They are never to be worn at night.
  • Pessaries, for women only, support the bladder and/or compress the urethra. In cases of pelvic organ prolapse contributing to incontinence, pessaries can both support and partially compress the urethra to attain continence.
Skin Care
  • Skin care is an important part of management. Gentle cleansers formulated to clean and condition skin and help break down wastes are available. These also help reduce odors. Special cleansers which remove urine and stool without the need for scrubbing and which are not drying to the skin are important to people with incontinence.
  • Moisture barrier creams and protectants forumlated especially for the perineal area in the form of ointments are ideal. They are most effective when applied immediately after daily bathing.
  • Frequent use of bar soaps may be very drying and irritating to the skin, because of high pH levels.
  • Fungal rashes usually require prescription-strength antifungal powder or cream. Ordinary cornstarch-based powders are preferable to baby powder. Water-repellant, oil-based creams coat the skin and protect it from penetration by urine and feces.
Odor Control
  • Odor control is one of the most worrisome concerns of people faced with blader control problems. Odor neutralizers or eliminators, rather than deodorizers that leave strong scents of their own, are preferable and longer lasting. Odor neutralizers leave little or no scent in the air and are packaged in aerosol or pump spray containers. Biological odor eliminators are the most effective.
  • Underwear should be made of breathable cotton, changed and laundered frequently, and worn under easy-to-remove clothing.
  • Highly perfumed and colored toilet tissue, bubble bath, oils, talcum powders, and bath beads used in the perineal area may cause skin irritation and may worsen the odor problem.
  • Some over-the-counter oral tablets or capsules contain chlorophyllin copper complex. This is helpful in controlling urine and bowel odors, as well as other body odors.
  • To help clean and remove odor from clothing, add one cup of white distilled vinegar or baking soda to wash prior to final cold water rinse. Two parts vinegar and one part water may be used for cleansing reusable urine collection devices.
  • Some liquid deodorizing drops that neutralize offensive odors are approved for use in leg bags and bedside drainage systems and are not intended to be applied directly to the skin or onto products in contact with the skin.

Monitoring

Management of incontinence requires ongoing monitoring and educational initiatives of family members. Family caregivers should be aware of symptoms that should be reported to a health provider:

  • Increased urgency (the overwhelming sesation of needing to empty the bladder) and frequency (excessive number of times the bladder is emptied in 24-period)
  • Increased use of asorbent products
  • Blood in the urine
  • Urine that smells
  • An increase in nighttime trips to the bathroom to urinate
  • Difficulty emptying the bladder
  • Change in mental alertness
  • Loss of appetite
  • Fever and chills