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Urinary incontinence: Incontinence products to help keep you dry

In some circumstances, bladder control problems are difficult to manage. These effective and discreet incontinence products can help.

By Mayo Clinic staff

Although medical devices don't cure bladder control problems, they can help you manage urinary incontinence. A number of devices — including urethral inserts and pessaries — are available to reduce urine leakage or help you better control your urge to urinate.

Incontinence products fall into two main groups. One group consists of internal and external devices that keep urine from leaking out of the bladder. The other group includes various nerve stimulation devices that, used over time, strengthen the muscles that support your pelvic organs and help maintain continence. Here's a rundown of different incontinence products that may help you.

Internal devices

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Illustration showing how the FemSoft Insert works FemSoft Insert
Illustration showing different types of pessaries Pessary use

An important benefit of these devices is that you can use them only when you think they'll be needed. The downside is that some people find them uncomfortable.

Urethral inserts
Urethral inserts are small, tampon-like disposable plugs that a woman inserts into her urethra to prevent urine from leaking out. Urethral inserts aren't for everyday use. They work best if you have predictable incontinence during certain activities, such as while playing tennis. You insert the device before the activity. Whenever you need to urinate, you simply remove the device. Urethral inserts are available by prescription.

One example of a urethral insert is the FemSoft Insert. The single-use disposable device — made of soft silicone — is a tube with a balloon-like tip at one end and a flange at the other. Encasing the tube is a sheath filled with mineral oil. After the device is inserted into the bladder with an applicator, most of the mineral oil flows into the balloon tip. Because the balloon tip is soft and filled with fluid, it conforms to the shape of your bladder and creates a seal around your bladder neck, preventing urine from leaking out. To remove the insert, you grasp the flange, which remains on the outside of your urethra, and pull the device out.

Pessaries
Your doctor or nurse practitioner may prescribe a pessary (PES-uh-re) — a silicone or latex device, usually shaped like a ring or a dish, that's inserted into your vagina and that you can wear all day. The device helps support your bladder to prevent urine leakage. You may benefit from a pessary if you have incontinence due to a dropped (prolapsed) bladder or uterus.

A pessary usually is fitted and put into place by a doctor or nurse practitioner. If you have a pelvic infection, it should be treated before you're fitted with the device, to avoid complications. You usually don't need to remove the pessary to urinate, but you do need to regularly remove it to clean it. Some of the side effects of pessary use include an allergic reaction to the latex or silicone, infection and pressure sores. Pressure sores are more common if you're postmenopausal because vaginal tissue can become more sensitive and less elastic after menopause. Vaginal estrogen cream may help prevent this.

External devices

These devices come in a variety of shapes and materials. They're designed to block urine flow to reduce urine leakage.

Self-adhesive foam pads
These disposable pads, about the size of a postage stamp, fit in between your labia. When you need to urinate, you remove and dispose of the pad you're wearing. After you urinate, insert a new pad.

Silicone cap
This small, rounded, hollow device fits over your urethral opening and uses suction to stay in place. It can be washed with soap and water and reused for up to one week.

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References
  1. Pettit P, ed. Mayo Clinic on Managing Incontinence. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2005:73.
  2. Anders K. Devices for continence and prolapse. BJOG: an International Journal of Obstetrics and Gynaecology. 2004;111(suppl):61.
  3. Vaginal pessary. American Academy of Family Physicians. http://familydoctor.org/online/famdocen/home/women/reproductive/gynecologic/578.html. Accessed Dec. 18, 2008.
  4. DuBeau CE. Patient information: Urinary incontinence treatments. http://www.uptodate.com/home/index.html. Accessed Dec. 18, 2008.
  5. Urinary incontinence in women. National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC). http://kidney.niddk.nih.gov/kudiseases/pubs/uiwomen/index.htm. Accessed Dec. 18, 2008.
  6. Norton P, et al. Urinary incontinence in women. The Lancet. 2006;367:57.
  7. Brazzelli M, et al. Efficacy and safety of sacral nerve stimulation for urinary urge incontinence: A systematic review. The Journal of Urology. 2006;175:835.
  8. Abed H, et al. Urinary incontinence and pelvic organ prolapse: Diagnosis and treatment for the primary care physician. The Medical Clinics of North America. 2008;92:1273.

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Jan. 30, 2009

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