Incontinence Pads – what you should know
Incontinence is treatable. It is therefore essential that assessment and treatment of incontinence is sought before you consider using pads as a permanent way to manage your bladder problem. Following this assessment, some patients may then need to only use pads whilst waiting for diagnosis or treatment.
There are a wide variety of pads available and so it is very important that you get the correct pad for your particular problem. It is therefore essential that you are assessed before receiving incontinence pads. The assessment is usually undertaken by a district nurse, trained in this area of healthcare. In some cases, the local Continence Service will carry out assessment.
Pads are available in a wide range of sizes and absorbencies, but tend to fall into two main categories:

Light incontinence

Moderate/heavy incontinence
The absorption capacity of a pad doesn’t determine the best suitability for a patient. Some patients may have frequent low volume, low flow incontinence and others may have several dry days and then have a high flow, high volume incontinence episode. If you are mobile and independent you may prefer small pads and frequent changes rather than a large pad. However if you are immobile, you may prefer a large pad to reduce your dependence on others for frequent changes.
Categories: Disposable (single use)
Sub-categories: Bodyworn Underpads
Design groups: Inserts
All in ones
(nappies)
Pull ups
Pouches
Bedpads
Chairpads
Reusable(washable)
Bodyworn
Inserts
All in ones
(nappies)
Pull ups
Pouches
Underpads
Bedpads
Chairpads
Sub groups: Groups sub-divide according to the severity of incontinence(light or mod/heavy) and the sex of the intended user (M, F or unisex).
Table taken from
Cottenden, A et al.,. (2005). Management with Continence Products. In P. Abrams, L. Cardozo, S. Khoury & A. Wein
(Eds.), Incontinence (3rd ed., pp. 45). Bristol: Health Publication Ltd/ICS.
Inserts are usually held in place by close fitting underwear (either own or mesh pants). They can be rectangular or shaped, with elastication to improve fit and help prevent leakage & aid fitting and sometimes with an adhesive strip.
All in ones are an adult version of a baby’s nappy. These have had a recent modification, where they fasten around the waist and the front is pulled up. This is intended to aid the changing of the pad when standing.
Pull ups are an adult version of trainer pads for toddlers. When they are reusable, they are often know as pants with integral pad and look more like normal underwear.
Male pouches are made for light incontinence and the pad is designed to fit around the penis and/or scrotom. They are also intended to be worn with close fitting underwear.

Underpads (chair and bed) are usually rectangular and the reusable bedpads often have material wings to tuck under the mattress and hold the pad in place.
The composition of the pads is usually in three layers, comprising of a:

Waterproof backing

Absorbent core

Water permeable top sheet
In disposable products the absorbent core is usually wood pulp with powdered super absorbers, where as the reusable products have rayon/polyester fibres in their absorbent core.
It is generally not advisable to use sanitary products to contain incontinence, as the composition of the pad is designed for a much thicker fluid i.e. blood, and so the core may not have a fast enough absorption capacity to deal with urine. Generally sanitary pads stay damp and can make the skin sore, so although incontinence pads tend to be a bit more expensive they are usually more effective and comfortable. However for very light incontinence, sanitary products may still be suitable.
You would not normally be offered pads until a full continence assessment has been carried out; this is to ensure that there are no treatment options available that would avoid you even needing to use pads. The assessment will include taking a history of your problem including symptoms, a bladder diary recording how often you pass urine (over a minimum of three days), a urine test and in some cases a physical examination. Whilst undertaking the assessment the nurse will also consider the degree of incontinence, mobility and assistance required to go to the toilet or wash and dress.
Incontinence pads cost the NHS something in the region of £80 million per year and are often one of the areas of greatest expenditure within Community NHS Services. Unfortunately this had led to a degree of rationing and variation around the country with regards to the provision of incontinence pads.
They are usually only provided free of charge for patients with moderate to heavy incontinence, those requiring 3-6 pads a day. Some areas may also provide fewer pads of a higher absorbency. Some areas do not provide pads for light incontinence (often linked with stress incontinence) and require patients to purchase their own pads. These are now widely available in pharmacies and supermarkets. Some trusts will provide reusable underwear, with an integral pad for light incontinence. If you don’t want to buy pads in person, then there are a variety of mail order companies (who also offer online purchasing via their websites) that stock a wide range of products, both disposable and reusable.
Pads can be disposed of in th e normal household waste in the same way as babies’ nappies. If they are particularly soiled they should be wrapped in old newspaper or a plastic bag. No special facilities are needed.
If you feel that the assessment undertaken by the district nurse, results in products that do not meet your needs, then ask to have an appointment with one of the specialist nurses from the
Continence Service. If you still feel that your needs have not been met, then ask for details of the Patient Advice and Liaison Service (PALS), who should be able to help and support you.