What are female or internal vaginal devices?
These are mechanical devices designed (primarily or in part) to prevent urinary leakage. There are three main types:
Internal vaginal devices are placed inside the vagina to support the bladder neck or compress the urethra
External urethral devices are applied over the urethra at the opening.
Internal urethral devices are placed inside the urethra.
Most female devices currently available are for women with stress urinary incontinence (SUI) or mixed urinary incontinence, and are designed to prevent urinary leakage.
Female devices can be hazardous if used incorrectly. Always follow manufacturers’ instructions.
| More likely to suit you if... |
Less likely to suit you if... |
- You mainly have stress urinary incontinence
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- Your leakage is mainly associated with urgency
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- You have good hand control
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- Urinary tract infection is a major concern for you
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- You have good memory and mental function
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- You experience vaginal discomfort or pain (internal vaginal devices)
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- Using a device (as opposed to a pad) is acceptable to you
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- You experience skin irritation around the urethra (external urethral devices)
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- Preventing leakage is more important to you than containing it
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- You experience pain or discomfort on passing urine or urinary tract infections (internal urethral devices)
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Internal vaginal devices
When do internal vaginal devices work best?
Internal vaginal devices are intended for use during normal everyday activities. While the devices work well for some women, for others they do not.
They may be most effective for women with minimal to moderate SUI leakage. Intravaginal rings have been found to be less effective in women with mixed urinary incontinence.14
Pessaries can also be used to manage pelvic organ prolapse (POP), which is often accompanied by SUI. While for some women with POP the use of a pessary to support the prolapse can help to reduce SUI, others report newly occurring SUI when they use a pessary.151617232425
Any internal device can cause discomfort or irritation so that it may be best to limit their use to times when wearing a pad may be less convenient. They may be most suitable for use intermittently to provide occasional continence protection during physical activities such as exercising or dancing.18 The intravaginal bladder support is intended to be used only for up to twelve hours in any twenty-four-hour period.
Internal vaginal devices can be used by women with both bowel and bladder leakage, but they will not improve the bowel leakage. You can read more about products that work well if you have bowel leakage.
What about fitting?
If you have good use of your hands and are used to inserting tampons or diaphragms, then you will probably have no difficulty using the devices.
The intravaginal bladder support is designed to be inserted into the vagina by the user herself using an applicator much like a normal tampon applicator, which is then withdrawn. It is available in different sizes with a starter kit for women to find out which size is most effective for them.
Some women find fitting devices difficult, especially those with altered vaginal anatomy after childbirth or multiple surgeries14. If you are unsure about your ability to fit this kind of device, trying a tampon first will give you an indication as to whether or not you would be able to use other devices. Otherwise, ask you healthcare professional for help with fitting.
Pessaries should be sized and fitted by a trained healthcare professional. Once the device has been fitted correctly it may be possible for you to manage it yourself.
One consideration when selecting a device is the length of time it is intended to last. Some silicone pessaries last for up to 6 years but other devices have a more limited shelf life.
What other products could ‘mix and match’ well with internal vaginal devices?
Some women find that while the devices reduce their incontinence, they do not prevent leakage completely. You may find you still need a pad but that a smaller one or washable pants would work.
Might vaginal devices cause any problems?
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Tampons: There is much discussion (especially on the internet) about how often they must be changed and whether they can be worn overnight. However, the consensus is that if they are changed at least every 12 hours or more often they are safe.
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Diaphragms can cause discomfort and long-term use of pessaries can be associated with bleeding, extrusion (the device is pushed out), discharge and pain.419
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The intravaginal bladder support can cause discomfort, pain and spotting with blood.1011
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Intravaginal rings can cause discomfort or irritation and, less commonly, urinary tract infection.20
Although these devices may cause some discomfort, women can find this an acceptable trade-off for a reduction in leakage.21
If you do try an internal vaginal device, it is recommended that you see your health care professional every 6-12 months to have its use reviewed.22
External urethral devices
External urethral devices are made from medical grade, biocompatible foam or silicone and hydrogel adhesive patches. They are designed to sit over the opening of the urethra, sticking to the surrounding skin and creating a temporary seal to prevent urinary incontinence. There are two types currently available: Moxypatch has a reusable applicator and disposable adhesive patch; Finess is a disposable item.
When does an external urethral device work best?
External urethral devices can be effective at preventing light to moderate urinary incontinence and lead to improved quality of life during exercise and everyday activities.26
They can be used by women with both bowel and bladder leakage, but they will not improve the bowel leakage. You can read more about products that work well if you have bowel leakage.
What about fitting?
External urethral devices are self-applied and removed intermittently to allow urine to be passed. They have a ‘fin’ on the outer aspect to the device to be held securely while placing it. The skin surrounding the urethra should be dry to allow adhesion. You may need to use a small mirror to locate the urethra when you first use these devices.
If you are unsure about your ability to fit this kind of device, ask you healthcare professional for help.
What other products could ‘mix and match’ well with the internal urethral device?
Some women find that while these devices reduce their incontinence, they do not prevent leakage completely. You may find you still need a pad but that a smaller one or washable pants would work.
Might an external urethral device cause any problems?
External urethral devices are unlikely to prevent urge urinary incontinence or heavier stress urinary incontinence. Skin irritation can occur but may not be severe enough to stop you using the device. They are unlikely to increase the risk of urinary tract infection.26
Internal urethral devices
There is currently only one of this type of device available. The Femsoft is made up of a short silicone tube surrounded by a fluid-filled silicone sheath. The tip is designed to conform to and close off the opening of the bladder and the part of the urethra closest to it. It is available in two lengths (3.5 cm and 4.5 cm).
When does an internal urethral device work best?
The Femsoft is intended for daytime use during physical exercise. Use of this device has led to reduced or no episodes of incontinence especially where the incontinence is heavy, and in women who have had surgery for a fistula.2728 A small study found that the device significantly decreased stress urinary incontinence during exercise compared to not using the device.29
Internal urethral devices can be used by women with both bowel and bladder leakage, but they will not improve the bowel leakage. You can read more about products that work well if you have bowel leakage.
What about fitting?
The Femsoft is self-inserted (using a separate insertion probe) and removed intermittently to allow urine to pass. Before insertion, the proximal end of the cylinder is distended relative to the distal end but, as the user pushes the device (guided by the insertion probe) into the urethra, fluid transfers temporarily to the distal end, returning once the device is in place, so securing it.
If you are unsure about your ability to fit this kind of device, ask you healthcare professional for help.
What other products could ‘mix and match’ well with the internal urethral device?
Some women find that while the devices reduce their incontinence, they do not prevent leakage completely. You may find you still need a pad but that a smaller one or washable pants would work.
Might an internal urethral device cause any problems?
Some women find this type of device uncomfortable to use. In trials, common side effects included bacteria in the urine and urinary tract infection (approximately 40% of women). Uncommon side effects included the device moving into the bladder and the device rupturing (less than 3% of women).2728 In a small study of six women, there were two reports of pain or discomfort when passing urine (dysuria) and one case of blood in the urine (haematuria). These side effects did resolve while the women continued to use the device.29
Where can I get these devices?
How you get these products and where they are available varies according to which part of the world you live in. Speak to your healthcare professional or contact the supplier using the links below to find out how to get them where you are.