More about pads

Categories of pad

•Absorbent pads (commonly known as pads) come in disposable and washable versions and in a range of absorbencies and sizes.

•Body-worn pads can be categorised into four main design groups: inserts (also called ‘liners’ or ‘shields’), diapers, pull-ups and male pouches. Click on Bed and chair protectors for information about bed and chair pads.

•Broadly speaking pads can be divided into two main sub-groups based on the amount of urine they will hold ² those suitable for light leakage (usually smaller pads) and those suitable for moderate-heavy leakage (usually larger pads). Manufacturers generally indicate the severity of leakage that their pads are designed to contain.

Important features of pads

•There are several important aspects to pad performance and, when deciding the best pads for you, it’s important to think what your priorities are. Research has shown that for both men and women the most important aspect of pad performance is the ability to contain leakage. In addition they want a pad which is discreet, contains smell, stays in place, is comfortable when wet and keeps the skin dry ³

•Many factors are important when selecting a pad including the frequency/severity of your leakage, whether you will use them day or night, whether you are able to change your pad independently or need help, and your pad changing position e.g. standing or sitting. For more help with self-assessment on these and other factors, click on People.

•It is quite usual for the amount leaked to vary considerably from day to day or even leak to leak. Although leakage can be any amount, dividing it into ‘light’ leakage or ‘moderate/heavy’ leakage is useful when selecting a pad. Click on Amount If you need help working out how heavy your leakage is.

Choosing pads that work for you

•Not surprisingly, people with heavier leakage tend to prefer using bigger pads ⁴⁵ However, both men and women often prefer to use a smaller pad and change it more often, than a bigger one which can be changed less frequently particularly if they are mobile and independent. People who are dependent and relatively immobile may prefer larger pads which are changed less frequently for security, particularly if help is required for changing the pad.

•However, people do not always choose pads based only on the amount the pads absorb. Some people have frequent, dribble-type loss and others may be dry for days and then experience a 'gush' or 'flood'. Both may prefer to use a small pad (which is likely to offer greater discreetness) changing it often.

•People often find that using a mixture of different pad types works best for them. For example, selecting very discreet pads (which may be more expensive) for social circumstances such as when at work, and cheaper, bulkier pads for when at home. Pads may also be combined with other product designs e.g. male or female devices, to suit your needs at different times.

Other FAQ's

The pack of pads I have suggests it holds 100 mls or has 5 droplets on - what does this mean?

•Packs of pads usually have a printed guide on the packaging indicating the amount of leakage for which they are designed - often a droplet symbol is used. This is only a guide! When you start to wear the pad you will find that a number of factors influence how well it works, for example, how active you are and how well the product fits.

•Pads come in a range of absorbencies to cater for people with different levels of bladder leakage. Understandably, people buying products wish to know how much urine pads will hold. But there is no simple answer: a pad does not have a volume of urine below which it is guaranteed not to leak; it is more likely to leak the more urine it has to hold.

•Pad manufacturers generally indicate the severity of incontinence that each product is designed to accommodate. However, this can be misleading if based on laboratory tests in perfect conditions ⁶ Such figures should be used as a guide only and you should try out samples of pads before buying large amounts.

•Many manufacturers of disposable products will send you free samples in the post. Look out for advertisements in magazines and on the internet or contact the manufacturer directly through their customer helpline.

Which size pad do I need?

•Pads come in different sizes and absorbencies. You need to consider the size and absorbency of the pad together. Pads generally increase in size with increasing absorbency. Click on Amount of leakage for help working out how heavily you leak.

•Fitted pads such as pull-ups or all-in-one products have a range of size (i.e. to fit different size bodies) for each absorbency level. Depending on the manufacturer you may need to know your weight or waist / hip measurement to order your pads in the correct size.

I have bowel leakage which pads should I use?

•Although pads are designed and most commonly used for bladder leakage, many people need a pad for bowel leakage or combined bladder and bowel leakage. Much less is known about how well pads work for bowel leakage. Click on Faecal Devices for suitable products.

•If you only have bowel leakage (without bladder leakage) and the stool is solid you may be able to manage with a thinner more discreet pad as the pad does not need to be particularly absorbent. However, you are likely to want a pad which is shaped to give maximum coverage over your bottom and some people find that they prefer a pad that is very secure such as an all-in-one style pad or a large insert with very secure pants.

•If you have liquid bowel leakage you may find a more absorbent pad is useful, but this type of stool can irritate the skin and you will probably want to change it as soon as possible to minimise the risk of odour and skin soreness. Some people find a barrier cream helps to protect their skin and as long as this is used sparingly it will not affect the absorbency of the pad.

Can I use washable products if I have bowel leakage?

•Small washable products are probably less suitable for bowel leakage as they do not cover the buttock area. It is possible to use larger washable products (such as traditional terry towelling or all-in-one type products) if you use a flushable disposable liner so that any stool can be contained and then flushed away down the toilet.

How are disposable pads made?

•Disposable pads usually have three layers: a top layer in contact with the skin, a middle absorbent layer and an outer waterproof layer.

•In disposable pads the absorbent core is made from fluffed wood pulp fibres. This is usually combined with a superabsorbent polymer (SAP) powder which absorbs much more urine - weight for weight - than fluff pulp and holds it far more tenaciously under pressure; that is, when the person is sitting or lying on the pad.

•The SAP is usually concentrated in the central region of the pad closest to the urethral opening (where urine exits the body). Some disposable pads have ‘breathable’ plastic backings designed to promote healthy skin.

•Some small disposable inserts/pads have an adhesive (sticky) strip on the back to help secure them to underwear.

•The larger pads for heavier incontinence often also have an indicator that changes colour when the pad is wet to signal the need for a change of pad.

•Inserts may be flat or they may be slightly elasticated along their length - this is intended to improve fitting to the body. Others have ’standing gathers’ or cuffs which are intended to reduce the risk of leakage from the side. Inserts are sometimes rectangular but are more usually shaped to fit the body more snugly.

How are washable products made?

•Washable product designs can be broadly split into two sub-groups - traditional terry towelling and purpose-made washables. Traditional products are only made for moderate to heavy incontinence whilst purpose-made washables are available in a range of designs from very light to heavy incontinence.

Traditional:

•The traditional washable product is a terry towelling square which is made entirely out of cotton and can be folded into different shapes to suit different people. Extra layers of absorbency can be added by simply adding a smaller quantity of terry towelling. Cotton tends to feel comfortable against the skin when it is dry but can be uncomfortable when it is wet this is because cotton is hydrophilic.

Purpose-made:

•Purpose-made washable products are usually made up of three separate layers. The layer closest to the skin is called the top sheet and is usually made from polyester. This has the advantage of feeling dry against the skin even when wet because polyester is hydrophobic.

•The absorbent core of the product is usually made from a felt or knitted material comprising rayon and / or polyester fibres.

•A variety of plastics are used for the water-proof backing. In general, thicker, stiffer materials are more hard wearing but less comfortable.

Are washable products better for the environment?

• There has been very little research on the environmental impact of disposable and washable products for adults. However a recent report looked at the environmental impact of diapers for babies in the UK and concluded that there was no significant difference in environmental impact between three diaper systems (disposables, home and commercially laundered washables) although the types of impacts did vary ⁷

• An important consideration in the comparison of washable and disposable designs is the relative environmental cost, particularly disposal (landfill) costs of disposable designs and energy costs associated with washing and drying the washables.

Are washable products cheaper than disposables?

•Although washable pads can be expensive to buy compared with disposable pads, they can work out cheaper per use if they are re-used repeatedly (62 Grant). The longer they are used for e.g. months or even years, the more cost effective they become.

•The main disadvantage of washable products is that they add to the washing in the home. They can be hand washed although this is not recommended long term as they can become discoloured. They can be air or tumble dried.

•With all products, if there is a failure to contain leakage there will be costs associated with laundering clothes, bedding or soft furnishings. Research studies have found washable products to be generally more leaky than disposable products and therefore for laundry costs to be higher (69 Brown, 71 Hu).

•People often consider using a combination of washable and disposable products; for example, using washable products when at home or leaving the house for short periods and using disposable products at other times.

Are washable or disposable products better for the skin?

• There is no clear evidence that either disposable or washable products are better or worse for the skin (61 Beber, 62 Grant, 70 Hu)