Pads FAQ - What to expect from pads

Pads have several characteristics and some perform better than others for these. When choosing pads o think what your priorities are. Research has shown that for 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 (ref 19, Getliffe et al 1997). . If you are unsure about how light or heavy your incontinence is or which size pads to choose, or you have faecal incontinence here are some FAQ’s which you might find useful:

How do I know if I have light or heavy incontinence?

• People’s perceptions of how heavy their leakage is varies widely. Some people who leak quite heavily consider it insignificant whereas others with light leakage interpret their leakage as heavy.
• Some women leak small amounts of urine frequently (“dribble”); other women are dry for days but then leak large volumes of urine (“gush” or “flooding”).
• The most simple way to determine how heavily incontinent you are is to try some different sized products and see which suits you best. Think about the size of the products which you have already tried and whether they contained your leakage, you can then try slightly smaller or larger pads to see if they still work well for you.

Can I find out exactly how much urine I leak?

• If you want to be more precise you can establish the amount of urine that you leak easily using some scales (kitchen scales are fine - set to grams).
• Weigh a dry pad before you put it on and weigh it again after you have finished using it. If you substract the dry pad weight from the wet pad weight you will be left with the amount of urine that was in the pad. This will be in grams but we know that one ml of urine weighs one gram so if the dry minus wet weight was 50g then you know that there was 50mls of urine in the pad.
• People are often surprised how much or how little they leak!
• If you want, you can do this several times and keep a record to get an idea of how much you leak each time and you may also be able to see if your leakage varies after different activities etc.

The pack of pads I have suggests it holds X mls or has X 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 product 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 urinary incontinence. 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. 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.

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.
• Fitted pads such as pull ups or all-in-one products have a range of sizes 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 faecal incontinence which pads should I use?

• Although pads are designed and most commonly used for urinary incontinence many people also have both urinary and faecal incontinence and some people have faecal (or bowel) incontinence alone. Much less is known about how well pads work for faecal incontinence. Click here to find out about pads for faecal incontinence
• If you only have faecal incontinence (without urinary incontinence) and the stool (bowel motion) 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 you 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. Add in about pull-ups click here to link to these types of pads
• If you have liquid faecal incontinence 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 faecal incontinence?

• Small washable products are probably less suitable for faecal incontinence 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 flushed away down the toilet.

How pads are made and environment

How are disposable pads made?

• In disposable pads the absorbent core is made from fluffed wood pulp fibres. This is usually combined with a superabsorbent powder (SAP) 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 health 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 - 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 entirely made 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 of three separate layers. The layer closest to the skin is called the topsheet 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 nappies for babies in the UK and concluded that there was no significant difference in environmental impact between three diaper systems (disposables, home and commercial laundered) although the types of impacts did vary.

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 laundering the washables.

Are washable products cheaper than disposables?

• Although washable pads can be expensive to buy compared with disposable pads, they work out cheaper per use as they can be used repeatedly for months or even years.
• 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 and 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 and cleaning bedding, chair covering etc.
• People often consider using a combination of washable and disposable products; for example, use washable products when at home or leaving the house for short periods and using disposable products at other times.