What is your bladder leakage like?

There are several characteristics of leakage that are important to consider when selecting products.

The amount of urine that leaks is the most important factor to consider. People’s views about how much they leak vary widely. Some people who leak very small amounts of urine consider it to be heavy leakage, while others who leak rather more consider it to be mild.

Thinking about how much you leak can help you to select the most appropriate products.¹ as products are usually designed for either “light” leakage or “moderate to heavy” leakage. Some products state the capacity of urine that they can hold. Although these stated capacities may not be very accurate, they can be a useful indicator of whether the product is likely to be suitable for you.

It can be useful to measure how much you actually leak, as this information can help you identify the best products – see sections below.

The speed of leakage can vary - some people have frequent, dribble-type leakage, while others may be dry much of the time and then experience a 'gush' or 'flood'.

The speed of leakage also influences how well a product works. This is especially true for absorbent pads and pants. If your leakage is mainly slow drips a small pad is likely to be able to absorb urine very effectively. But if your leakage tends to be fast gushes, a larger pad offering a greater surface area for absorption may be more effective. It is quite usual for the amount you leak or the speed of leakage to vary considerably.

How often leakage occurs will affect the type of product that is most suitable, and how many you need. Some people prefer to use small pads when out and about and change them often, because they can be more discreet under clothing. At other times a larger pad may contain more leaks and need changing less often. You may find that you need a mix of products for use in different circumstances – some that cope with lighter leakage and others that cope with heavier leakage.

Estimating how much you leak from manufacturers’ descriptions

You can work out roughly how heavy your leakage is by thinking about your experience with pads you have used. Pad manufacturers will generally indicate on the packaging the amount of leakage for which their products are suitable. They do this in several ways:

• Giving an estimated absorbent capacity - this can sometimes be misleading. The figures given sometimes reflect absorbency under ideal (laboratory) conditions, which is usually quite a lot higher than the absorbency of the pad in real use.²

• Descriptions of levels of leakage - for example, ‘heavy night time loss’ or ‘suitable for light leakage'.

• Using a coding system - for example, supplying products or packaging in varying colours, and using a coding system such as different numbers of teardrop symbols to indicate whether they are for light or heavy leakage.

If you have found that pads described as being for light leakage or with a stated capacity of only 200-300ml are not sufficient, you probably need to use pads for moderate or heavy leakage.

On the other hand, if you have found that pads described as being for moderate or heavy leakage or a stated capacity of nearly a litre are only a little wet when you change them, you might consider using a lighter pad.

Measuring how much you leak by weighing pads

If you want to be precise, you can establish the amount of urine that you leak using some scales.

You will need: a dry pad, a plastic bag and a set of digital scales (the sort you use in the kitchen are fine).

• Wrap the unused pad in the plastic bag and weigh it in grams (set the scales to zero first).

• Wear the pad until you have leaked.

• Place the used pad in the same plastic bag and re-weigh using the same scales.

• Subtract the first (dry) weight from the second (wet) weight. This will give you the amount you have leaked in grams (providing the pad has contained all the leakage).

• We know that one ml of urine weighs about one gram. So, if the weight you are left with is 50g then you know that there was about 50mls of urine in the pad.

• If you want, you can do this several times and keep a record to get an idea of how much you leak each time. You may also be able to see if the amount you leak varies between different activities or if you have a ‘usual’ amount you leak.

Estimating how much you leak if you don’t use pads

Estimating how much you leak if you don’t use pads is less accurate. You need to think about how far urine that leaks from your body (when you are not wearing a pad) spreads into your clothing. This will depend on several things. For example, the number of layers of your clothing, your position at the time (sitting, standing, lying) and whether you were active or still.

As a very rough guide:

• very light leakage = confined to a damp patch on underpants

• light leakage = usually confined to underpants but may spread as far as outer clothing

• moderate leakage = usually spreads beyond underpants to outer clothing

• heavy leakage = usually spreads beyond outer clothing onto the chair, bedding or floor

If you have sufficient warning of when you are going to leak, try passing urine into a measuring jug – that is the amount of urine that could have leaked!

Recording how often and when you leak

Keeping a record of how often you leak and when it happens over a few days or a week can be helpful in several ways.

• by allowing you to plan being close to a toilet when you are likely to leak.

• by helping you to work out how many products you are likely to need – for example, the number of pads per day or the number of sheaths per month.

• by helping health care professionals to assess whether your leakage changes over time, for example before and after a treatment.

You can record how often you leak and when it happens quite simply using a chart, sometimes called a “bladder diary”. This is normally a simple sheet divided into columns for each day of a week, and rows for each hour of the day and night. You enter a tick for each time you pass urine in the toilet, and a cross for each time you have a bladder leakage.

You can download a chart here, and see an example of a completed chart here.

For thinking about what products you may need, and to help your health care professional to understand your leakage better, it can also be useful to record other information:

• some estimate of the amount you leak (for example in grams if you did pad weighing or by describing how far the urine leaked)

• what you drink, how much and when

• what you were doing when you leaked (such as coughing or standing up)

• how well your product contained the leakage

• if you had to change your product

It may be easier to record this information on separate charts.

Types of bladder leakage

In general, bladder leakage is more common in women than in men. There are several different types of bladder leakage. The most common of these are called:

Stress urinary incontinence

Involuntary leakage of urine that happens with physical exertion. It has nothing to do with emotional stress, but rather the physical stress and strain that movement can put on the muscles that support the bladder. Typically leakage can happen when coughing, sneezing, laughing or exercising.

Stress urinary incontinence is most common in women around childbirth and menopause. Stress urinary incontinence is uncommon in men but may follow some surgery, for example, as treatment for prostate cancer.

Urge urinary incontinence

Involuntary leakage of urine associated with urinary urgency (a sudden, compelling desire to pass urine). Some people may experience urgency but are able to get to a toilet in time. For others the urgency may be accompanied by leakage.

Men are more likely to experience urge urinary incontinence that stress urinary incontinence.

Mixed urinary incontinence

A mixture of stress and urge incontinence. Older women are more likely to have mixed urinary incontinence than younger women.

Nocturnal enuresis

Involuntary leakage of urine while asleep – often referred to as 'bedwetting'³. This is often thought to be a problem only for children and young people but can persist into adulthood.

Choosing products

Finding a suitable product or combination of products can be difficult. This section gives you some general advice.

When choosing products, think about your needs carefully. Consideration of a range of factors is important for successful product selection.⁴⁵⁶ You need products that are suitable for the amount you leak and how often, but the products should also fit in with your everyday life, activities and personal preferences. Many people find that it is best to use a range of different products at different times and during different activities.⁵

It is recommended that you look at all sections in this website as there may be relevant information in more than one section. In About you, you can find information about choosing products where you live that are suitable for your physical characteristics, lifestyle and preferences.

Research has shown that people manage bladder leakage more effectively when they participate in choosing their products⁷, find products that are reliable and easy to use⁸⁹¹⁰, and when they have good information and instructions for product use¹⁰.

Go to Products for Women or Products for Men for product-specific information and the interactive Product Advisor, which will help you find the right products for you.