by Nancy Weikel, RN



  1. Level of Incontinence
  2. Reusable vs. Disposable
  3. Measurement and Sizing

  4. The 'Style' - Women's, Men's, or Generic
  5. Specialty Sizes - Youth or Bariatric
  6. Unique Products Just for Men

  7. Unique Products Just for Women
  8. Deciding on your level of incontinence
  9. Fecal and/or Urinary Incontinence
  10. Discreteness?
  11. Do they want discreet shipping?
  12. How Much Does It Cost?

The First Step in Choosing a Product - Level of Incontinence

Where do you start in how to choose the right incontinence product? The first step one needs to do to is to determine their level of incontinence. It's best if they also keep in mind whether they want products that are reusable or disposable. See all the details below. One can then further choose using comfort, discretion, and budget as a guide.

A simple list is below for determining a person's level of urinary incontinence:

a. Light is dribbling and occasional urine release.

b. Moderate is large releases of urine but not a full bladder.

c. Heavy is the release of a full bladder in the daytime.

d. Overnight is the release of urine throughout the night.

e. Fecal is loss of bowel control.


Step up one level of incontinence for people needing assistance to the bathroom and/or have an altered level of consciousness.


Choosing Between Reusable or Disposable

Reusable Products are more expensive initially but cheaper in the long term. The reusable products are more eco friendly in that they do not fill up landfills. Most reusable products come in singles to try out.

The reusable products are designed for all level of incontinence. Pads, liners, panties, and men's briefs are designed for light and moderate incontinence and there exists non-gender briefs with snaps designed for heavy and overnight incontinence. A booster pad can also aid with extra absorption when needed.

The Ultra Fit Reusable Brief is a heavy incontinence brief with snaps made specifically to incorporate fecal and urinary incontinence and it is bleachable.

Disposable products offer more choices and do not need to be laundered. Specially designed products have highly absorbent cores to wick away the fluids from the skin. Some have added protection for odor control and legcuff guards to help prevent leakage. Many are now designed with cloth like outer coverings and breathable side panels. Side panels are occasionally made stretchable to help obtain a snug fit with movement. Incontinence products have come a long way to help anyone with incontinence achieve maximum protection while at home or in public.

Disposable products include male urine guards, pads, and liners for light incontinence. For heavy moderate, heavy, or overnight incontinence, there are belted garments, briefs with tabs, pull-ups, and heavy pads. There are also specifically designed products for loss of bowel control.




Getting the Right 'Fit' - Measurement and Sizing

The next step in how to choose the right incontinence product is an important one: once the person has identified the brand and style that they want, and identified the single product that will work best, it's time to choose a size. To determine what product size to select, carefully measure the waist and hip size of the person. Use the larger of the two measurements to select the size to use. Carefully use the given table in the product's description to choose the correct size. It is important to remember every brand and style may have a slightly different fit and measurement for a particular size. Don't depend on a stated size being the same measurements for every manufacturer. For example, a medium in one product might not be the same size as a medium in a different brand of product. A snug fit around the legs is important to help prevent urine and/or fecal leakage.




The 'Style' - Women's, Men's, or Generic

Male products made specifically for men include urine guards and pouches that fit on the end of the penis. They also include pads with cups, pull-ups, and both reusable and disposable briefs. Some of the reusable briefs look and feel like real underwear.

Female specific products include pads, pull-ups, and reusable panties. These panties look and feel like regular underwear.

The majority of both reusable and disposable products are gender generic.



Specialty Sizes - Youth or Bariatric

For youth and bariatric people, there's extra factors in how to choose the right incontinence product. For both the youth and bariatric sizes it is more difficult to find the right fit due to unique shapes and sizes. Most successful people try several different brands until they get the fit and product that controls their incontinence. Purchase by the bag when first selecting a product and then buy by the case from then on for economy.

Youth Size is a person between toddler and adult sizes. Both briefs and pull-ups are made in this size. Products are categorized by weight and/or measurements.

Bariatric Sizes are waist or hip measurements greater than 55-60". Products for bariatrics include pads, belted undergarments, pull-ups, and both disposable and reusable briefs.


Uniquely Designed Products Just for Men

Are there other factors for men in how to choose the right incontinence product? Yes, sometimes - some manufacturers have designed male specific products. These products help preserve the dignity of having to wear an incontinence product. They also are normally built for creating comfort from the style. Some products for men are reusable and some are disposable.

Reusable products for men can be washed 200 times, which makes them more economical over time. They are, however, more expensive to purchase in the beginning. The reusable products specifically for men are made to accommodate light to moderate incontinence, from the dribbler to a person who loses half of their bladder in an incident. Reusable styles that fit both men and women are available for heavier incontinence needs, and there are disposables for men that are heavier as well.

A very popular style for men is the briefs made to look and feel like real underwear. Salk has made a brief with a fully functional fly and built in padding. Other manufacturers have made briefs with either built in padding or pouches for disposable pads. Products are designed to help the man retain their dignity, yet control the urine leakage. Male specific products include guards, pouches, male pads, boxer style shorts, and underwear for men.

Urine guards and pouches fit on the end of the penis. These pads are made for the dribbler and allow men to wear their regular underwear. Guards and pouches are so that men don't have to worry about the leakage or the bulkiness of a long pad. Pads designed specifically for men have adhesive strips to hold them in place inside regular underwear. These pads wick away moisture and have odor control. They put the padding where it is needed most, at the end of the penis area.

For heavier urine leakage there are pull-ups designed specifically for men. They have absorbent cores with concentrated protection. They also have odor control. In Prevail products, the leg openings are designed specifically for men with comfortable waist panels. Tena features a pull up anatomically made for the male with a cottony-soft material for maximum comfort.

Generically made, yet popular among men are the belted garment and the overnight Tranquility pull up. The belted garment is easy to keep in place and designed for light to moderate incontinence. It is a basically a pad with either elastic or button-style straps. The Tranquility pull up is great for overnight control to prevent leakage onto the bed.


Uniquely Designed Products Just for Women

Some manufacturers have designed female specific products, both reusable and disposable. These products are meant to give the woman a sense of style, comfort, control, and dignity.

Reusable products designed just for women are designed to be washed from 200 to 300 times depending on the manufacturer. They cost more money in the initial purchase but they save money long-term. These reusable products range from light to moderate incontinence. There are unisex reusable products made for heavier incontinence, and there are also disposables for women that hold a more urine.

A very popular style for women are those made to look and feel like real panties. These panties have either a built in pad or a moisture proof pouch. They either hold a disposable or reusable pad. The panties come in a variety of fabrics. They range from cotton to the cotton blend and some have a silky smooth feel. Some are designed to wick away the moisture from the skin.

Disposable products have some unique designs made specifically for the women. These products embody comfort while maintaining dignity from bladder leakage.

Tena has a pull up designed with cottony soft fabric for a closer fit to make it less visible under clothing. It has all the features of heavy protection for daytime needs.

Prevail has a pull up designed for women with a form fitting shape and it is stretchable. This smooth fit maintains discreetness under clothing. The absorbent core is designed for maximum absorbency.

Depend designed a style that is Silhouette. It has been made to feel like real underwear yet provides heavy protection with odor control.

Unisex, also called generic products, are popular amongst men and women. Popular styles are the belted garment and the overnight Tranquility pull up. The belted garment is easy to keep in place and designed for light to moderate incontinence. It is a basically a pad with either elastic or button-style straps. The Tranquility pull up is great for overnight to prevent leakage on the bed.

Don't give up till you find the product that suits your needs in both leakage prevention and comfort.


Incontinence Products - Their Design and Designated Uses

Now it is time to discuss the different types of product designs and their intended uses. The manufacturers spend a lot of resources every year improving their products making them more comfortable with optimum leakage control.

Pads and liners have the greatest variety of all the styles made. They range from a very thin strip for the occasional day leakage to the large overnight design for overnight incontinence. The shapes, styles, absorption, and sizes vary between manufacturers, each trying to find products that will be popular.

Adhesive strips are applied to some pads and liners to hold them in place inside regular underwear, while other pads and liners do not have the adhesive strips. The pads and liners without an adhesive strip are designed to be held in place by mesh pants. Read the descriptions carefully before purchasing your pad or liner. There are reusable pads as well.

Booster pads are completely different than regular pads. They are designed for added absorption. Booster pads do not have a moisture proof barrier, thus the urine will leak through the booster pad to the padding or panty below. Booster pads are to increase the amount of urine absorbed to help prevent leakage. There are both disposable and reusable booster pads and they come in a variety of sizes.

Belted Undergarments are basically a pad with a belt attached to hold them in place. They are one-size fits all design. Some of the belts are permanently attached while others are either self-gripping or button attached. The Tranquility brand has extenders for their belts making the range of fit extend to 78". The belted garments are a more discreet design for a person with light to moderate incontinence.

Pull-ups are designed to replace regular underwear. They are put on like regular underwear, but the sides tear away for removal. They have an elastic waste, cuffed stretchy legs, and padding in the crotch. The sizes range out there is roughly toddler to 2X-large.

The manufacturers have added many different qualities over the years. These range from designing men's, women's, and youth sizes to adding odor protection, cuffed legs, and stretchy side panels.

Briefs open up like a diaper and have tabs, hook and latch, or tapes that hold them together after being put on. Some of these closures are refasten able. Briefs have cuffs around the legs and padding in the crotch. The sizes range from newborn to bariatric. The bariatric sizes out there are from 60" to at least 108" around the hips or waist area. They are designed for moderate, heavy, and overnight incontinence. Pricing will depend on the manufacturer, size of the brief, and level of incontinence. Larger sizes and higher level of incontinence usually means more cost per brief.

The manufacturers vary tremendously in design, quality, absorption, pricing, and variety of sizes offered. Most have designed their own specialized core to wick away the fluid from the skin and have developed briefs to feel more like real underwear. Every year new products are added to the line of choices as manufacturers compete to have a popular product.

Booster pads mimic their name. They are added protection for any product used. A booster pad does not have a barrior for fluid. Its design is to absorb urine and then allow the extra liquid to flow through to the product underneath. They range in sizes and amount of fluid they retain. They are also offered in disposable and reusable types.

Bed Pads are designed to protect the bed or furniture. They are manufactured in reusable or disposable versions with a wide range of sizes, styles, and amount of liquid absorbed.

Bed Sheets are designed to replace the regular sheet only there is a backing to prevent urine from seeping through to the mattress. They are designed for anywhere from small to king-size beds. They are washable.

Reusable products can be washed up to 200 times making their use very economical in the long run. Reusable products cost more money in the initial purchase. It is best to purchase a single reusable product, and then if the product works well, purchase by the case for economy. Many of the reusable products can be washed like normal clothing and some can be bleached. The Ultra-Fit Reusable Brief is designed for both urine and bowel leakage and can be bleached to remove the stains.



Deciding on your level of incontinence

Deciding on your level of incontinence is important when choosing what product to order. Incontinence is simply uncontrollable urine or bowel leakage. How much is lost during a short period of time determines your level of incontinence. The ability to make it to the bathroom without leaking is the ultimate goal for people that still have bladder control. Keep in mind how long it takes to reach a toilet once the body signal is given for the need to urinate.

Light incontinence means slight leakage, usually less than 4oz per episode. This might happen when a person makes an action that puts a little pressure on the bladder area like a cough or sneeze. It might also happen when the bladder is too full and can't contain the overflow. This type of leakage is most common in women, but some men suffer the same problems. For light incontinence, the products most often used are pads that fit into regular underwear or the reusable padded panties and briefs. The adhesive strips on the disposable pads help to hold the pad in place. The larger pads are held in place by the mesh panties.

Moderate or medium incontinence is more than just dribbling, but less than full bladder loss. Moderate incontinence leakage is usually from 4 to 10oz at one episode or short period of time. Medium incontinence usually needs a heavy-duty pad, a belted garment, or even a pull up or brief with tabs designed for medium protection. Look for an incontinence product that is labeled 'Moderate' absorbency. It is better to have too much padding than not enough - control of leakage is the goal.

Heavy incontinence is almost full or complete bladder loss during the day. Heavy incontinence leakage is usually 10-16oz of urine. This is a cup to two cups of urine. This amount is the average amount of urine held by the bladder. This level of incontinence often takes a heavy or overnight pull up or brief with tabs. Control of urine and feces is the goal. A person could measure their urine loss by putting a plastic container in the toilet or bedside commode and measure their urine loss. This would help them in knowing if they need a heavy or overnight product to control their urine. Tranquility overnight products are very popular, they have an overnight pull up and brief. There are also reusable products at this (and any) level of incontinence.

Overnight Incontinence is simply when the person has full bladder loss at night. Often the person doesn't make it to the bathroom at night, so a quality product has to catch the complete bladder loss to protect the bed and the dignity. Booster pads can be added to give extra absorbency at night. The Tranquility overnight pull up or brief is great for overnight incontinence. There are other products that work well, for example Prevail, Medline, or even a reusable, the IBEX Ultra-fitted brief. Understanding the product, how much urine is eliminated, and the ability to make it to the bathroom are key factors in determining how much padding is needed.

Mattress pads and sheets are designed to protect the mattresses and chairs. These are useful for overnight incontinence. The pads are both reusable and disposable and the sheets are reusable only. The pads come in a large variety of sizes and absorbencies while the sheets are made to fit different size mattresses. The reusable products are a one-time purchase and wash up quite nicely.



Fecal and/or Urinary Incontinence

Some manufacturers have designed products for both bowel and urine incontinence. There are nicely designed briefs with tabs, pull-ups, and pads for fecal incontinence. A couple of popular fecal incontinence products are the Tranquility Slimline Disposable Brief or one of the Abri-Sans products. Many people go with Tranquility but the Abri-Sans are good too. Read the product description when buying a product to make sure you are ordering a bowel incontinence product.


Discreteness?

Discreteness is very important to most people dealing with incontinence. If discreteness is important, there are several options. One option is using a cloth-like outer covering, which helps prevent the rustling of the sound of plastic. Plastic backing is what all incontinence products used to be, but today cloth-like backing is common. Also, some manufacturers have developed a compact core to keep down the bulkiness. Other companies like Prevail have designed a very compact pull up. The Prevail technology is great. Another choice is to wear loose clothing so the product does not show. Then there is the reusable underwear and panties with built in padding or pouches for the padding. The reusable Ultra Fit is also snug fitting.

Choosing between fit, style, composition, and most of all level of incontinence will help the person to be discreet and retain your dignity through control of the leakage.


Do they want discreet shipping?

Many companies have a few or a whole section of products designated by the manufacturers for discrete shipping. This means they are shipped in a cardboard box with no markings on the outside as to the content. Find a company with discrete shipping that will ship Fedex or UPS.



How Much Does It Cost?

Another determining factor in how to choose the right incontinence product is price. The higher the level of incontinence needs, the more expensive the product is going to cost. For light incontinence, there are more choices with cost effective solutions. The highly absorbent products are more expensive but necessary for adequate control. There are brands that are more economically priced that many people rely on like 'Select' and 'Nightingale'. Nightingale is made for moderate incontinence while Select includes heavy to overnight products.

For heavier forms of incontinence control the quality of the product is very important. Tranquility is great for full bladder loss and overnight control. A nice Tranquility, Medline, or Prevail brief or pull up works quite nicely for the majority of people. Remember to buy a pack at first before ordering a whole case.

One of the most common phone calls online incontinence stores get is that of a person who has purchased an over the counter product that leaks so they have added multiple layers of pads. These layers of pads create a very uncomfortable fit and most of the time the pull up or brief still leaks. These customers are encouraged to try a well-fitting overnight product like the Tranquility Premium Disposable Absorbent Underwear and are usually very satisfied with the control of the urine, the fit, and the comfort. This happens all the time.

So the lighter the incontinence, the lighter the cost and the more choices a person has. The heavier products cost more money, but controlling the heavier urine leakage prevents embarrassment and frustration.

Always remember to buy a pack first when trying a product and then purchase by the case for economy once satisfied with it. Most reusable products can be purchased in singles and then by the case for less money per product.

No one needs to be worried about having an accident in public. Incontinence control is possible with the right fit, style, and weight of brief or pull-up. If a person properly measures and purchases correctly, they will be successful at controlling their incontinence.


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About the Author: Nancy Weikel, RN is a registered nurse who consults and writes for IDiaper.com. She has been consulting for IDiaper since 2007.