Absorbent products for containing urinary and/or faecal incontinence in adults

  • Review
  • Intervention

Authors

  • M Brazzelli,

  • E Shirran,

  • L Vale


Miriam Brazzelli, Research Fellow, Health Services Research Unit, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UK. m.brazzelli@abdn.ac.uk.

Abstract

Background

Incontinence is a distressing condition with significant medical, social and economic implications. People suffering from incontinence, who cannot be successfully cured, depend, almost exclusively, on the use of containment products to manage their symptoms.

Objectives

To assess the effects of different types of absorbent product for the containment of urinary and/or faecal incontinence.

Search strategy

The literature searches covered the Cochrane Incontinence Group trials register (February 2003), The Cochrane Library (Issue 1, 2000), MEDLINE (January 1966 to January 2000), EMBASE (January 1980 to January 2000), CINAHL (January 1982 to November 1999), HealthSTAR (January 1975 to December 1999), The UK National Research Register (Issue1, 2000), ClinicalTrials.gov (searched on 4 April 2000). Reference lists of relevant articles were perused. Date of the most recent searches: February 2003.

Selection criteria

Types of studies
All randomised or quasi-randomised trials of absorbent products for the containment of urinary and/or faecal incontinence.

Types of participants
All adults with urinary and/or faecal incontinence were eligible. The intention was to subdivide participants by severity of underlying incontinence, level of mobility and gender, but this proved not to be feasible.

Types of intervention
Absorbent products (bodyworns, underpads, and different fabric types for disposable products), for any severity of incontinence.

Data collection and analysis

Two reviewers assessed the methodological quality of eligible studies and independently extracted data from included trials.

Main results

Six studies with a total of 415 participants met the selection criteria. Two trials compared disposable with non-disposable bodyworns, one trial assessed the performance of disposable and non-disposable underpads, one trial compared the outcomes and costs of bodyworns with underpads and together with the remaining two trials evaluated the performance of fluff pulp and superabsorbent products. Data presented on effects were available for few outcomes and were subject to potential bias.

Authors' conclusions

The data were too few and of insufficient quality to provide a firm basis for practice. Disposable products may be more effective than non-disposable products in decreasing the incidence of skin problems and superabsorbent products may perform better than fluff pulp products. However, based on the available evidence, these conclusions can only be tentative. Costs of absorbent products depend upon their features (e.g. pad and pant system) and their composition (i.e. fluff pulp core or superaborbent material) as well as their ability to shorten clean-up time and consequently reduce laundry costs.

Plain language summary

Plain language summary

Some evidence that disposable absorbent pads work better than washable absorbent pads for people with incontinence.

Incontinence is the inability to control the urge to go to the toilet and is a common and embarrassing problem. People who cannot be cured rely on pads to protect their clothes. Pads can be divided into four main categories: washable and disposable bodyworns and washable and disposable underpads (also called bedpads). Bodyworns are available in a diaper/'nappy style' format or as a pad+pant system. Bodyworns and underpads may contain 'superabsorbent' material. The review of trials found some evidence that disposable products may work better than washable products in reducing skin problems. The review also found that products containing superabsorbent material may work better than those without it. More research is needed.