Male Incontinence: A Full Guide To Wearable Solutions

Incontinence in males is quite prevalent but not discussed nearly enough.

Male urinary incontinence causes accidental leakage of urine and indicates a loss of bladder control. According to studies, it can reduce the quality of life in men significantly[1].

Urinary incontinence can be a result of underlying issues, such as being overweight or having prostate problems. An enlarged prostate can affect urine flow, causing frequent urination, leaking, and a weak stream.

The prostate may also be removed due to cancer, causing stress incontinence[2], which triggers urine leakage with actions such as sneezing or laughing. Men may also experience incontinence if they suffer from medical conditions that cause nerve damage like stroke, Parkinson’s disease, multiple sclerosis, diabetes, herniated discs, dementia, and spinal cord injury.

Incontinence in men is not as prevalent as it is in women, which makes the conversation about possible solutions much harder to have. Furthermore, with the majority of incontinence products being marketed to women, men are often left with little to no awareness of the solutions they have available to them to manage it.

In this article, we will look at some of the most common wearable solutions for managing incontinence in men.

Absorbent Solutions: Briefs & Guards

Absorbent solutions refer to products that can absorb the involuntary urine released due to incontinence. These can either be one-time-use (disposable products) or multi-use (reusable products).

Depending upon the type of incontinence you have, you might need different kinds of products. Some cases may require a cloth-backed absorbent product, while a plastic-backed product might be better in other situations.

These products come with an absorbent layer that traps any leaks. They also pull moisture away from the skin to prevent infections or incontinence-associated dermatitis (IAD).

Briefs or Pull-Ups

Briefs, also known as pull-ups, are ideal for men that are active or retain a level of independence. They require the user to bend forward in order to wear the briefs, much like regular underwear.

Gender-specific briefs, such as pullups for men, are made with the male anatomy in mind. They consider the flow of urine and position the absorbent core accordingly. They are also made in more masculine colors such as black, grey, or blue.

Many brands even manufacture boxer-style pull-up diapers that feel pretty much exactly like boxers and enable you to be confident and comfortable.

Ideal User And Absorbency Range

If you’re a man dealing with light to moderate incontinence issues, pull-ups are the ideal protection for you.

As long as you are mobile, you can manage these briefs yourself. However, they need to be slid up and down. So, if you aren’t mobile, briefs may not be the product for you.

Another consideration is waist size. Men with small to medium waists may find pullups comfortable enough. Men with large to plus size waists may find these products to be too restricting and uncomfortable.

How Discreet Are Pull-Ups?

Pull-ups are created to look and feel like real underwear and are very discreet and comfortable. Modern technology has allowed manufacturers to create products that are low noise, odor-reducing, and thin; crucial considerations when your main concern is keeping your incontinence a private matter.

Brands such as Prevail or Depend provide pull-ups designed to mimic the underwear men are accustomed to wearing while still providing adequate absorbency to manage incontinence needs.

Finding The Right Pull-Up For You

Everyone has different needs, so you need to find a product that satisfies your requirements.

• First, determine the level of absorbency you require.

  • Do you experience a full bladder void or minor dribbles?

  • If you need extra protection against leakage, you should go for a design with leg gathers or leg guards.

• Second, take note of your waist size.

  • Measure your hips and waist in inches to determine the right size for you. Ideally, you would use the larger of the two figures when buying a pull-up.

  • A product is the right fit for you when it is breathable, fits your body in a snug manner, and does not bunch up at the bottom.

  • Excessive bunching in the perineum, the area between the genitals and anus, is an indication of a poor-fitting brief.

• Third, consider the application.

  • Will you be using this product during the daytime or nighttime? Daytime products tend to absorb less than nighttime products because the user is able to change them more frequently.

Troubleshooting Common Issues With Pull-Ups

Getting used to pull-ups might take some time, and you could face some issues in the beginning. A few of the common problems are leakage, odor, poor fit, and skin irritation.

• Excessive leakage: If you face leakage concerns, check that you are wearing the right size of briefs, ones that don’t sag.

• Foul odor: Incontinence products contain materials that neutralize the ammonia found in urine. If you experience a foul odor, it may be an indication that the brief you are wearing is no longer capable of neutralizing the ammonia. More frequent changes of the brief or finding a more absorbent solution is recommended.

• Skin irritation: This problem typically occurs when the product is not close enough to your body to provide a snug fit. Moreover, incorrect placement of leg elastics can lead to blisters. Another possible cause of skin irritation is improper hygiene prior to wearing the briefs. Make sure you’re cleaning any area making contact with urine thoroughly before wearing another brief.

Tabbed Briefs or Diapers

Tabbed briefs are essentially adult diapers that come with convenient refastenable tabs. The absorbent function remains the same as pull-ups with the added convenience of not needing to bend forward to wear the product. The refastenable tabs allow the brief to be applied from a standing or lying position.

Gender-specific tabbed briefs are not as common as pull-ups due to the fact that most individuals wearing them require much fuller protection. As a result, the core covers more of the underwear, ensuring leakage from almost any direction will be absorbed.

Ideal User And Absorbency Range

These briefs are available in both high and low absorbency variations. The low absorbency tabbed briefs are ideal for individuals that experience minor leaks but are immobile, handicapped or bedridden. The high absorbency tabbed briefs are ideal for men experiencing urinary and bowel incontinence that also suffer from lower mobility.

Tabbed briefs are favored by caregivers because they make it easier to clean up and change the individual they’re caring for.

In some cases, these diapers are also suitable for men capable of caring for themselves that require a higher level of absorbency.

How Discreet Are Tabbed Briefs?

Tabbed briefs are not as slim and discreet as pull-ups. The added absorbency tends to increase the bulk of the brief. If discretion is important to you, this may not be the solution for you.

Finding The Right Tabbed Brief For You

Finding the perfect tabbed brief can take some trial and error. The same sizing recommendations being applied to pull-ups should be applied to tabbed briefs.

Whichever figure is the larger of the two should be used when searching for a tabbed brief. A comfortable brief does not sag and lets you roam around freely. Keep in mind that most tabbed briefs will sit higher at the waistline than pull-ups.

Troubleshooting Common Issues With Tabbed Briefs

If you notice leakage with your tabbed briefs, you should check whether the bottom tabs are angled upwards to cup the buttocks. Additionally, the top tabs should be angled downwards to offer a snug fit.

You might experience some skin irritation if you do not change your brief from time to time and skip out on your skincare.

Briefs: Monthly Expenditure and the Cost Savings Fallacy

The average male with light to moderate incontinence will use two to three briefs per day. Considering that most packs carry between 14-20 briefs, this amounts to a little over four boxes to get you through the month.  A male experiencing heavier incontinence will most likely be purchasing tabbed briefs, which cost more due to the amount of material being used in them.

Your average monthly expenditure on the briefs or pull-ups could go up to $54. In case you use more than three diapers daily, you could be spending over $70-$100+ every month.

Cost can be a major concern for incontinent males or anyone dealing with the symptoms, for that matter. Several of our customers have experienced what we call the “cost-savings fallacy”. They erroneously assume that spending less on inexpensive briefs will allow them to save significantly every month when in reality they end up spending more due to the fact that the cheaper products are made poorly. Poorly made products mean more frequent changes, lower capacity, and less comfortable materials.

The adage “you get what you pay for” remains true even in the incontinence space. Consider spending a bit more than you’re comfortable with and you’ll find yourself changing briefs less frequently and enjoying an overall better quality of life.

Be sure to ask your insurance provider if they cover the cost of incontinence products. Several incontinence brands can also be purchased using an FSA/HSA account.

Guards

If you are looking for light incontinence protection, male guards might just be your savior.

Also known as incontinence pads, these guards are specially shaped to fit the male anatomy. The form-fitting pads go a long way in keeping you dry and confident and preventing any leakage.

Unisex pads or feminine pads will not suit men since they are not designed to fit the male anatomy. Guards typically adhere to the inside of the underwear. Guards should not be used with boxer briefs because the loose nature of the underwear fails to hold the brief high enough, causing it to be ineffective.

Ideal User And Absorbency Range

Guards are suitable for light incontinence but not recommended for moderate to heavy leakage. Males recovering from a prostatectomy have found them to be perfect solutions for the temporary incontinence they experience after surgery.

Remember that these pads are attached to the clothing and stay in one place, so they are great for targeted protection. However, they are not the best choice for bowel incontinence.

How Discreet Are Incontinence Guards?

If discretion is a concern, male guards will solve all your worries. They attach directly to your underwear and are virtually invisible.

Caroli is an excellent brand offering thin and discreet incontinence guards. You can even use these guards on the go, as they come individually wrapped and can be carried easily in your pocket.

Finding The Right Incontinence Guard For You

You need to determine which features are essential to you in an incontinence guard to be able to decide on the right product. Some common features are thickness, adhesive backing, and inner leg cuffs. Again, let the level of absorbency you require determine which direction you go.

Troubleshooting Common Issues With Incontinence Guards

• Poor fit: Is the front of the guard wide enough for your needs? Consider a wider product with wings if it is not. Is the guard slipping down your underwear? Consider a product with a better adhesive backing and make sure you’re not using boxer briefs while wearing the guard.

• Skin irritation: At times, manufacturers add fragrance to incontinence guards to cover up the ammonia odor present in urine. While this may work for some people, others might experience skin irritations. Be sure to shop for hypoallergenic products without fragrance or harmful chemicals.

• Frequent leakage: Is your guard not absorbing the majority of your leakage? You may need to consider choosing a different product such as a pull-up or brief while your level of incontinence improves.

Monthly Costs

The average pad costs around $0.49. So, if you use up to three pads every day, you will be spending about $44 every month. If you use more than three guards in a day, your monthly expenditure on these pads can go over $60.

As with pull-ups and briefs, keep in mind that cheaper products do not always equal good performance.

Other Wearable Products

Absorbent products are not the only option available for men with incontinence. Catheters have also been used to mitigate the symptoms of incontinence.

Catheters

Urinary catheters are soft and hollow tubes that are passed into the bladder through the urethra to drain out urine.

When inserted into a body, a small balloon-like device is inflated, preventing the catheter from slipping out.

Types Of Catheters

1. Straight Tip Male Catheters. Traditional simple catheters are referred to as straight tip male catheters. These are typically made up of rubber, silicone, or plastic.

   Straight tip catheters can be used for urethral self-dilations as well as intermittent self-catheterization that some people need to perform regularly for urethral strictures.

2. Coudé Tip Male Catheters. “Coudé” is French for “elbow” and describes the curved tip of such catheters.

   These catheters are especially useful for men with prostate issues since it enables the tubes to better navigate the curvature between the prostatic urethra and bulbous urethra.

3. Pre-Lubricated Male Catheters. Some men may not be comfortable with touching the catheter before use due to past infections or urethral trauma from intermittent catheterization.

   Pre-lubricated catheters are great in such situations since they come ready to use. You will not have to apply lubricant because these catheters come with a gel lubricant on the tubing. All you need to do is remove the package and use the catheter immediately.

4. Hydrophilic Male Catheters. These catheters come with a lubrication coating that binds to the surface of the catheter. They do not require direct touch and are therefore more sterile and less prone to infections.

   Hydrophilic catheters either come packaged in sterile water or come with a pouch of sterile water that can be released into the package for preparing the catheter before use.

   When these catheters are immersed in water, the lube absorbs and binds the water to the catheter. As a result, the surface becomes smooth and slippery and remains intact while being inserted into the urethra.

5. Closed System Male Catheters. Such a catheter is designed with a urine collection bag attached and pre-lubricated for immediate use. Closed system male catheters come in direct contact with the user’s hand and can be used only once.

Ideal User And Capacity

Men of any age group can use catheters. If you cannot control your bladder or empty your bladder by yourself, you should explore the option.

The drainage bags that are attached to catheters come in different capacities to suit different users. Some of the commonly used variants are 350ml, 500ml, 750ml, and 1-liter bags.

At night, you can attach an additional bag to prevent any leakage.

How To Find The Right Catheter For Yourself

Finding a suitable catheter for yourself might be tricky, but here are a few things to remember. These factors can make your decision easier.

• Since a catheter tube’s diameter is measured on the french scale, you should determine the right size for yourself by trying out different sizes.

• The length of the catheter also plays a significant role. While the standard length for males is 16 inches, you might need more or less depending on your urethra.

• Finally, you need to decide on the type of catheter you require by looking at which features suit you best.

Troubleshooting Common Catheter Issues

Catheters can be a little difficult to get used to, and you might face some issues initially. If your catheter does not go in, do not try to force it. Try again in intervals and reach out to a medical professional if the problem persists.

Sometimes, the urine might not drain in the case that the lubricating gel blocks the drainage holes. If your catheter is far enough into your urethra, but you still face the issue, consult a doctor.

If there are kinks in the catheter or the tubing of the drainage bag, you might notice that urine does not drain into the bag. It might happen because the catheter is blocked. The best course of action would be to visit your nearest emergency room.

Catheters Cost & Maintenance

On average, standard catheters cost between $1 to $1.50. However, the price can shoot up to $5 depending upon the type of catheter you use[3].

Maintenance of catheters and their attached urine bags is a long and continuous process. Let us glance over some quick tips that can prevent infections.

• Always keep the drainage bag away from the floor.

• Never lie on your catheter or block urine from flowing in the tubing.

• Wash your hands before and after you touch the catheter or urine bag.

• Shower every day to keep the catheter clean.

• Place the drainage bag below the level of your bladder.

• Secure the catheter to your thigh to prevent it from moving.

Medical Procedures and Medication

Several kinds of drugs and medications are used for treating incontinence in men.

Although the condition is typically manageable with drugs and the right products, some cases might also need surgery.

Artificial Urinary Sphincter (AUS) Balloon

In this procedure, a balloon is inserted around your bladder’s neck. It shuts off the urinary sphincter until the body needs to urinate.

Whenever you are ready to urinate, the valve under your skin deflates the balloon, and urine is released and fills up the balloon again.

This surgery is recommended for men with moderate to severe urinary leakage, like those who have undergone prostate surgery.

Sling Procedure

In a sling procedure, the doctor uses tissue or synthetic material to form a supportive pouch around your bladder neck. As a result, the urethra remains closed when you cough, run, laugh, or sneeze.

The surgery is ideal for men that experience moderate to mild urinary incontinence.

Anticholinergics

Anticholinergics, like Oxybutynin (Ditropan), can be used to calm overactive bladder muscles. They are a good option for urge incontinence.

Alpha-Blockers

Alpha-blockers, like tamsulosin (Flomax), are ideal for men with an enlarged prostate. They are helpful in the treatment of urge or overflow incontinence.

Mirabegron

Mirabegron, or Mybetriq, can increase the amount of urine the bladder can hold by relaxing bladder muscles. It even helps in emptying your bladder better when you urinate.

Botox

Botulinum toxin type A, commonly known as Botox, can be injected into the bladder to help relax bladder muscles.

Endnotes

Incontinence in men needs to be talked about more often and more openly. The social stigma associated with it can lead to a lower self-image[4] and a frustrating search for solutions that help mitigate the issue.

It is vital that men speak up and get the help required to manage and treat incontinence. Every male is different, and the same products, procedures, or medicines may not work for everyone.

Understand the level and type of incontinence you have and allow that information to dictate the solution that works best for you.

References

1. Hester, A. G., Kretschmer, A., & Badlani, G. (2017). Male incontinence: the etiology or basis of treatment. European urology focus, 3(4-5), 377-384.

2. Shamliyan, T. A., Wyman, J. F., Ping, R., Wilt, T. J., & Kane, R. L. (2009). Male urinary incontinence: prevalence, risk factors, and preventive interventions. Reviews in urology, 11(3), 145–165.

3. Medical Advisory Secretariat (2006). Hydrophilic catheters: an evidence-based analysis. Ontario health technology assessment series, 6(9), 1–31.

4. Higa, R., Lopes, M. H. B. D. M., & D’Ancona, C. A. L. (2013). Male incontinence: a critical review of the literature. Texto & Contexto-Enfermagem, 22, 231-238.