Absorbent products for light urinary incontinence in women

Bladder control problems are common in women and many wear absorbent pads to contain urine leakage and protect their clothes. There are four main designs of absorbent products used for light urinary incontinence (i.e. urine loss that can contained within a small absorbent pad): disposable insert pads, disposable menstrual pads, washable pants with an integral pad and washable inserts. This review found only one eligible clinical trial which compared different designs of these products and had been carried out in the last ten years. This trial included all the designs. There is evidence that for leakage prevention, overall acceptability and preference, disposable inserts are better than menstrual pads, which are better than washable pants with integral pad, which are better than washable inserts. There is no clear benefit for skin health using either washable or disposable designs. Most women preferred the disposable insert pad but some preferred the other cheaper designs or would find them acceptable in some situations. Allowing women to choose their preferred design of absorbent product (or combination of different designs for different circumstances) would be more cost-effective and provide better patient satisfaction than provision of disposable insert pads alone.

Authors' conclusions: 

Although data were available from only one eligible trial the data were sufficiently robust to make recommendations for practice. Disposable insert pads are typically more effective than the other designs considered. However, because they are the most expensive, providing choice of designs (or combinations of designs for different circumstances) is likely to be cost-effective.

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Background: 

Incontinence is a common and embarrassing problem which has a profound effect on social and psychological well-being. Many people wear absorbent products to contain urine leakage and protect their clothes. It can be difficult to define light urinary incontinence because urine volumes, flow and frequency rates may vary substantially whilst still being considered 'light'. Light incontinence may encompass occasional (monthly) leaks of very small amounts (e.g. 1 g to 2 g) up to frequent leaks (several times per day) of larger amounts (e.g. 20 g to 50 g). A practical definition is urine loss that can be contained within a small absorbent pad (typically 50 g to 500 g; ISO 1996).

Objectives: 

To assess the effectiveness of different types of absorbent product designs for women with light urinary incontinence.

Search strategy: 

We searched the Cochrane Incontinence Group Specialised Trials Register (searched 2 April 2009) and the reference lists of relevant articles were perused.

Selection criteria: 

Types of studies
All randomised or quasi-randomised trials of absorbent products for women with light urinary incontinence.

Types of participants
Women with light urinary incontinence.

Types of intervention
Absorbent products (disposable insert pads, menstrual pads, washable pants with integral pad, washable insert pads) suitable for light incontinence.

Data collection and analysis: 

Two review authors assessed the methodological quality of potentially eligible studies and independently extracted data from the included trial.

Main results: 

One study with 85 participants met the selection criteria. This trial studied all the absorbent product designs included in this review. Data were presented on all included outcomes. For preventing leakage, for preference and for overall acceptability disposable insert pads are better than disposable menstrual pads which are better than washable pants with integral pad which are better than washable insert pads. There is no strong evidence that either disposables or washables are better for skin health. The disposable insert is the most expensive design and there is no dominant design for cost-effectiveness. There is evidence that some women will prefer alternative designs which are all cheaper than disposable inserts.

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