Supportive Measures and Devices to Help Manage Male Urinary Incontinence

Andrew Siegel MD   4/11/20

To urologists, pads or diapers are signs of FAILURE, our goal being to keep people OUT of pads, diapers and other devices that manage (but not treat) urinary incontinence and for this reason you will rarely witness a urologist writing about this topic. 

I cringe every time I see an ad in a magazine or newspaper for adult diapers. These advertisements give the false impression to the reader that diapers are the only solution, whereas the truth of the matter is that incontinence is a largely treatable problem. These ads should be footnoted with the following: “Please consult your urologist before consideration for these products.”   

Although urinary incontinence can often be significantly improved, if not cured, with behavioral modifications, pelvic floor muscle training, medications or surgery, there are times when incontinence cannot be satisfactorily addressed by these means and situations for which more aggressive forms of treatment are not a feasible consideration (the elderly, those with significant medical issues, those with allergies or side effects to medications, etc.)  Some patients desire only the simplest and most basic and non-invasive form of management. Today’s entry is a brief review of absorbent pads, padded undergarments, external urinary collection devices and compressive devices, all of which can be quite helpful under the proper circumstances.

Note: Many of the products discussed below can be purchased online at the Urology Health Store

Pads and undergarments

There are numerous male guards, pouches, incontinence pads and undergarments available at drugstores, supermarkets, medical supply stores and online. These items have in common the ability to absorb urine and wick it away from the skin. The choice of product is usually based upon the extent of the urinary incontinence. The gamut of products includes absorbent padded sheaths that fit around the penis (drip collectors), pads placed within the underwear, cup-shaped guards, incontinence briefs and absorbent underwear, some of which are disposable and others of which are washable.

External collection devices/portable urinals

These are latex or silicone condom-like devices that are placed on the shaft of the penis and are secured to the penis with an adhesive.  They drain via tubing into a urine collection bag.

Compression devices

These devices have a pinching mechanism that is applied to the urethra, similar to squeezing one’s penis to prevent urinary leakage.  The goal is to stop the incontinence while not compromising penile blood flow and maintaining a reasonably comfortable fit. Only minimal pressure on the urethra is required to stop urinary leakage. There are many such devices on the market. The devices reviewed below work by applying compression pressure to the penis and with the exception of the Urostop device are worn just behind the head of the penis. They are removed for urinating and should not be worn while sleeping.

Cunningham clamp is a foam-padded metal clamp that comes in a variety of sizes. The pressure is regulated by spring wire loops that can be ratcheted into 5 different settings.

Baumraucker clamp is a foam-padded clamp similar to the Cunningham clamp, but has no metal parts and uses Velcro to secure the closure.

Dribblestop is a foam-padded, lightweight plastic device consisting of two clamps held together by adjustable links (of 3 varying lengths) to calibrate the urethral compression.  The compression can be further fine-tuned by choosing one of two notches on the clamps.

Regain is a flexible plastic compression device that wraps around the penis and is available in 3 sizes.  It consists of two arms connected by a hinge in the middle.  A control pad is present on the inner surface of the lower arm and the upper arm is attached to a Velcro wrap-around strap. The penis is placed through the central opening and the device is hinged to envelop the penis. The elastic strap is wrapped around to hold the device in place and to apply urethral pressure.

Acticuf is a disposable pouch that contains an absorbable pocket.  It has a mouth that opens to allow placement of the penis within the pouch. The pouch functions to collect and absorb urine and the mouth to compress the urethra.  It can be loosened up by squeezing and releasing the compression mechanism a few times. It should be repositioned every 3-4 hours or so and not worn while sleeping and should be removed and discarded when saturated.

 

Urostop is used for preventing urinary leakage that occurs with sexual activity, whether during foreplay, intercourse or climax.  It is an adjustable tension silicone loop that is placed at the base of the penis prior to sex and cinched down to occlude the urethra. The device should not be left on for more than 30 minutes.

Wishing you the best of health,

2014-04-23 20:16:29

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Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community. He is a urologist at New Jersey Urology, the largest urology practice in the United States.

The content of this entry is excerpted from his new book, PROSTATE CANCER 20/20: A Practical Guide to Understanding Management Options for Patients and Their Families

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Video trailer for Prostate Cancer 20/20

Preview of Prostate Cancer 20/20

Andrew Siegel MD Amazon author page

Prostate Cancer 20/20 on Apple iBooks

PROSTATE CANCER 20/20: A Practical Guide to Understanding Management Options for Patients and Their Families is now on sale at Audible, iTunes and Amazon as an audiobook read by the author (just over 6 hours). 

Dr. Siegel’s other books:

FINDING YOUR OWN FOUNTAIN OF YOUTH: The Essential Guide to Maximizing Health, Wellness, Fitness and Longevity

PROMISCUOUS EATING— Understanding and Ending Our Self-Destructive Relationship with Food

MALE PELVIC FITNESS: Optimizing Sexual and Urinary Health

THE KEGEL FIX: Recharging Female Pelvic, Sexual, and Urinary Health

 

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