For urine incontinence, diapers may be the most cost-effective disposable design for men both day and night. For women disposable pull-ups may be better than the other designs (except for those living in nursing homes when used at night), but they are more expensive. There is insufficient data to make any recommendations for people with faecal incontinence.
A Cochrane review 1 included 2 studies with a total of 185 subjects. One trial took place in nursing homes, the other in people's own homes. Gender was found to be a significant variable in both trials, and accordingly the results were analysed in gender groups. The results show that there is no single best design. The main findings from the comparisons were:
- For all users, the leakage performance of the disposable inserts was worse than the other designs for day and night.
- For all users, disposable pull-ups were preferred and were rated better overall than disposable inserts for daytime.
- For all users, the newer disposable T-shape diaper was not preferred or rated better overall than the traditional disposable diaper for day or night use.
- For nursing home participants for ease of putting on, pull-ups and inserts were better than diapers and T-shaped diapers during the daytime, but during the night-time, pull-ups were more difficult to put on than the other designs.
- There was not enough evidence to draw firm conclusions about the performance of designs for faecal incontinence.
- There was no firm evidence that there were differences in skin health problems between designs.
Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in interventions and outcomes) and by imprecise results (few patients and wide confidence intervals).
1. Fader M, Cottenden AM, Getliffe K. Absorbent products for moderate-heavy urinary and/or faecal incontinence in women and men. Cochrane Database Syst Rev 2008 Oct 8;(4):CD007408. [PMID:18843748]
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"Absorbent Products for Moderate-heavy Urinary And/or Faecal Incontinence in Women and Men." Evidence-Based Medicine Guidelines, Duodecim Medical Publications Limited, 2019. Evidence Central, evidence.unboundmedicine.com/evidence/view/EBMG/454396/all/Absorbent_products_for_moderate_heavy_urinary_and_or_faecal_incontinence_in_women_and_men.
Absorbent products for moderate-heavy urinary and/or faecal incontinence in women and men. Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. https://evidence.unboundmedicine.com/evidence/view/EBMG/454396/all/Absorbent_products_for_moderate_heavy_urinary_and_or_faecal_incontinence_in_women_and_men. Accessed March 1, 2021.
Absorbent products for moderate-heavy urinary and/or faecal incontinence in women and men. (2019). In Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited. https://evidence.unboundmedicine.com/evidence/view/EBMG/454396/all/Absorbent_products_for_moderate_heavy_urinary_and_or_faecal_incontinence_in_women_and_men
Absorbent Products for Moderate-heavy Urinary And/or Faecal Incontinence in Women and Men [Internet]. In: Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. [cited 2021 March 01]. Available from: https://evidence.unboundmedicine.com/evidence/view/EBMG/454396/all/Absorbent_products_for_moderate_heavy_urinary_and_or_faecal_incontinence_in_women_and_men.
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