L Pettersson

Coated catheters for intermittent catheterization: smooth or sticky?

Objective To evaluate the current range of hydrophilic‐coated catheters for intermittent self‐catheterization, focusing on the adherence of the catheter to the urethral mucosa at the end of catheterization.

Sheaths for urinary incontinence: a randomized crossover trial.

Objective To evaluate the full range of self‐adhesive continence sheaths for men available in the UK and thus provide clinicians and consumers with a basis for product selection.

How well does ISO 11948-1 (the Rothwell method) for measuring the absorption capacity of incontinence pads in the laboratory correlate with clinical pad performance

The ability of ISO 11948-1 (the Rothwell method) to predict the leakage performance of disposable bodyworn pads for heavy urinary incontinence was investigated by measuring correlations between models based on clinical evaluations of 138 diapers and inserts (the two major design categories), and technical models based on their Rothwell absorption capacities and design features. Correlations were poorer than in the original 1993 study for the standard (r < or =0.87 compared with r < or =0.95), but still strong enough to help with purchasing choices. For a given Rothwell capacity, the leakage performance of diapers was far superior to inserts; for example, diapers containing 450 and 300 g of urine performed, as well as inserts containing 300 and 100 g, respectively. No evidence was found for any other design feature having a significant impact on leakage performance. The coefficient of variation for Rothwell capacity (a measure of product consistency) had significant impact on the leakage performance of diapers, but not inserts. The probability of diapers with the poorest consistency leaking exceeded that for the best by about 10 percentage points. Similarly, diapers were about 10 percentage points more likely to leak when used at night than during the day. Differences between day-time and night-time use of inserts were not studied.

A pilot study to evaluate reusable absorbent body-worn products for adults with moderate/heavy urinary incontinence.

OBJECTIVE The purpose of this pilot study was to evaluate the performance of reusable absorbent body-worn products for adults with moderate/heavy urinary incontinence, compare their performance with a group of equivalent disposable products, and establish the need for a larger statistically robust study. SETTING AND SUBJECTS Ten men and 4 women living in the community were recruited from locations throughout the United Kingdom. METHODS A randomized multiple crossover design was used in which all subjects were given the opportunity to test each product. All the products were available on the UK market in January 2001. The following tools were used in the evaluation: a product performance questionnaire and a pad leakage diary. Overall opinion was used as the primary outcome indicator. RESULTS The reusable Paddy T was the best performing product overall, outperforming the disposable products. For low leakage and good absorbency (the most important product attributes identified by the subjects), the disposable all-in-one product performed best during the day. However, the Paddy T performed best for night use. The remaining reusable products performed poorly overall. CONCLUSIONS Reusable products for moderate/heavy incontinence remain unpopular for use in isolation. Surprisingly, a product manufactured from terry toweling, a traditional material, performed relatively well. Reusables may provide a useful alternative to disposable products in certain circumstances. The results from this study do not support a more comprehensive costly study.

A multicenter comparative evaluation: disposable pads for women with light incontinence

OBJECTIVE The purpose of this study was to evaluate the current range of disposable pads for women with light incontinence available in the United Kingdom. SETTING AND SUBJECTS Sixty community-based women aged 50 years or older were recruited to the study from several locations throughout the United Kingdom. METHODS A multiple crossover design was used, which enabled all subjects to test all of the 12 products that were available on the UK market at the time of the evaluation. Two tools were used to evaluate the products: a product performance questionnaire and a pad leakage diary. This incorporated both subjective and objective outcome measures. RESULTS Statistically significant differences were found between the products in 13 of the 17 performance aspects, eg, ability to hold urine without leaking and the fit of the pad. CONCLUSIONS As a group, all of the products tested performed well in terms of their ability to hold urine without leakage. However, two products performed particularly well and scored highly on most aspects of performance and represented successful “all-round” products; these were the Tena Lady Extra and the Prevail Extra Plus.

A multicenter evaluation of absorbent products for children with incontinence and disabilities.

OBJECTIVE To evaluate all disposable pull-up-style pads (pull-ups) designed for children with learning and or physical disabilities and compare these with a representative sample of disposable diapers (diapers). DESIGN A multicenter randomized crossover trial where all children evaluated each product. SETTING AND CHILDREN A total of 61 community dwelling children with disabilities were recruited from 5 areas throughout the United Kingdom. Families were invited by letter to participate through their local clinical nurse specialist for continence care. INSTRUMENTS Instruments used included a range of questionnaires (product performance, design performance, and design preference questionnaires) and pad weight and leakage diaries. METHODS The children tested 10 products (5 pull-ups and 5 diapers) for up to 1 week per product both at home and at school. Caregivers (parents and guardians) completed the questionnaires after evaluation of individual products and design groups had been completed. They recorded wet product weights and scored pad leakage at each pad change. School staff completed an abbreviated product performance questionnaire for each product. RESULTS There was little difference in the overall performance of the pull-ups compared with the diapers. In the pull-up group, one product performed significantly worse than the others for some performance aspects. Pull-ups worked particularly well for children able to assist with toileting and pad changes. Diapers were liked for ease of changing if the child used calipers, adapted footwear, or trousers. Diapers were more popular than pull-ups for night use, when greater absorbency was required. Neither design performed differently for school or home use. Most caregivers expressed a preference for diapers or pull-ups based on a range of individual needs, for example, level of independence in toileting, discreetness in pad change, fit, and product appearance. CONCLUSIONS Diapers and pull-ups have different strengths and limitations, and both meet the specific needs of individual children. Although pull-ups are more expensive than diapers, their use is justified if based on a thorough assessment of individual need.