External incontinence devices

There are several products available. The features of these different products are listed below.

FECAL INCONTINENCE DEVICES

There are many types of products for managing long-term diarrhea or fecal incontinence. These devices have a drainable pouch attached to an adhesive wafer. This wafer has a hole cut through the center that fits over the anal opening (rectum).

If put on properly, a fecal incontinence device may stay in place for 24 hours. It is important to remove the pouch if any stool has leaked. Liquid stool can irritate the skin.

Always clean the skin and apply a new pouch if any leakage has occurred.

The device should be applied to clean, dry skin:

• Your health care provider may prescribe a protective skin barrier. This barrier is usually a paste. You apply the barrier to the skin before attaching the device. You can put the paste in the skin folds of the buttocks to prevent liquid stool from leaking through this area.
• Spread the buttocks apart, exposing the anus, and apply the wafer and pouch. It may help to have someone help you. The device should cover the skin with no gaps or creases.
• You may need to trim the hair around the anus to help the wafer stick better to the skin.

An enterostomal therapy nurse or skin care nurse can provide you with a list of products that are available in your area.

URINARY INCONTINENCE DEVICES

Urine collection devices are mainly used by men with urinary incontinence. Women are generally treated with medicines and disposable undergarments. An alternative for some women may be a urinary wicking device.

The systems for men most often consist of a pouch or condom-like device. This device is securely placed around the penis. This is often called a condom catheter. A drainage tube is attached at the tip of the device to remove urine. This tube empties into a storage bag, which can be emptied directly into the toilet.

Condom catheters are most effective when applied to a clean, dry penis. You may need to trim the hair around the pubic area for better grip of the device.

You must change the device at least every other day to protect the skin and prevent urinary tract infections. Make sure the condom device fits snugly, but not too tightly. Skin damage may occur if it is too tight.

Condom catheter; Incontinence devices; Fecal collection devices; Urinary incontinence - devices; Fecal incontinence - devices; Stool incontinence - devices

Boone TB, Stewart JN, Martinez LM. Additional therapies for storage and emptying failure. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 127.

Newman DK, Burgio KL. Conservative management of urinary incontinence: behavioral and pelvic floor therapy, urethral and pelvic devices. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 121.

Updated by: Sovrin M. Shah, MD, Associate Professor, Department of Urology, The Icahn School of Medicine at Mount Sinai, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.