Incontinence Cloth

Reusable Incontinence Products

What are reusable incontinence products?

So what are reusable incontinence products and how do you use them?

As with disposable products, there are many different reusable solutions to manage incontinence. The problem sometimes is finding the right one to suit your needs and finding it at a price that is affordable. These days it is possible to find someone to make almost anything you want, but the skills to do that are rightly valuable and so it is not always cheap to find a good solution, however it is often possible to find an affordable and acceptable solution, but it is important to know what your priorities and necessities are in order to do so.

Non-absorbent Products

So firstly I will discuss (briefly) items that can help manage bladder problems, but aren’t including any absorbency. These can be as simple as having travel bottles in the car which allow you to have a wee in an emergency if needed. These can be bought with fittings to allow use by both those with both male and female anatomy and can be useful in a pinch for those with urgency, but probably aren’t going to be the only solution required for most people and definitely won’t help with stress leakage or neurogenic bladder problems, as you will need something to help when you leak rather than helping you not to leak.

That said, prevention is better than cure, and there are reusable devices to help aid with pelvic floor exercise. These exercises can significantly improve and in some cases cure stress incontinence, but it is notoriously difficult to perform them effectively without proper training by a professional. Devices such as vaginal cones can provide some assistance by helping you to isolate the correct muscles and have been shown in a systematic review, available in the Cochrane Library (I will try to get reference together!), to be beneficial compared with self-directed exercises. That said they are still not as effective as properly guided exercises, so you would be better with a good pelvic health physiotherapist, if you can access the service. The other downside is that the cones do not work for men, but exercises still can.

There are some reusable, wearable collection devices, but I have yet to see anything that appears to be comfortable, discreet and effective, but if anyone has then please let me know so I can spread the word.

Absorbent Products

As mentioned above, you can get most things that are available as a disposable product in a reusable version. I will run through the basic options with some in more detail. Where I can I will provide links and reviews on this site if I’ve tried them.

Washable Underwear

One of the most common solutions available in the reusable absorbency market is underwear with built in absorbency/protection. I am very pleased that these products seem to be much more available these days and even the big incontinence brands like Tena and Abena are getting in on the act and have created washable underwear. I have tried the Tena ones and am happy to report that they are both comfortable and discreet, however they run up against a common problem in that they are only designed to hold a small amount of fluid. They are great if you have some stress leakage or a bit of a dribble every now and then, but can’t really cope with anything approaching a significant void. The largest capacity I have found any underwear-type product advertising is in the 500ml range, which doesn’t really cut it for those with heavier loss. They also aren’t suitable for anyone with bowel incontinence. The reasons for this are quite simple; in order to have enough absorbency to cope with heavier loss you need quite a lot of absorbent fabric along with adequate waterproofing to stop leaks. Once you combine these into something that would work adequately you no longer have something that is discreet and looks like a normal item of underwear.

I have worked with a wonderful manufacturer on Etsy who has tried to develop a product which does the job, but as yet there are a few issues that need to be overcome before it could be used reliably.

So, for anyone with light incontinence who wants a discreet and environmentally friendly solution, washable underwear is a great solution. If you have heavier leakage or bowel incontinence, then alternative solutions are going to be better.

Below is a (non-exhaustive) list of options. I get no benefits from the links, they are just for information and I can’t guarantee the availability of the products, but I hope they are useful!

Washable Pads

Another option that has massively increased in availability in recent years are washable pads that can be used in normal underwear or sometimes in specially designed underwear. The most commonly available products are those shaped like sanitary towels and are similar to reusable period protection, but generally a bit more absorbent. It is possible to get male products too that are used in a similar manner to the disposable pouches that are available.

The problems here are similar to the absorbent underwear, in that most are designed for light loss only. I have not used them myself, as they don’t really offer the kind of protection I need, but I have read the reviews etc. and they seem to be more prone to leaks than underwear with built in absorbency. On the flip side, they are easy to store, carry, wash and dry which certainly makes them an attractive proposition if they work for you. They are also fairly common and you have options to buy ethically or locally if that is something that is important in your decision-making.

  • Cheeky Pants Pads

Washable Nappy/Diaper Style Products

Just as there are disposable briefs or slips that are similar to disposable nappies, it is possible to get larger versions to fit older children/adolescents all the way to adults. There are 3 main types of washable product within this category that I will explain briefly. Put very simply these products comprise of 2 elements:

  • the absorbency
  • the waterproof cover

but these can be arranged in a variety of different ways to provide different benefits.

All-in-one

As the name implies, this kind of product has the absorbency built in and usually can’t be removed. From the perspective of convenience and ease of use, these are an excellent choice. This does come at the price of some loss of flexibility in the capacity of the absorbency, although many products will allow the user to add extra absorbency if needed. They do also tend to take a lot longer to dry, which can be an issue in terms of cost (if using a tumble drier), space (especially if not using a tumble drier) and turnover (need more products to allow for laundering). Another downside is that once soiled or wet the whole product needs to be changed and washed, which can increase the number of washes you need to do and the number of products you need to have an adequate supply.

There are a few options available and I have linked to them in the list below. This is not exhaustive and I am more than happy to hear of any other options available. Some of the links will take you to where you can buy the product, but please note that they may not be available in all countries or they may not be available any more. I am only trying to share resources, so they are not reviewed here (although I will try and come back and link to my reviews later if I can) and I receive no benefits from any of these links.

All-in-two

These are similar to the all-in-one, but have a little more flexibility because the absorbency is removable. This enables you to tailor which absorbency is used to what you need in a given situation. It also allows you to reuse the waterproof element of the product, if it isn’t wet or soiled itself, which decreases your laundry bills and can help prolong the life of the waterproof cover, as washing tends to be what caused most of the issues with wearing out over time.

There are a couple of different ways these systems can work.

  • The commonest and easiest to use is the pocket nappy/diaper. These comprise of a waterproof outer shell (usually PUL) with an internal layer of a stay dry fabric, like suede cloth or micro fleece, which has an opening (usually at the back) into which you can insert your absorbency. They are probably the most common of the adult nappy-style products and can be bought relatively cheaply. They are also quite flexible as you can use whatever you want for the absorbency including dedicated shaped pads, rectangular inserts in a variety of fabrics or foldable trifold inserts. The price you pay for the flexibility is the fact that, like the all-in-one, the whole product (cover and absorbency) needs to be washed after use, as the lining is integral to the cover.
  • The other style used a cover with an insert that either snaps in place or is attached with Velcro or similar. These allow a used insert to be removed and the cover to be reused after a quick wipe down. These are less commonly available, but there are a few options available. They do allow you to tailor your absorbency a bit more too, but you often have to use inserts that are specifically designed for the cover, which can be a limitation. The covers are relatively versatile however and can be used as the waterproof layer with other absorbency that doesn’t need to be fixed in place, or as an extra layer of security against leaks, if needed, without additional absorbency.

Again, the list below is not exhaustive and again I can’t vouch for whether the relevant products are available, but hopefully they will be useful as a resource.

Fitted Nappies/Diapers

Now we are moving into the realms of products that are much less common, but I think have an important role in the appropriate management of those with heavier incontinence (particularly overnight) for whom having a washable product is desirable and important.

Fitted products comprise of the same 2 elements as before: waterproof outer and absorbent inner, but here I am only considering the inner absorbency. They are shaped the same as an all-in-one or two outer shell would be and tend to be front-closing using either snaps or Velcro. The benefit you have here is that the whole product is absorbent, unlike in the previous category, and this can be really useful overnight, as it can accommodate different sleeping positions. Again, only the absorbent part needs washing every time, if not soiled etc. so the same benefits about washing and longevity of waterproof outer layers apply. They often allow extra absorbency to be included as needed which makes them more flexible and meaning that they can be a solution for both daytime and nighttime wetting. The main downsides are that they are much less common than some of the other solutions and that in accommodating heavier wetting they are potentially much bulkier.

Not so many links this time and some are no longer available 😢.

Flats and Preflats

These are probably the simplest/cheapest solution out there in come ways and involve going back to basics to some extent. You can buy terry squares in large sizes which can be folded and fitted to an adult in the same way as used as a baby nappy. As the simplest to manufacture, they tend to be the cheapest to buy, so if your budget is limited then they could be a reasonable option. They are one of the best options for side sleepers given the all round absorbency. As they tend to be simple fabrics, the do take quite a thickness to absorb well and as a result are very bulky. While this isn’t always a problem at home, they aren’t necessarily going to be an option out and about. Discretion whilst wearing such a thick product is going to be non-existent, however washing and drying isn’t a problem, as they will just look like normal towels, so you won’t be embarrassed to hang one on the washing line. They will require a waterproof barrier and probably a larger size than for any of the other products and need some form of closure method whether nappy pins, Snappis or even a nappy belt. The dexterity required to apply the appropriate closure is not a problem for me personally (I use Snappis/Nappy nippas) but could be a problem for some. There are also many different folds that can be used (Kite fold tends to work best for me) and you can add inserts and booster where needed/wanted. Most of the other nappies have some kind of stay dry layer which is supposed to be next to the skin, which is not present in these more simple designs, so you may find your skin more prone to irritation if you can’t change so often.

Preflats are a slight step up in design, but basically you have a flat with 2 wedges cut out below the waist portion of the flat. The longer sections then fold into the centre to make the nappy a T shape, with this then being applied with the central long portion coming up between the legs and the waist “wings” brought around and again attached with pins/Snappi etc. some will have extra absorbency built into the central portion and if not, it can be added as necessary.

Flats are good as a backup option for me and are pretty bombproof, but I do prefer something slightly trimmer and more anatomically shaped. I haven’t yet used a preflat properly, but am getting one soon, so I will try and update when I get chance.

Furniture Protection

Another way of countering leaks is not to try and contain the urine in the underwear, but instead to try and avoid contact with furniture etc. a common method of doing this is to use waterproof sheets, often with an absorbent pad built in. These are analogous to the blue “puppy pads” people often use when toilet training animals, but in washable form. Various types exist that can protect chairs and beds etc. My feeling is that they may have a good rôle in catching unexpected leaks, but will mean that your clothes or pyjamas will be soaked and a duvet (or partner!) could come into contact with the wet pad. As a result I don’t use these, but they may have places where the are useful.

Which is best?

There is no one answer to this question and different people will find different solutions to work better for them in different situations. I think my favourite product so far is the Ecoable Nighttime Set which includes a pocket nappy for the waterproof shell, a fitted nappy for the main absorbency and a booster/insert which can either snap inside the pocket nappy for daytime use or into the fitted nappy for extra absorbency. I love the flexibility and absorbency and the fact that it still feels dry even after being wet for a while. I do use with a plain cover rather than the pocket nappy sometimes though, as it helps reduce the washing! But whatever works for you or your loved ones is the best choice, but hopefully you will be able to make that decision a little better informed now.