Technology for managing incontinence: What are the research priorities?

Abstract

Incontinence and toileting difficulties can often be successfully addressed by treating their underlying causes. However, (complete) cure is not always possible and continence products to prevent or contain unresolved leakage or to facilitate toileting are in widespread use. Many people use them successfully but identifying the product(s) most likely to meet individual needs can be challenging and the recently published Seventh International Consultation on Incontinence includes a chapter which draws on the literature to provide evidence-based recommendations to help clinicians and product users to select appropriate products. This paper is based on the same evidence, but reviewed from the different perspective of those keen to identify unmet needs and develop improved products. For each of the main continence product categories it (i) outlines the design approach and key features of what is currently available; (ii) provides a generic functional design specification; (iii) reviews how well existing products meet the requirements of their main user groups; and (iv) suggests priorities for the attention of product designers. It also flags some core scientific problems which - if successfully addressed - would likely yield benefits in multiple incontinence product contexts.

Keywords: Incontinence; continence products; functional design specifications; research priorities; toileting products.

Figure 1.

Example female handheld urinal (left) and male collapsible, handheld travel urinal (shown collapsed, and ready for use) (right).

Figure 2.

Chair with commode (left) and toilet frame with integral raiser and grab bar (right).

Figure 3.

Disposable, bodyworn absorbent products for moderate/heavy incontinence: shaped pad (top left), all-in-one (top right) and belted pad, shown open (bottom left). Male pouch (bottom right).

Figure 4.

Sheath without integral adhesive, secured with external fixation.

Figure 5.

Bodyworn urinal with leg bag.

Figure 6.

Example of a bodyworn urine drainage bag attached to a sheath and secured on the calf.

Figure 7.

Examples of mechanical devices for women with UI: InFlow Intraurethral Valve-Pump (by Vesiflo, USA), in position (left) and Poise)/Impressa (by Kimberly Clark, USA) intravaginal device (right).

Figure 8.

An example penile clamp.

Figure 9.

An indwelling catheter with balloon inflated.

Figure 10.

Examples of products for preventing FI: Peristeen anal plug (by Coloplast, Denmark) (left) and Renew anal insert, with applicator (on the end of the finger) in place (by Renew Medical, UK) (right).