www.incontinentsupport.org

I have yet to find a pull-up disposable brief/diaper/underwear that gives me confidence. I have a 48" waist and 50" hips. Even the "made for men" versions do not have padding that goes up high enough in front.

For a long time, I used Abena Abri-San pads (size 5 or 7) inside an Abena Abri-Fix fixing pant, as I could position the pad higher in the front to give me the protection I needed. The only annoyance was that these pads do not have an adhesive strip, so they would roll over, bunch, and shift inside the fixing pants. I had a couple of leakage incidents where the urine flowed over the top end of the pad. I tried using double-sided photo album tape to mimic the adhesive strip typically found on male guards and feminine napkins, but it didn't work nearly as well. I asked Gary Evans at XP Medical if he could source the adhesive tape in bulk rolls, but it isn't available in small enough rolls to make it practical or affordable for purchase by users of incontinence pads.

In the meantime, my urge incontinence got worse and my floods became heavier, making the Abri-San pads insufficient for my needs. As a result, I switched to taped diapers. I wear the Seni Super Quatro, Seni Super Plus, or Abena X-Plus plastic-backed diapers, depending on what is appropriate for my activities on a given day. I always wear a GaryWear PUL active brief over the diaper as added protection against leaks, and an Abena Abri-Fix fixing pant over the GaryWear brief to keep things snug and smooth.

On hot days when I perspire a lot and I'm at home with easy access to the bathroom for scheduled voiding, I will use the Abena Abri-Man Level 2 guards inside the Abri-Fix fixing pants to collect leaks and spurts. It also allows my skin to breathe and be out of diapers at least part of the time.

In my earlier stages of urge incontinence I also tried managing with just pullups but gave up after a couple of years to briefs. I found it to be a catch 22 situation. While it sounds like pullups have gotten better since then they are still risky for handling a sudden full bladder loss especially if your bladder capacity is still in the normal range. As my continence nurse at the time pointed out they are really only meant for people who do timed voiding and need it to just catch the occasional urge in between. Briefs allowed me not to worry about public embarrassment but I did find it hard and a bit futile to make it to the toilet and undo and redo them. Stuff like pee on my hand or tapes don't really work. A another nurse also pointed out to me that is it risky to actually try to extend an already slightly damp brief since you let in a bunch of air which will cause bacteria to grow rapidly leading to UTI's so once you already peed in it once best to just pee in it to saturation and then change. While it sounds like everybody is different, briefs for many like me did lead to complete dependency on them after a while. But by the time I noticed I was so used to being in briefs it didn't really matter much. Just needed to be more careful about getting them on quickly after a shower or put down a pad on the bed.

Wait, really? I haven't heard this before.

I have, several times.

It makes sense too. Urine is naturally sterile, but it is a warm and wet environment. There is also a lot of natural bacteria floating in the air too.

Even if you keep the same diaper on while periodically wetting it, bacteria will eventually start to grow. This is after 8-12+ hours though, so you typically won't have to ever worry about it so long as you just use the diaper and change it at least 2 or 3 times each 24 hours.

On the other hand, taking a damp diaper off and exposing it to even more air (and bacteria) will greatly decrease the time it will take for that bacteria (and now more) to take root and start growing. Add in the extra time you're extending how long you wear that same damp diaper, and well yeah you are increasing your risk for an infection.

Of course, some people are more prone to getting infections while others are naturally more resistant. You might never get an infection from doing this, but your chance for it is still increased overall. So yeah, it actually is healthier to just use your diaper fully which will lead to changing it sooner.

Urine is actually not sterile (that's just a long standing myth), but we generally pass it frequently enough not to have bacteria breed to infectious levels.

This is one reason that people with urinary retention are more prone to UTIs

Actually not a myth. When urine is produced by the kidneys it absolutely is sterile with absolutely no bacteria in it. In a perfectly health body, that urine is dumped into an also bacteria free bladder, where it eventually gets dumped out again when we pee.

That said, not everyone is going to be perfectly health. UTIs can occur in anyone and at any age- with or even without any outward symptoms. When this happens, bacteria will become present in the bladder. Since that bacteria can also live in the bladder wall lining, its possible that bacteria can stay in you for years or decades (or even possibly life)- even without any infectious symptoms ever occuring.

This is where the not-sterile myth comes from. Yes, urine absolutely can, and often does, have bacteria in it. Notice though I had said "urine is naturally sterile". I didn't say it always is for this very reason.

So sorry, but my original statement still stands. And that isn't a myth.

MSUSpartan is correct. Urine is not sterile.



Other sources say the same thing:

http://www.webmd.com/news/20140519/ster ... -be-a-myth

http://www.smithsonianmag.com/smart-new ... 09/?no-ist

http://www.sciencealert.com/sorry-guys- ... ly-sterlie

Noe

Thank you guys for all the good info. So wearing a diaper for long periods of time, no matter how used, is generally a bad idea all around. I'll need to adjust my habits and techniques for this kind of stuff taking this into consideration. It also gives me renewed motivation to get these issues fixed. Though, recent doctor visits don't give me much hope.

Of course I'm right, I'm always right.

Personally I found talking to nurses better than doctors about my future chances and options related to incontinence. They are more pragmatic and frankly honest. Doctor's I've found think they are gods and always recommend the latest surgeries and drugs. If you can get a nurse to open up to you (it takes time since they can get in trouble so you usually have to coax them first you will keep their advice private) they will frequently contradict the doctor since they know the stats better especially since if the doctors fails they have to deal with the cleanup (pun intended). In many cases failure usually means constant catherization, paralysis of genital area, and fecal incontinence in addition to urinary incontinence.
Then comes the hard decision. The adage "once a brief user, always a brief user" is a fact for most. The product by definition and design is meant for heavy to total loss of self control. So even for many nurses once they find out you have moved from pullups to briefs their focus changes from timed voiding and urge suppression techniques to recommendations on different briefs and just using them for long term containment of all your urination since most likely that's where you will be in a few years anyway.