Because for most people, wearing a giant plastic diaper is pretty unpleasant--If you only have less-than-complete incontinence, you don't want a product taped to your body like a bandage. I'm sure if you have complete urinary incontinence, it can make sense to use the most-absorbent thing you can get. But the majority of people who have some sort of incontinence are not in that situation.
When my problems first started, the only adult diapers were very thick and impossible to hide under my jeans. And even though some days I had accidents that needed them, most days I was leaking perhaps 30ml. It was liquid feces, blood, mucus, and other mysterious fluids from my intestines. But I didn't need a giant diaper for 30-60ml; that's 1-2oz. i needed something to contain it and absorb as much fluid as possible so it wouldn't sit on my skin. A lot of that stuff is pretty hydrophobic and doesn't absorb well.
When the Depend Protective Underwear came out--that was the original all-white unisex product with a full pad from front-to-back--it made a huge improvement. I still had some accidents when things got away from me, but it solved the majority of my daily issues. But I dared wear it to my college classes, and it worked a whole lot better than me modifying women's urinary or menstrual pads to fit my underwear, where thy often came off and got stick to me halfway across the large campus.
And since I had chronic diarrhea 24x7, sometimes with intense urgency, I could quickly pull them down the Depends Underwear and use the toilet. Extra delays caused by trying to shimmy out of a diaper could be a catastrophe. Sometimes I had my pants undone before I even reached the restroom because I knew my timing was that tight.
About this time, the (old, green) Depends briefs got much thinner and had a great waistband (which kept getting better for a while); if I fastened them carefully, I could pull them up-and-down all day like plastic underpants. As long as I didn't have a leak more than a couple ml, I would wear them until my shower the next morning. I used these when I was feeling sick and the pull-ups when I was feeling okay. My disease would flare and go into remission, and in remission even with I was basically normal for a week or two, the pull-ups gave me great confidence that I could handle leakage. Both the pull-up and the diapers saved me from some terrible accidents, and yes a couple times I had a bigger problem than the pull-ups could handle. For several years when I was sick, I alternated between the "underwear" and or diapers during the days and used the diapers at night.
The modern Depend Underwear is useless for me. The mens products have trimmed the pads so much it no longer goes over my rectal area and when I leak, it just gooshes out through the nonwoven fabric panels. The woman's products are better that way, but they have no room for my genitalia and though I am used to being humiliated and I actually like the color purple ones, the peach and printed pink pullups are just too much for my pride. My wife has the same disease (it's how we met) so at times I've tried hers to see if they will work; I hate having to special-order everything.
But today's quality pull-ups are great. The Abena Abri-Flex M1 and M3 are my go-to products now when I have problems. I only turn to a diaper when I am expecting an accident, or after I've had one and worry another might be coming. I've torn off many pull-ups and taped on a diaper in a restroom stall. Or when I am doing a bowel prep or something.
Plus, you can get some of the pull-ups colors. In Europe there is a Tena Active Fit for men in a really nice dark blue. But it doesn't fit me quite right. I know some here are not bothered by them, but seeing myself in the mirror in a white diaper (tape on or pull-up) makes me a bit ill. I look like an escaped patient or a giant toddler, neither look is good for my ego. I was using the Seni Active for Men which was an idea product for me. It fit me like it was tailored, it was just the right absorbency and it was grey. It had active fecal cuffs to contain mucus and things (those raised leak guards around the pad). The grey wasn't as uniformas I would like, but still I wasn't totally ashamed to be seen in them, so naturally they stopped making them.
When I am not expecting anything more than a tiny bit of leakage (I am doing really, really well on a new medication right now), I use the Tena ProSkin for men, which are a very nice grey and quite comfortable. But they have no real leak guards except the leg cuffs, so I move away from them if I feel "off".
Again, all of those products I can remove quickly to use the toilet, which is important with chronic diarrhea.
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