External incontinence devices are products, called appliances, worn on the outside of the body to protect the skin from constant leakage of stool or urine. Certain medical conditions can cause people to lose control of their bowel or bladder.
There are several different products available. The general features of these products are described below.
FECAL INCONTINENCE DEVICES
Several devices are available 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 applied 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 is very irritating to the skin.
If leakage has occurred, always clean the skin and apply a new pouch.
The device should be applied to clean, dry skin:
Your health care provider may prescribe a protective skin barrier (such as a paste). You apply it 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 rectum, 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 rectum 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. (See also: Skin care and incontinence)
URINARY INCONTINENCE DEVICES
Urine collection devices are mainly used by men. (Women are generally treated with medication and disposable garments like Depends.)
The systems for men usually consist of a pouch or condom-like device that 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. The drainage 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 so the device attaches better.
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. (If it's too tight, skin damage may occur.)
Payne CK. Conservative management of urinary incontinence: Behavioral and pelvic floor therapy, urethral and pelvic devices. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 69.
Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Medicine, UW Medicine, School of Medicine, University of Washington; and Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.