Some medical conditions can cause a person to frequently lose bowel or bladder control. To address this problem, several externally worn devices can be used to protect the skin from constant leakage of liquid stool or urine. These appliances are usually referred to as external incontinence devices.

Although there are several different products available, the general features of these products are described below.

FECAL INCONTINENCE DEVICES

Several devices are available for managing chronic diarrhea or fecal incontinence. These devices consist of a drainable pouch that is attached to an adhesive wafer. This wafer has a hole cut through the center that fits over the anal opening (rectum).

With proper application, a fecal incontinence device may remain in place for 24 hours. It is important to remove the pouch if any stool leakage has occurred. Liquid stool is very caustic to the skin and may lead to skin irritation and breakdown.

If leakage has occurred, always cleanse the skin and apply a new pouch.

The device should be applied to clean, dry skin:

• A protective skin barrier may be prescribed by your healthcare provider. It is applied to the skin prior to attaching the device. You can also use a skin barrier paste to fill in the skin folds of the buttocks to prevent liquid stool from leaking through this area.
• Spread the buttocks apart, exposing the anus. It may be helpful to have one person support the buttocks while another applies the wafer and pouch. The wafer should conform to the skin with no gaps or creases where liquid stool can seep through.
• It may be necessary to trim the hair around the anus to help the wafer adhere 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 primarily 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 then 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. It is sometimes helpful to trim excess pubic hair from the area, because excess hair may prevent the appliance from securely attaching to the penis.

These devices must be changed at least every other day, to protect the skin of the penis and prevent urinary tract infections. Make sure the condom device fits snugly but not too tightly, as this may cause skin breakdown.