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Incontinence Prescription Items
History of Urinary Incontinence Appliances
Incontinence Product Descriptions

Company Backgound in Urology and Ostomy
Location and Contacts

2001, S G & P Payne.
Registered Dispensing Appliance Contractor
There are many causes of urinary incontinence, either through congenital deformity, post operative damage, nerve or muscular damage or disease. Urinary incontinence, can also occur in various degrees - "dribble", "overflow", "stress", "full flood" - caused by "involuntary voiding", "frequency" and 'urgency". The severity of the problem will determine the best method of dealing with it. Incontinence appliances of one sort or another have been around for hundreds of years, brought about by the obvious need to prevent soiling of clothing and surroundings, not to mention the more personal embarrassment factor of the sufferer. The range of alternatives available to both the practitioner and the patient is still growing. For example, there are currently 130 male body worn appliances listed in the NHS "Drug Tariff", some of which were designed over 50 years ago - obviously well designed and practical in use to have stood the test of time, and still available because patients still find them successful. It is always important to remember, that the best appliance is the one that suits the patient.

Since the end of the nineteenth century, "Body Worn Appliances" as they are known (meaning external non-adhesive appliance), were made of cold cured rubber, but in the years after the last war, new mixing compounds and curing methods were perfected. In the 50's, the "Kipper Bag" was developed, making use of a condom sheath, a plastic connector and a short piece of rubber tubing pushed into the top of the bag. The name "Kipper", stems from the fact that medical grade rubber at the time, was red - the shape of the bag when laid out flat looked just like a "Kipper". Even though the colour changed to black and is also now available in Latex, the same name has stuck and it is known today as a "G.U." Pattern (Company name) Kipper Bag and there are many copies. This type of appliance was used by the majority of paraplaegics who passed through Stoke Mandeville Hospital up until the early 80's and it is still favoured by many patients, because they like the large capacity, it's strength and the fact that urine is not visible. It is re-usable, which also makes it very cost effective. However, this type of appliance is best suited to the use of condoms or penile sheaths, as opposed to catheters.

The use of bags and particularly "Leg Bags" (bags strapped to the leg), created the need for penile sheaths which were made from Latex Rubber. In the late 1970's, 'pre-shaped' sheaths were introduced. These were supplied with "double sided adhesive strips" or, "sheath holders", to hold the sheath in place. In the middle 80's, "self adhesive" sheaths were developed as an alternative. Silicone clear sheaths have now been developed, and are particularly useful for patients who perform intermittent self catheterisation, but who still require a collecting device, as they can disconect the bag without the need to remove the sheath each time. Where patients are unable to use a sheath for one reason or another - Rubber Cones which fit directly onto a flange are available. These, in fact, apart from offering an alternative method, do have other advantages. Of all the body worn appliances, the "Pubic Pressure Urinal" and it's derivatives, is generally recognised as the most successful design, because it pulls the flange to the body, consequently forcing the penis forward preventing spillage. This Urinal was originally designed by Percy Payne in the 50's, to help young Spina Bifida sufferers who were incontinent. Over the years, it has been modified to enable it's use by adults as well as children. In the early 80's Stuart Payne (Percy's son) re-designed some aspects of this.

Since then, Stuart Payne has specially developed his own range of different Male Incontinence Urinals, known as the mk's 1 - 12 plus Pubic Pressure Urinals. Re-usable and therefore very economical in use, many of the parts are interchangeable thus offering the patient and the practitioner the ability to create an almost bespoke appliance, with a choice to suit most needs.

With the introduction of PVC and improvements in technology to perfect welding techniques, most of the Leg Bags in use today, are now made of this type of material with numerous alternative shapes and capacities. Bags are made with a non-return valve and can be supplied with varying lengths of tubing and various fitments. These can also be used with catheters and can be supplied "Sterile" for such purpose. For the male patients, suffering with "Dribble Incontinence" many various alternatives have been developed. For example "Dribble Pouches". If made of Rubber or Plastic and are re-usable they may be available on NHS Prescription, but "Disposable Absorbent Pouches", made from other materials, which are not reusable, are not! In certain cases a "Cunningham Penile Clamp", may be recommended by a Consultant but, these are only available through a Hospital.

The alternative to a body worn appliance, can be 'Indwelling Catheters', such as a "Foley Balloon", which became widely used in the 60's. Before that date, "Malecot" or, "de Pezzers" Catheters (inserted with a special Introducer") were in regular use. These are however, accepted only as a last resort when all else has failed, as with longer term use, catheters can cause infection and urethral erosion. "Intermittent self catheterisation", is a very useful alternative method of control for the patient with "Overflow Incontinence" and is often recommended for M.S. sufferers or those with Spina Bifida. This is not a new idea as, in the 1930's, Farmers were renowned for carrying a rubber catheter curled up in their hats. Of course, with the advent of "Plastic Disposables", this has now become more sophisticated. For those female patients, who experience difficulty in using 'plastic' catheters, a range of metal ones are also available. However,it is worth mentioning at this point, that these are not yet available on NHS Prescription.

For those who are not incontinent, but who have a problem, when passing urine, of it spraying all over the toilet, we have developed urine directors for both males and females. These are washable and re-usable.


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