Many healthcare professionals recommend absorbent pads for men with urinary incontinence. These can be seen as easy to use and convenient (Chartier-Kastler et al, 2011), but potential odour and skin irritation are a significant concern (Williams and Moran, 2006; Gray, 2007). They can also impact dignity and quality of life (Williams and Moran, 2006). To provide a high level of holistic care, patients should be made aware of all suitable management options appropriate for them to be empowered to manage their bladder accordingly. 
 
As part of a urinary collecting system, Conveen® Optima sheaths meet the majority of users’ need for security, ease of use, comfort and discretion (Data on file). They are designed with features like the anti-kink bellow to ensure maximum security against leakage. This article looks at how healthcare professionals can support patients in finding an incontinence solution that is both effective and compatible with individual patient needs. 

INTRODUCTION  


Differing definitions of incontinence and reluctance of men to seek help on this topic make it challenging to precisely state the prevalence of male urinary incontinence. However, it is estimated that approximately one in 20 men aged over 18, and one in 10 men aged over 60 have symptoms of urinary incontinence (Anger et al, 2006; Shamliyan et al, 2009; Chartier-Kastler et al, 2011).  

Urinary incontinence negatively impacts many men, leaving them feeling unable to socialise, take part in sports, go to work, or even leave home. Emotions such as fear, embarrassment and shame can affect relationships and may prevent men from seeking medical help (Williams and Moran, 2006). 

What is male bladder incontinence?  


Bladder or urinary incontinence is the medical term for being unable to hold back or control the release of urine. Some of the most common types of male urinary incontinence are (Abrams et al, 2012):  
  • ●​ Stress urinary incontinence: this occurs when sudden pressure (such as sneezing or laughing) results in an involuntary leakage of urine  
  • ●​ Urge urinary incontinence: this is caused by involuntary, uncontrolled contractions of the muscle in the bladder resulting in a sudden urge to pass urine and involuntary leakage  
  • ●​ Incontinence associated with chronic retention: this can result in frequent/constant dribble of urine due to incomplete bladder emptying. 

TREATMENT OPTIONS  


Effective and discreet solutions for urinary incontinence are key to enabling some level of normality for men who face these challenges. Although absorbent products can be viewed as easy and convenient, they can also impact skin integrity and quality of life, with patients often conscious of odour and leakage. For patient comfort and hygiene, many healthcare professionals now recommend sheaths, while others appear to remain sceptical and perhaps consider sheaths to have no benefits over pads (Chartier-Kastler et al, 2011). 

69% OF PATIENTS PREFER SHEATHS OVER PADS  


Below is a summary of two clinical papers that describe the benefits of Conveen Optima urinary sheaths and their positive impact on patient quality of life, and ease of use for the clinician.  
 

Patient preference and impact on quality of life (Chartier-Kastler et al, 2011)


The objective of this study was to evaluate the impact of sheaths versus absorbent products on quality of life (QoL) in incontinent men. 

All dimensions of the King’s Health Questionnaire indicated an improvement in QoL, especially for ‘limitations of daily activities’ (-10.24 ± 3.99, p=0.01) and ‘impact of incontinence’(-7.05 ± 3.45, p˂0.05) (Figure 1). 

In terms of product performance, sheaths scored significantly higher for all parameters (efficacy, self-image, odour management, discretion, skin integrity), other than ease of use. The majority (69%) of patients preferred sheaths to their usual absorbent product (p=0.002) (Figure 2). 

Conveen Optima sheaths showed a positive impact on QoL in moderate/heavily incontinent men who were long-term users of absorbent products.  

Figure 1. KHQ scores — the lower the score, the higher the quality of life. *Significant difference (p<0.05).

Figure 2. Patient preference. 

Patient satisfaction and preference (Pemberton et al, 2006)  


The objective of this randomised, prospective, crossover clinical study was to compare two sheaths with regard to patient satisfaction and preference. The primary endpoint was urinary sheath product preference, and secondary endpoints were handling, application, comfort, leakage and skin reactions.  

The overall product preference for Conveen Optima was 67% (Figure 3), indicating that it is more acceptable than the previously well-established alternative.  

With Conveen Optima, more participants found that:  
  • They felt safe immediately after application of the sheath  
  • The sheath was comfortable to wear  
  • It was easier to connect and subsequently disconnect the sheath from the urine bag (Table 1).  
Participants felt more secure when using the Conveen Optima (P=0.029, Wilcoxon test). Where nurses applied the urinary sheaths wearing gloves, more nurses found Conveen Optima easy to apply.  

Conveen Optima urinary sheaths provided a higher feeling of security than the alternative sheath and were found to be easier to handle and apply. They were also more comfortable to wear and preferred by the majority of patients.  

Figure 3. Product preference.

Table 1. Handling, application, comfort, and packaging.   

CONVEEN OPTIMA — A RELIABLE ALTERNATIVE TO PADS  


As demonstrated above, Conveen Optima sheaths have a range of features designed to support men with urinary incontinence: 
  • Easy-to-open packaging that is lightweight, smart and discreet and ensures the sheath remains in optimum condition 
  • Easy-on and smooth roll-out, even when wearing gloves, due to the unique double-grip strip 
  • Comfortable, secure and skin-friendly fit due to its stretchy, breathable, 100% silicone material 
  • Extra reliability due to an anti-leak system with a push ring connector and sure-grip ribs for secure connection to the urine bag, and anti-kink bellows and flexible material. 

Patient story  


Bernard has been married to his wife Brenda for over thirty years and they like taking walks together in the local parks. However, Bernard was diagnosed with prostate cancer and had his prostate gland removed. Bernard reported, ‘After the operation, the next challenge was trying to live with the incontinence.’  

He tried pads, but these did not work for him, and he gradually lost his confidence because of the incontinence: ‘It stopped me doing a lot of things, which I took for granted, like actually just getting out the front door of my home and trying to lead a normal life.’ However, after starting to use Conveen Optima Sheaths he regained his confidence and his quality of life subsequently improved. 

As he said:  
‘My wife got the old Bernard back, thankfully, and I went from never, ever thinking I’d get back to work and seeing my old colleagues to actually getting back to work, doing my old job and back to normal.’ 

Fitting guide  


To ensure comfort and optimal performance of the sheath, it is essential that a sheath of the appropriate length and size is fitted correctly (Brodie, 2006): 
  • Measure the diameter of the penis with the Conveen Optima measuring guide* If in between sizes, select the smaller size 
  • The use of creams and powders on the skin should be avoided as they may interfere with the adhesive. For sensitive skin, preparatory wipes and adhesive removers are available*  
  • Fit the sheath leaving a small gap between the tip of the penis and the outlet 
  • Holding the tip in place, pull the loop to unroll the sheath over the penis. Gently squeeze the unrolled sheath around the penis to ensure a secure fit 
  • Connect to an appropriate drainage bag. If possible, allow the skin to breathe for short periods between changes and do not leave a sheath on for more than 24 hours. 
*Samples of Conveen Optima, measuring guides and supporting products can be requested via Coloplast Charter’s dedicated healthcare professional team on:  


PM-20388 

References

Abrams P, Cardozo L, Khoury S, Wein A (2012) 5th International Consultation on Incontinence, Paris, February 2012; 364  
 
Anger JT, Saigal CS, Stothers L, et al (2006) The prevalence of urinary incontinence among community dwelling men: results from the National Health and Nutrition Examination survey. J Urol 176: 2103–8  
 
Brodie A (2006) A guide to the management of one-piece urinary sheaths. Nurs Times 102(9): 49, 51 
 
Chartier-Kastler E, Ballanger P, Petit J, et al (2011) Randomized, crossover study evaluating patient preference and the impact on quality of life of urisheaths vs absorbent products in incontinent men. BJU 108(2): 241–7  
 
Gray M (2007) Incontinence-related skin damage: essential knowledge. Ostomy Wound Management 53(12): 28–32  
 
Pemberton P, Brooks A, Eriksen CM, et al (2006) A comparative study of two types of urinary sheath. Nurs Times 102(7): 36–41  
 
Shamliyan TA, Wyman JF, Ping R, Wilt TJ, Kane RL (2009) Male urinary incontinence: prevalence, risk factors, and preventive interventions. Rev Urol 11: 145–65  
 
Williams D, Moran S (2006) Use of urinary sheaths in male incontinence. Nurs Times 102(47): 42
 
This piece was first published in the Journal of General Practice Nursing. To cite this article use: Supporting men with bladder incontinence (2022) J Gen Pract Nurs 8(3): 26-28 


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