Pad Users Research Articles

Exploration of user satisfaction in using the newly redesigned MoliCare Premium Men Pad: in-home use study.

Men frequently underestimate the significance of urinary incontinence and fail to disclose their condition owing to embarrassment and the associated social stigma. Therefore, successful incontinence management with absorbent products helps individuals cope with the emotional and social challenges arising from incontinence, including visible urine leakage, frequent urination, unpleasant odours, and isolation. To assess the most essential performance features of the newly developed MoliCare Premium Men Pad. Computer-assisted personal interviews were conducted to obtain the opinions and satisfaction levels of 69 male users with incontinence in Germany regarding different performance characteristics of the newly designed MoliCare Premium Men Pad after using the product. All performance characteristics of the new MoliCare Premium Men Pad design received positive ratings from all interviewees. Notably, 90% of participants were 'highly satisfied' and 'satisfied' with the new MoliCare design. The new MoliCare SkinGuard absorbent core technology, anti-leakage guards, and well-engineered product design provide protection, discretion, and comfort to individuals with incontinence. The newly developed MoliCare Premium Men Pad is specifically tailored to meet the primary needs of male pad users and help them maintain a normal lifestyle.

Adverse Health Outcomes 3 Years after Radical Prostatectomy Compared with Men in the General Population: A Study from the Cancer Registry of Norway

IntroductionStudies about adverse health outcomes (AHOs) after radical prostatectomy (RP) in population-based contemporary prostate cancer (PCa) patients are limited, as well as knowledge about corresponding data from age-similar men from the general population (Norms). We compared selected AHOs (pad use, intercourse inability), related problems (bother) and quality of life (QoL) between PCa patients and Norms. Patients and methodsThe Cancer Registry of Norway (CRN) provided data on PCa patients diagnosed in 2017-2019 and treated with RP who completed the EPIC-26 and EORTC-QLQ-C30 questionnaires 24-48 months after surgery (n = 1501). The CRN also established a group of Norms (n = 1894). Dichotomized EPIC-26 outcomes: daily use of ≥1 pad (Item#3), quality of erections (Item#9) and related bother (Item#4a/#12). EORTC-QLQ-C30: quality of life (Item#30). Multivariable logistic regressions explored associations between selected covariates and outcomes. ResultsIn total, 41% of the patients and 5% in Norms reported pad use, the comparable figures for intercourse inability being 84% (Patients) and 48% (Norms). Among pad users, 24% of the patients and 25% of the Norms described bother. 52% of patients and 35% Norms with intercourse inability. Only bilateral nerve-sparing surgery (NSS) significantly reduced the risk of pad use and intercourse inability. Compared to Norms, PCa patients were associated with pad use, intercourse inability, related bother, and good/ fair QoL. ConclusionIn these population-based cohorts, 2 in 5 patients used pads 3 years after RP, compared to 1 in 20 Norms. Intercourse inability was reported by 4 of 5 patients compared to 1 of 2 Norms. PCa patients were associated with good/ fair QoL. Bilateral NSS significantly reduced the risk of AHOs, highlighting the importance of this approach. Function and bother are different dimensions of urinary and sexual AHOs and must be reported separately. The findings from this study should be considered when counselling patients before RP.

Absorbent incontinence pad use and the association with urinary tract infection and frailty: A retrospective cohort study

BackgroundUp to 40% of adults over 65 years are full-time users of absorbent incontinence pads due to urinary incontinence. Simultaneously, urinary tract infection is amongst the most common hospital-acquired infection in older patients. ObjectivesTo explore the association between (1) full-time use of absorbent incontinence pads and urinary tract infection at acute hospital admission, (2) state of frailty and becoming a pad user during hospitalization, and (3) becoming a pad user and acquiring a urinary tract infection during hospitalization in older patients. DesignA retrospective cohort study. SettingAdmissions in an emergency department with transfers to geriatric, cardiac, infectious, or endocrinological wards from September 7th, 2017 to February 18th, 2019. Patients1,958 patients aged 65 years or more, having daily homecare or moderate comorbidity, hospitalized due to acute illness, and living in the municipality of Aarhus. MethodsThe study was conducted by two researchers reviewing the patients' electronic health records combined with data on frailty status from a geriatric quality database. In the electronic health records, data on baseline characteristics, absorbent incontinence pad use at admission and during the hospital stay, and urinary tract infection were obtained. ResultsFull-time users of absorbent incontinence pads had a higher probability of being admitted with urinary tract infection (Odds Ratio=2.00 (95% Confidence Interval: 1.61–2.49); p<.001). Patients identified as severely frail had a higher probability of becoming pad users during hospitalization (Odds Ratio=1.57 (95% Confidence Interval: 1.45–1.71); p<.001) compared to non/mild/moderate frail patients. Patients who became pad users during hospitalization had a higher risk of a hospital-acquired urinary tract infection (Odds Ratio=4.28 (95% Confidence Interval: 1.92–9.52); p<.001). ConclusionsThere was an association between the use of absorbent incontinence pads and the development of urinary tract infections in older hospitalized patients, both in full-time users and those who were frail and became pad users during hospitalization. These findings emphasize the need for further research on preventing urinary tract infections and unnecessary pad use in older patients.

Outbreaks of Acute Gastrointestinal Illness Associated with a Splash Pad in a Wildlife Park - Kansas, June 2021.

In June 2021, Kansas state and county public health officials identified and investigated three cases of shigellosis (a bacterial diarrheal illness caused by Shigella spp.) associated with visiting a wildlife park. The park has animal exhibits and a splash pad. Two affected persons visited animal exhibits, and all three entered the splash pad. Nonhuman primates are the only known animal reservoir of Shigella. The splash pad, which sprays water on users and is designed so that water does not collect in the user area, was closed on June 19. The state and county public health codes do not include regulations for splash pads. Thus, these venues are not typically inspected, and environmental health expertise is limited. A case-control study identified two distinct outbreaks associated with the park (a shigellosis outbreak involving 21 cases and a subsequent norovirus infection outbreak involving six cases). Shigella and norovirus can be transmitted by contaminated water; in both outbreaks, illness was associated with getting splash pad water in the mouth (multiply imputed adjusted odds ratio [aORMI]=6.4, p = 0.036; and 28.6, p = 0.006, respectively). Maintaining adequate water disinfection and environmental health expertise and targeting prevention efforts to caregivers of splash pad users help prevent splash pad-associated outbreaks. Outbreak incidence might be further reduced when U.S. jurisdicitons voluntarily adopt CDC's Model Aquatic Health Code (MAHC) recommendations and through the prevention messages: "Don't get in the water if sick with diarrhea," "Don't stand or sit above the jets," and "Don't swallow the water."†.

Menstrual Hygiene Management : A Study of Perception, Problem, and Practices Among Urban Slums of Delhi

Menstruation starts a new phase in every woman’s life and indicates the initiation of the reproductive period. However, this milestone becomes distinctly painful for women with a lack of awareness and availability of hygienic menstrual products. At many places, the taboo attached to menstruation further adds to this suffering. This scenario is common in the slum communities of developing countries. This study was conducted in the context of urban slums of Delhi, with an aim to understand and assess women’s problems, perceptions, and practices of menstrual hygiene management. It also studied the practices around different absorbents (cloth and pad) and compared the practices around absorbents amongst different user groups (cloth users, pad users, and both). For the study, 1,475 women from 14 urban slums of Delhi were surveyed. The findings of the study indicated the lack of awareness amongst the women regarding menstruation &amp; hygiene practices. Further, affordability, availability, and comfort came out as the key factors influencing the choice of studied absorbents, with affordability being the most important factor. Based on the study’s findings, significant implications for public policymakers and marketers were drawn.

Feminine Hygiene Products and Volatile Organic Compounds in Reproductive-Aged Women Across the Menstrual Cycle: A Longitudinal Pilot Study.

Background: Volatile organic compounds (VOCs) have been detected in feminine hygiene products (FHPs), especially in tampons and sanitary pads. However, little is known about whether menstrual products can contribute to VOC exposure in women. Our objectives were to: (1) examine the variations of urinary VOC concentrations during menstrual cycles; (2) evaluate the relationships between the use of menstrual products and urinary VOC concentrations; and (3) link urinary VOC concentrations to those measured in menstrual products. Methods: We measured urinary concentrations of 98 target VOCs in 25 reproductive-aged women with 100 repeated measures collected between October 2018 and February 2019. First-morning-void urine samples were collected four times for each woman during one menstrual cycle. Urinary VOC concentrations were measured using gas chromatography-mass spectroscopy. Results: Of 98 target VOCs measured in the urine samples, 36 VOCs were detected. We did not see statistically significant variations in VOC concentrations across the menstrual cycle. After multivariable adjustment, tampon users had significantly higher concentrations of 2-butanone (β = 1.58 log ng/g, 95% confidence interval [CI]: 0.16-3.00, p = 0.03) and methyl isobutyl ketone (β = 0.63 log ng/g, 95% CI: 0.03-1.22, p = 0.04), compared with pad users. Higher n-nonane, benzene, and toluene estimated from menstrual products were associated with higher urinary concentrations in women. Conclusion: The use of FHPs during menses might be a potential source of VOCs. A larger cohort study is warranted to confirm our results and evaluate clinical implications.

Perceptions, attitudes and practices of menstrual hygiene among rural and urban high school girls in a northern district of Kerala

Background: Menstrual hygiene practices are poor in developing countries and exist as an insufficiently acknowledged problem. The objective of this study was to assess and compare perceptions, attitudes, and practices among rural and urban high school girls.Methods: Cross sectional study was conducted in randomly selected 4 rural and 4 urban schools in Kozhikode district by cluster sampling method. 8th and 9th standard school girls who attained menarche were included in study. Data were collected by questionnaire.Results: Most of the girls gained information prior to menarche. Girls who wrongly perceived cause of menstruation was more in rural subjects compared to urban. Almost half of girls were either unaware or wrongly perceived source of bleeding. 50.9% urban girls were not mentally prepared for menarche as compared to 44.4% of rural girls. Majority of rural girls shared information with mothers compared to urban. 83.9% in rural and 78.2% urban had an attitude of menstruation as an unclean phenomenon. Majority had some form of restrictions during menstruation. Higher proportion of urban girls used sanitary pad compared to rural. 50.3% of urban and 42.8% of rural girls were disposing absorbent in to closet when at school. Among pad users, similar findings were noted at home also. A higher proportion of urban girls (55.9%) practiced good menstrual hygiene as compared to average hygiene practiced by rural girls (48.9%).Conclusions: The study shows significant rural-urban differences in perceptions, attitudes, and practices on menstrual hygiene in both areas.

The impact of menstrual hygiene management on adolescent health: The effect of Go! pads on rate of urinary tract infection in adolescent females in Kibogora, Rwanda.

To determine the rates of urinary tract infection (UTI) in adolescent users of menstrual pads versus non-users in a rural area of Rwanda. An interventional prospective cohort study was conducted at four secondary schools in the Western Province of Rwanda from May 12, 2017 to October 20, 2017. Inclusion criteria were female students aged 18-24 who were menstruating and volunteered to participate in the study. In total, 240 adolescent participants were assigned to two cohorts;120 received menstrual pads for 6months and the other 120 did not use pads. Baseline symptoms and urine cultures were obtained. Symptoms and methods of menstrual hygiene management were assessed and urine cultures were obtained every 2months. The primary outcome was the presence of UTI diagnosed by positive urine culture. Secondary outcomes were symptoms of UTI, vulvovaginal symptoms, sexual activity, dyspareunia, and self-reported sexually transmitted infection. Generalized estimating equations with nesting were used to assess associations of pad use with study outcomes. A total of 209 participants completed the study. There was no difference in rates of positive urine culture. Adecreased odds of vulvovaginal symptoms was found in self-reported"always" versus "never" pad users (odds ratio [OR] 0.64, 95% confidence interval [CI] 0.43-0.96; P=0.031). Despite not finding any difference in rates of UTI, the present study showed a decreased rate of vulvovaginal symptoms in users of menstrual pads. Further research investigating rates of genital infections in this population is thus necessary.

Prevalence of genital infections among women in reproductive age group in a rural area in North Kerala

Background: Genital infections, a major cause of illness among women in reproductive age group, affect their quality of life and social living. Early diagnosis and treatment of STI/RTI is also an important aspect in prevention of HIV transmission. As there are only a handful of studies in Kerala and none in Kannur assessing the prevalence, associated factors of genital infections and health seeking behaviour among women in reproductive age group, this study stands important.Methods: A community based descriptive study was conducted in Kulappuram area of Cheruthazham Panchayat which is the field practice area of Department of Community Medicine, Government Medical College, Kannur, Pariyaram from June, 2017 – July, 2018. A total of 404 women in reproductive a group were studied. A semi-structured, pre-tested questionnaire was used to collect relevant information. Data was analyzed using SPSS-version 19 software.Results: The mean age of the study population was 32.20±10.741years. 52.7% of the study population had genital infection, with 40.6% having symptoms of Reproductive Tract Infections (RTI) and 12.1%, symptoms of Urinary tract Infections (UTI). The presence of these was significantly associated with menstrual disorders, cloth as menstrual pad users, marriage, sexual activity and absence of infertility. Only 39.0% of the women with infections had sought treatment.Conclusions: Although there was high prevalence of genital infections among the study population, treatment seeking behaviour was very low. There is a need for sustained motivation and support to promote women to seek timely medical care than to suffer silently.

A study of menstrual hygiene and related personal hygiene practices among adolescent girls in rural Puducherry

Background: Adolescent population occupies 1/5th of world’s population and in India 20.9% of the population falls into this age group. Social prohibitions and traditional beliefs blocked the access to get the right kind of information to adolescent girls that led to poor hygiene practices. These practices results in harbouring of micro-organisms that increases susceptibility to genito-urinary infections. Hence this study was conducted to study the menstrual hygiene practices among adolescent girls and in rural Puducherry.Objectives: To study the menstrual hygiene practices among adolescent girls in rural Puducherry.Methodology: A community based descriptive cross sectional study was conducted in rural field practicing area of MGMCRI, Puducherry, from 15th of March 2013 to 31st April 2014 by using semi-structured questionnaire. 528 adolescent girls were included by complete enumeration.Results: Majority (89.2%) of the adolescent girls was using sanitary pads, fresh and reusable cloths were used by 6.6% and 4.2%, respectively. 65.3% girls changed their soaked absorbent 2-5 times in a day. Majority (60.8%) of the girls disposed their used absorbent by burying or burning. 67.9% girls were washing genitalia during micturition. 54.4% used soap and water for hand cleaning purpose and 1.4% used ash &amp; mud etc.Conclusions: Even though sanitary pad users were high, unhygienic practices were noticed, so more emphasize is needed to be given on awareness of menstrual hygiene practices among adolescent girls.Key words: Adolescent girls, menstrual health and hygiene, sanitary pads, genito-urinary illness.

An Exploratory Study of Skin Problems Experienced by UK Nursing Home Residents Using Different Pad Designs.

The primary aim of this study was to determine whether the severity of incontinence-associated dermatitis (IAD) among nursing home-based incontinence pad users varies between pad designs. A second aim was to examine the utility of a simple method for reporting skin health problems in which healthcare assistants were asked to record basic observational data at each pad change. Randomized, multiple crossover, observational, exploratory. Twenty-one men and 57 women using absorbent continence products to contain urinary and/or fecal incontinence were recruited from 10 nursing homes in London and the south of England. A day-time variant and a night-time variant of each of the 4 main disposable pad designs on the market for moderate/heavy incontinence were tested: (1) insert pads with stretch pants; (2) 1-piece all-in-one diapers; (3) pull-up pants; and (4) belted/T-shape diapers. All pad variants for day-time use had an absorption capacity of 1900 mL ± 20% (measured using ISO 11948-1 International Standards Organization) while the capacity of night-time variants was 2400 mL ± 20%. Each resident used each of the 4 pad designs (day-time and night-time variants) for 2 weeks and the order of testing was randomized by nursing home. Skin health data were collected using 2 methods in parallel. Method 1 comprised visual observation by researchers (1 observation per pad design; 4 observations in total over 8 weeks). In method 2, healthcare assistants logged observational data on skin health at every pad change for the 8 weeks. The primary outcome variable was severity of the most severe skin problem noted by the researcher for each resident, and for each pad design (method 1). Descriptive data on skin care methods used in the nursing homes were also collected using short questionnaires and researcher observation. No significant differences in the severity or incidence of skin problems were found between observations using the 4 pad designs. However, a wide range of skin conditions was recorded that made classification difficult; the skin was often marked with creases from absorbent products, temporary marks, and pink/purple discoloration. We observed few cases of the severe erythema, rashes, and vesicles that are commonly used descriptors in previous skin tools. Nevertheless, the collected data reflect an abundance of skin problems that were difficult to categorize neatly. Researcher observations (method 1) showed that nearly all the residents (96%) had at least 1 IAD skin problem recorded over the 8-week period and 64% of residents had at least 1 problem that was rated as maximum severity. Healthcare assistants logged skin problems on 6.1% of pad changes. The discrepancy between researcher and healthcare assistant data appears to be largely due to healthcare assistants sometimes discounting low-grade IAD as normal for that population. Incontinence-associated dermatitis is common among nursing home residents who use incontinence pads, and it is often severe. No evidence was found that any design of pad was more likely than any others to be associated with skin problems. The method devised to enable healthcare assistants to record basic observational data on skin health in the diaper area at each pad change (Method 2) proved simple to use but still resulted in substantial underreporting of IAD, suggesting that further work is needed to develop a tool that more successfully encourages them to log and treat IAD problems.

Menstrual Needs and Associations with Sexual and Reproductive Risks in Rural Kenyan Females: A Cross-Sectional Behavioral Survey Linked with HIV Prevalence.

Background: Females in low and middle income countries (LMICs) have difficulty coping with menstrual needs, but few studies have examined the social or health implications of these needs.Methods: Responses from 3418 menstruating females aged 13–29 years were extracted from an HIV and behavioral risks cross-sectional survey conducted in rural western Kenya. We examined sanitary products used, provision of products from sexual partners or from transactional sex, and demographic and sexual exposures.Results: Overall, 75% of females reported using commercial pads and 25% used traditional materials such as cloth or items like paper or tissue, with 10% of girls <15 years old depending on makeshift items. Two-thirds of females with no education relied on traditional items. Having attended secondary school increased the odds of using commercial pads among married (adjusted odds ratios [AOR] 4.8, 95% confidence interval [CI] 3.25–7.12) and single females (AOR 2.17, 95% CI 1.04–4.55). Married females had lower odds of pad use if they reported early (<12 years of age) compared with later (≥18 years) sexual debut (64% vs. 78%, AOR 0.45, 95% CI 0.21–0.97). Two-thirds of pad users received them from sexual partners. Receipt was lower among married females if partners were violent (AOR 0.67, 95% CI 0.53–0.85). Receipt among single females was higher if they had two or more sexual partners in the past year (AOR 2.11, 95% CI 1.04–4.29). Prevalence of engaging in sex for money to buy pads was low (1.3%); however, 10% of 15-year-olds reported this, with girls ≤15 having significantly higher odds compared with females over 15 (AOR 2.84, 95% CI 0.89–9.11). The odds of having transactional sex for pads was higher among females having two or more partners in the past 12 months (AOR 4.86, 95% CI 2.06–11.43).Conclusions: Menstrual needs of impoverished females in rural LMICs settings likely leads to increased physical and sexual harms. Studies are required to strengthen knowledge and to evaluate interventions to reduce these harms.

An analytical model of the motion of a conformable sheet over a general convex surface in the presence of frictional coupling

Friction is important across a wide range of applications. In particular, in health care, friction is thought to be the cause of some pressure ulcers in largely immobile patients, and abrasion due to friction contributes to the deterioration of skin health in incontinence pad users, especially in the presence of liquid. Some of these frictional forces are due to stress in materials wrapped around curved anatomical surfaces, which are often complicated shapes. The little work to date that has considered friction arising by this mechanism has assumed very simplified geometries (prisms, or even cylinders), which have enabled coefficients of friction to be extracted from laboratory tests on arms, but which are certainly not applicable to, for example, the diaper region. This work describes the development of a much more general mathematical model for friction between a draped, stressed sheet and the substrate, relating geometry, material mechanical properties and stress for essentially any convex surface. A general, wide, class of frictional interfaces is described (which includes those which obey Amontons' law), and the model is presented in differential form for a generic member of this class. Finally, an analytical solution is developed for convex, instantaneously rigid substrates isomorphic to the plane draped with a low-density sheet exhibiting no Poisson contraction, a fair approximation to some anatomical situations. The solution is explicitly calculated for a general prism and a general cone, producing expressions consistent with previous published models and with limited new experimental data.

How do patients with urinary incontinence perceive care given by their general practitioner? A cross-sectional study

Urinary incontinence (UI) is a widespread problem, affecting quality of life and leading to high costs, mainly caused by incontinence pads. It seems that, despite guidelines, many UI patients get pads from their general practitioner (GP) without adequate diagnostics or treatment. To assess what further treatment UI patients receive from their GP next to pads and to measure patient satisfaction with care. A postal survey among UI patients who started pad use in the past 12 months. Satisfaction with UI care. We analysed 208 questionnaires. 29.3% of pad users had no direct contact with their GP for a pad prescription. Of 147 UI patients who visited their GP 50.3% only got pads. 25% of patients was not satisfied with the information on UI received from their GP, especially younger patients, women, less healthy patients and patients with urgency UI. Dutch UI patients using pads experience suboptimal GP care and management. Factors identified through patient feedback should be used to improve quality of care for UI in primary care.

Investigating five key predictive text entry with combined distance and keystroke modelling

This paper investigates text entry on mobile devices using only five-keys. Primarily to support text entry on smaller devices than mobile phones, this method can also be used to maximise screen space on mobile phones. Reported combined Fitt’s law and keystroke modelling predicts similar performance with bigram prediction using a five-key keypad as is currently achieved on standard mobile phones using unigram prediction. User studies reported here show similar user performance on five-key pads as found elsewhere for novice nine-key pad users.

Self-care practices used by older men and women to manage urinary incontinence: results from the national follow-up survey on self-care and aging.

To estimate the extent to which self-care practices are employed by older adults with urinary incontinence (UI); to determine how demographic and functional status measures are associated with self-care practice use; and to explore the relationship between contacting a doctor and disposable pad use. A cross-sectional analysis of a national probability sample using multiple logistic regression. Responses of subjects with UI (n = 787) from the 1993-1994 National Follow-up Survey on Self-Care and Aging, a follow-up survey of older Medicare beneficiaries living in the community within the contiguous United States drawn in 1990-1991 Subject responses about UI, fecal incontinence, dressing, eating, bathing, Instrumental Activities of Daily Living (IADL), Mobility Activities of Daily Living (MADL), age, gender, place of residence, race, education, proxy response to the survey, and self-reported medical conditions. Self-care practices used by more than 25% of respondents with UI included using disposable pads, limiting trips, and limiting fluids. Among older adults with incontinence, more women used disposable pads (44.5%; 95% CI, 36.9-52.1) and performed exercises (14.2%; 95% CI, 9.7-18.9) than did men (15.1%; 95% CI, 8.1-22.1; and 4.3%; 95% CI, 1.0-7.7, respectively). Bi-variate analysis showed respondents with severe UI or fecal incontinence reported greater use of self-care practices. In multivariate models of the three most commonly used self-care practices, measures of UI severity were not always associated independently with self-care practice use, whereas ADL measures of functional status were. Disposable pad use was positively independently associated (OR 3.36; 95% CI, 2.01-5.63) in multivariate models with contacting a doctor about incontinence, even after controlling for age, gender, demographics, and self-reported medical conditions. Use by older adults of self-care practices to manage urinary incontinence is predicted independently in multivariate models by measures of functional status such as dressing, eating, bathing, IADLs or MADLs, but not by all UI measures. Disposable pad users had increased odds of contacting a doctor, suggesting that self-care practices and formal medical care are not always inversely related.

Use and costs of incontinence pads in female study volunteers

Objectives: We examined the use and cost of incontinence pads and the relationship to factors such as age, duration of incontinence, diurnal frequency, incontinence severity indices, urodynamic diagnosis, and quality of life. Subjects and Setting: Three hundred fifteen women with urinary incontinence who volunteered to participate in 1 of 3 incontinence studies (behavioral intervention, estrogen supplementation, or surgery) were analyzed. Subjects were community-dwelling women aged 45 years and older living in 3 cities in the southeastern United States. Methods: Pad use was recorded on a daily diary. The type of pads used was reported on the history. Average price of pad types was assessed at local stores and reported in 1995 dollars. Statistical comparisons used nonparametric methods. Main Outcome Measures: The number of pads used per week and annual cost of pads in 1995 dollars. Results: Seventy-seven percent of subjects used pads at baseline. Median cost per year for the entire cohort was $46 (interquartile range $3–$138). For pad users, median annual cost was $76 (interquartile range $36–$177), with costs being greater for women with detrusor instability than those with pure genuine stress incontinence (median $135–$138 versus $63). This increased cost was likely associated with the greater use of special incontinence products among women with detrusor instability. For the entire cohort, cost and usage did not differ by urodynamic diagnosis. Cost and pad usage were significantly associated with number of incontinent episodes and quality of life, but not with age, pad weight, or duration of incontinence. Conclusions: The majority of incontinent women who sought treatment used absorbent pads at least once per week, with menstrual pads being the most common type of pad. The annual cost of pad usage was not as high as in previous estimates.

Tampon Use in Young Women

ObjectiveTo study the prevalence of tampon use among young females, the factors and persons influencing this choice, the role of primary care physicians, and the potential association of tampon use with sexually transn1itted diseases and urinary tract infections. MethodsAn anonymous questionnaire regarding the use of feminine hygiene products was completed by 250 female college students between 17 and 21 years of age and 90 primary care physicians. Percentages were calculated for most outcome measurements and Fisher’ s Probability Exact Test was used to compare groups. ResultsOf the participants, 19% use pads, 29% use tampons, and 52% use both, with a total of 81% using tampons alone or in combination. The choice was influenced mostly by the won1an herself or her mother. Only 22% reported that their physician discussed tampon usage with then1. Incidence of sexually transn1itted diseases was not significantly different between those using pads and tampons. In the pad group, 12% reported urinary tract infections versus 32% in the other group (P = 0.007). Among physicians, only 30% said they discussed hygiene products, although 52% of them thought it was medically important. Of the female physicians, 71% use tampons alone or in combination; 29% exclusively use pads, with 92% citing fear of toxic shock syndrome as a reason for their choice. ConclusionThe majority of young women use tampons based on own decision or maternal influence for comfort, convenience, and appearance. Physician input in this regard is not routinely provided, probably because of lack of agreement about the importance of the subject among physicians. Based on participants’ report in this survey, the incidence of urinary tract infections seems to be significantly higher among tampon users than among pad users. Physicians should assume a more active role in explaining the appropriate use, benefits, and potential risks of feminine hygiene products.

The Epidemiology of Pad Consumption among Community-Dwelling Incontinent Women

The aim of the study was to explore the use of incontinence pads among community-dwelling women in a well-defined area of western Norway (total female population 122,516). In Norway incontinence aids are prescribed by doctors and paid for by the national insurance. Data were collected at local insurance offices and through interviews with an age-stratified (20-89 years) random sample of incontinent women. Identified were 2,991 pad users (1-year period prevalence 2.4%). Prevalence rose sharply with advancing age, reaching a maximum of 30.1% in the 90+ age group. Median number of pads used per day was 1.8. Middle-aged women used fewer and smaller pads than the rest. When compared with the number of pads actually delivered, the incontinent women tended to overestimate their consumption.

Hymenal findings in adolescent women: Impact of tampon use and consensual sexual activity

We undertook a prospective study of 300 postmenarcheal female subjects (median age, 18.0 years) to examine (1) the relation of tampon use, sports participation, prior gynecologic examination, and consensual sexual activity to hymenal anatomy, (2) the factors leading to choice of tampons by girls not sexually active, and (3) factors related to ease of gynecologic examination. The sample included 100 subjects in group 1, who denied sexual intercourse and used only pads for menses; 100 subjects in group 2, who denied sexual intercourse and had used tampons; and 100 subjects in group 3, who gave a history of sexual intercourse. Sexually active subjects (81%) were significantly more likely than tampon users and pad users to have "complete clefts" in the lower hymen between the 2 o'clock and 10 o'clock positions ( p <0.001); tampon users were not significantly different from pad users (11% vs 5%). In subjects who were not sexually active, the presence of these complete clefts was not related to participation in sports or to prior pelvic examination. Although median hymenal opening diameter differed in the three groups (1.2 cm for group 1 vs 1.5 cm for group 2 vs 2.5 cm for group 3; p <0.0001), the ranges of measurements were wide. Tampon users were significantly more likely than pad users to have mothers and friends, but not sisters, who had a favorable attitude toward tampon use. The best predictors of tampon use in a multivariate model were a favorable maternal attitude (odds ratio [OR], 5.3; 95% confidence interval [CI], 2.4, 12.1) and friends' use of tampons (OR 7.9; 95% CI 3.5, 18.1). Only 26% of speculum examinations in pad users were rated as easy compared with 56% of examinations in tampon users and 81% in sexually active young women ( p <0.001). The best predictors of ease of speculum examination were sexual activity (OR 15.9; 95% CI 1.9, 135.3) and tampon use (OR 3.6; 95% CI 1.0, 12.7). This large sample should provide useful data for physicians who testify in sexual assault cases and gives new information on the predictors of tampon use and ease of gynecologic examination in young women. (J P EDIATR 1994;125:153-60)