The BioDerm external continence device: Evidence and assessment for use

Abstract

Urinary incontinence is a common problem experienced by many people with neurological conditions such as Parkinson's disease, multiple sclerosis, stroke and spinal cord injury and has a signifi cant impact on quality of life. Such patients may benefi t from using products designed to contain the urine that is voided involuntarily, often used in conjunction with medication or behavioural methods to promote continence. Until recently patients have had to rely on body worn pads and pants and male patients have also had to option of wearing a condom catheter or urinary (penile) sheath. This article will review the problems encountered when using urinary sheaths and will consider BioDerm as a possible alternative to this external condom catheter based system of urinary drainage for male patients.

Managing urinary incontinence with BioDerm® external continence device

“…BioDerm only attaches to the glans penis, and the hypoallergenic hydrocolloid strips are malleable (thus making them better able to accommodate changes in penile size). Therefore, it is suitable for patients who experience frequent erections (Pomfret, 2006;Woodward, 2007), including early wakening erections which are common in patients with neurological disease. Patients who have experienced ulceration or allergy with other urinary sheaths may also find the product useful (Vaidyanathan et al, 2005).…”

“…However, two authors (Kyle, 2007;Woodward, 2007) describe how initial patient feedback appears positive. Woodward (2007) states that patients who have been using the device in the UK include those with Parkinson's, MS ■ ■ Table 2. Care for individuals using containment products: performance criteria 1.…”

“…Patients have reported a benefit from a feeling of increased security and this has led to a return to social activities for some. Woodward (2007) also points out that although costs savings have been demonstrated in a number of cases owing to increased wear times and reduction in the number of changes required as a result of devices falling off, there is a need for large scale comparative clinical trials to be undertaken.…”

“…Patients must have reasonable manual dexterity and eyesight in order to be able to attach it to the glans penis. In addition, it is a little more involved than the majority of penile sheath systems to fit (Woodward, 2007) and patients may therefore be more reliant on carers to achieve a good fit. This is especially important as if it is not applied correctly it has more of a propensity to fall off.…”

“…If application is generally not good and it does fall off regularly this can lead to a lack of confidence by both the patient and the carer (professional and non-professional) into its efficacy and reliability. Woodward (2007) describes how, on occasions, patients wearing this device and who have a sudden large diuresis may experience a feeling of suction on the tip of the penis, which tends to be more noticeable than in patients who experience this sensation when wearing a more traditional form of sheath. As this device is applied directly to the glans penis, Vaidyanathan et al (2005) suggest that it is not suitable for patients who have phimosis, catheter-induced hypospadias, ulceration of the external urethral meatus or infection of the glans penis or prepuce.…”