Written by Cath Williams, Continence Service Manager
Hannah Braine, Continence Advisor
Alison Doherty, Senior Medicines Management Pharmacist
Produced December 2007
Review date December 2009
Document No: MM/Guid/002.2
Please note that all prices were correct at time of print; however these are subject to change. Refer
to the latest version of the Drug Tariff for up to date prices (www.ppa.org.uk)
1 Introduction 4
Indwelling catheters 5-6
Catheter valves 7
Male Sheaths 7
Intermittent catheters 8
4 Catheter Drainage Bags
Day bags 8
Night bags 9
5 Leg Bag Accessories 10
6 Lubricants 10
7 Catheter Maintenance Solution 11
8 Urinals 11
9 Drug Treatments
Urinary frequency and urgency 12-13
Stress urinary incontinence 13
Nocturnal polyuria 13
Faecal incontinence 15
10 Disposal continence products 16
Appendix 1 NSPCT Continence Service Team
Appendix 2 Catheter Blockage
Appendix 3 Criteria for issuing Disposable Continence
Guidelines for Use of Continence Products
These guidelines have been prepared by the Continence Service and the
Medicines Management Team, North Somerset PCT, to provide information
about urological products and medicine that are used regularly and
recommended by Continence specialists in this area. Products selected
have been chosen for specific reasons.
This document is intended to give guidance on products to use for the
majority of patients. However if the products listed are unsuitable or you
would like to use an alternative, please contact the continence service for
advice and samples to prevent ordering a box only to find that it is not
suitable for the patient, and the remainder wasted.
Medical representatives regularly target Care Homes, often leaving samples
or offering free training, delivery services etc. Continence advisers have
samples of products and can also offer independent training.
For further information and advice on individual patients or product choice,
please contact the NSPCT Continence Service. The service covers North
Somerset, offering advice and support to both adults and children (see
Appendix 1 for further details)
Considerations prior to catheterisation
• Is catheterisation the best way of managing the situation?
• Before choosing a catheter consider how long you expect the patient to be
• For patients who are permanently catheterised, a long-term catheter is
recommended with a maximum use of 12 weeks.
• For patients who are catheterised for up to 4 weeks (e.g. trial period), a
short/medium term catheter may be suitable. If a short/medium term catheter is
used it must be clearly documented.
• Review whether a catheter is still required at each change.
• If patients have had urinary tract infections following previous catheter changes,
consider the use of a prophylactic antibiotic. Consider the possibility of an
alternative catheter (see notes below)
Except for special cases that are likely to have been discussed with the urology
department, the following criteria are recommended:
• 10 ml balloon should always be used.
• Male use size 14-16ch.
• Female use size 12ch.
• Male, use male length.
• Female, use female length, unless for a large lady.
• For Supra-pubic catheters, use male length 16CH.
• Not all products are licensed for supra-pubic use, therefore check product
• If the patient has a latex allergy, use silicone.
• Use anaesthetic gel for all urethral catheterisations
• If prone to blockage, see separate guideline (Appendix 2).
• Contemporaneous notes must be kept including a catheter history. This must
be reviewed and catheter changes planned accordingly.
• Each patient should keep 2 spare catheters in stock in case of blockage. The
first time a patient is catheterised, three catheters should be prescribed, one for
use and two for spare. From then on only one catheter should be prescribed at
• Remember to order a suitable anaesthetic gel and check that the catheter is
either pre-filled or that sterile water and syringe are supplied.
A number of product companies offer a prescription collection and delivery service
for continence products (catheters, sheaths, bags etc.) These companies will
provide products from all companies and can be arranged over the telephone and
delivered within 48 hours. If you feel this service would benefit your patient we
would recommend the following companies. If you would like further information,
please contact the continence service.
o CHARTER HEALTHCARE (Coloplast) 0800 132 787
o SCRIPTEASY (Rochester) 0800 0121 699
However, please note, a prescription should be generated by a GP practice
(and authorised by the GP) prior to any ordering/delivery of appliances to
patients. This is for a number of reasons including preventing excessive
ordering (both quantity and frequency).
Catheter Male Female Comment/
Cost Code Cost Code Expected
Bard Biocath £8.29 D2264+ size £8.33 D2268+size 1 catheter
Aquamatic (14-22) (12-22) every 11
Hydrogel coated latex - weeks
Coloplast Folysil £5.97 AA81 + size £5.97 AA85 + size
X-tra (12-20) (12-18)
Silicone catheter with
Rusch PTFE £2.10 D1265AL +size As for male Short term use
Catheter (12-22) 1 catheter lasts
With water up to 4 weeks
Alternatives that may be considered according to clinical need are:
Coloplast Folysil open £5.97 Male length 2717106 Silicone 12 week
ended 12ch-18ch catheter
Bard I.C. silver alloy £9.41 Male Female Hydrogel coated latex
D236512s D230912s Licensed for 4 weeks
These are useful post-retention to try and regain bladder function and prevent the
need for wearing a leg bag, thus improving body image. However, the patient or
carer needs to be mentally aware to prevent overfilling of the bladder.
• Must not be used for patients post-radical prostatectomy.
• Are not recommended for patients catheterised due to incontinence caused by
urgency or small bladder capacity.
• Should be changed every 7 days or before taking a CSU (Catheter Specimen
• Most patients connect to a night bag to prevent waking at night.
Valve Cost Code Comment
(per box 5)
Bard Flip-flo £12.93 BFF5 Maximum 1 box
(Lever action tap) per month
Coloplast Simpla £12.69 T180
(Lever action tap)
Manfred Sauer £10.95 CVS
• These are single use, adhesive sheaths, applied to the penis then attached to a
drainage bag. Please contact the department for measuring guides and
teaching application technique to patients.
• A sheath should be changed after 24 hours, if a patient has to use more than
2 daily they should be referred to the service. Expect an average use of 1 box
of 30 per month.
Sheath – all have Cost Code and size Comment
self adhesive liner (box 30)
Coloplast Conveen £48.90 Standard length: 25-22025/30- Silicone, antikink
Optima 22030/35-22035/40-22040 design. May be
Shorter length: 21-22121/25- easier to apply due
22125/30-22130/35-22135 to pull down tag.
Rochester Medical £47.22 Style 1 - Standard Silicone with Aloe
Clear Advantage with 24mm-325-2722,28mm-326- Vera to protect the
Style 2 – shorter pop on
• Intermittent self-catheterisation (ISC) is used for patients with a neuropathic or
hypotonic bladder associated with poor bladder emptying or urinary retention.
• ISC avoids the need for other bulky external appliances such as drainage bags,
increases the self-confidence and sexuality for these patients. They can also
help reduce CAUTI’s (Catheter Associated Urinary Tract Infections). Intermittent
catheters are single use items. To use please follow manufacturers instructions.
• How many a patient uses each day depends on the medical reason for ISC,
ranging from 1 up to 5 daily.
• The continence service will provide teaching, support and assistance with
product choice to suit the patients individual need.
Single use Cost Code Comment
Catheter (box 25) Male Female
AstraTech Lofric £30.98 904000- 944000- If ordering more
than 6 boxes a
Plus 904800 944600 month – seek
Coloplast £26.89 28410 - 28510- advice
Speedicath 28418 28516
Hollister £65.93 (£2.64 10-94104 With urine bag
each) 12-94124 attached, suitable
for teaching but
14-94144 not long term use.
Catheter Drainage Bags
• Maintaining a closed system (i.e. not removing the leg bag), the risk of infection
• Leg bags should be changed every 5-7 days.
• In general short tube bags are suitable for women (the bag secured to the
thigh) and long tube bags for men (the bag secured to the calf). There may be
occasions where men may prefer to wear the bag on the thigh, such as in
summer when wearing shorts, or when mobility is poor as it may be easier to
drain the bag from this position.
• 500ml bags have been listed below, as this is the most common size used.
Other volume leg bags are available, 350ml, 750ml and up to 1300ml for
• A number of different taps are available. The choice of tap depends on the
patients own manual dexterity and mobility. Some patients will require taps that
are difficult to open (e.g. those with a mental disability with a habit of opening
the taps themselves), and some that are easy to open (e.g. patients with poor
• The day bag must remain connected overnight and the night bag attached to it.
Leg Bags Cost CODE Comments
for daytime use (box 10)
SHORT TUBE – 500ml bags. Expect to order 1 box every TWO months
Unomedical £25.43 45-05 SVC Lever tap
LONG TUBE - 500ml bags. Expect to order 1 box every TWO months
Unomedical £25.43 45-06 LVC Lever tap
• Non-drainable bags (also known as Single use drainable bag) require changing
daily and are more expensive than drainable bags.
• Non-drainable bags are recommended for catheterised residents of care
homes to reduce the risk of cross infection and to prevent the need for night
bags to be left in bedrooms during the day. 30 bags should be prescribed at
a time, enough for one month.
• Drainable bags only require changing weekly; therefore one box of 10 bags
should last 10 weeks. Patients and carers should bear this in mind when
ordering repeat prescriptions for residents, having a spare box in stock is not
necessary. One box of 10 bags should be the maximum prescribed at one
• Sterile night bags must be used for bed bound patients who have night bag
permanently connected to catheter. Non-sterile bags may be attached to day
bag overnight. These non-sterile bags must not be connected directly to the
Night Bags Cost Code Comment
2000mls (box 10)
Non-Drainable (or single use drainable) Change Daily
Expect to order 3 boxes per month
Unomedical Easi £3.18 47-60 LBH 2 litre bag do not
MT connect to catheter
Drainable (Multi-use) Change Weekly
Expect to order 1 box every two months
E4 Night bag £11.23 46-20 IDC 2 litre bag with tap,
E4 Careline £11.42 45-20 IDC 2 litre bag, non sterile
Leg Bag Accessories
• Generally we recommend leg sleeves rather than straps, as they hold the
catheter more securely, thus preventing traction and making the wearer more
comfortable. These sleeves are washable, one pack of 4 should last around
• Please ensure correct measurement of sleeve is used for either calf or thigh as
• Each box of bags should contain a pair of standard straps.
• Extra security leg straps are useful where a patient complains of the catheter
rubbing or pulling, or suffers a lot of spasms. One pack of 5 should last
around a year.
Item Cost Code
Leg bag sleeves
(1 box of 4 every 3 months)
Bard Urisleeve £7.93 per 4 sleeves 150111 – Sm (24-33cm)
150121– Md (35-55cm)
150131 – Lg (40-70cm)
Extra Security Leg straps
(1 box per year)
Bard Comfasure £13.86 per 5 Small
Retainer strap £13.86 Adult
Coloplast Simpla G- £13.52 per 5 383001
Anaesthetic Antiseptic Lubricant
• An anaesthetic antiseptic lubricant must be used for all urethral catheterisation
according to the PCT policy.
• This provides lubrication and dilates the urethra as well as having antiseptic
properties, which helps to reduce pain, trauma and infection.
Item Cost Comments
Clinimed Instillagel £15.76 Male catheterisation
11ml pre-filled syringe
Clinimed Instilagel £14.05 Female catheterisation
6ml pre-filled syringe
• In a nursing home where stock for male and female catheterisation is kept
together it may be appropriate to order only 11ml syringes to prevent under
dosage of Instillagel.
Catheter Maintenance Solution
• Catheter maintenance solutions may be used a part of a treatment regime for
catheters that block due to crystallisation.
• Please refer to Appendix 2 for guidance.
Item Cost Code Comments
Braun Urotainer Twin £4.25 9746625 6% citric acid
Braun Urotainer Twin £4.25 9746609 3.23% citric
Solution G acid
• Urinals may be use for patients assessed as having functional incontinence
where the urinal is part of their treatment or management plan.
• The urinals suggested are attached to a drainage bag which removes the
volume from the jug, thus preventing spillage and reducing cross infection.
Item Cost Code
Beambridge Lady jug £14.25 1425
Beambridge Male drainable £13.24 1324
The following part of the formulary gives guidance on some of the drug treatments,
which may be used in continence. This is intended as a guide and is based on the
available guidance from NICE.
Urinary frequency and urgency
(Due to involuntary detrusor contractions)
Initial assessment including bladder scan
Pelvic floor exercises
Bladder re training
Lifestyle e.g. caffeine reduction, weight loss
First line treatment
As recommended in the NICE Guideline* for women with an overactive bladder or
mixed urinary incontinence
*www.nice.org.uk CG40 issued Oct 2006
Drug Indication Dose Pack Comment
Oxybutinin Urinary frequency, 2.5 –5 mg, 2-3 56 tabs Common side
(oral) urgency, bladder times per day up £5.42 effect is dry
spasm due to to 5mg 4 times mouth
catheterisation per day
The following antimuscarinic drugs may be considered if the patient does not
respond to Oxybutinin or if the side effects are intolerable. See the latest edition of
the BNF (www.bnf.org.uk) for contra- indications, side effects etc and the latest
edition of NSPCT Drug Formulary for drug choice preferences
Drug Indication Dose Pack Comment
Solifenacin Urinary frequency, 5mg daily up to 30 (5mg
Succinate urgency and urge 10mg daily tabs)
(Vesicare ) incontinence £27.62
Tropsium Urinary frequency, 20mg twice daily 60
Chloride urgency and before food (20mg
(Regurin ) incontinence tabs)
Tolterodine Urinary frequency, 4mg once daily 28 (4mg
Tartrate urgency and tabs)
(Detrusitol XL ) incontinence £29.03
Darifenacin Urinary frequency, 7.5-15mg daily 28
Hydrobromide urgency and (7.5mg &
(Emselex®) incontinence 15mg
If Oxybutinin is effective but side effects are not tolerated or in patients with
swallowing difficulties, the following transdermal preparation may be a more
Drug Indication Dose Pack Comment
Transdermal Urinary frequency, 1 patch applied 1 box 8
Oxybutinin urgency and 3-4 days patches
preparation incontinence £27.20
Stress urinary incontinence
Recommended treatment is pelvic floor muscle treatment for women with stress
Treatment with Duloxetine is not recommended for first or second line
treatment, but may be considered by the consultant.
This is a condition where urine output is excessive only at night. The total 24 hour
output is within normal limits.
Restrict caffeine, alcohol and fluids especially in the evening
Compression stockings for fluid retention or oedema
Leg elevation in afternoon
Diuretics mid to late afternoon may increase urine output during early evening
and reducing nocturia.
Desmopressin may be considered to reduce nighttime urine output. It is not
licensed in the over 65’s
First line management should be education and advice on diet and fluid intake for
all constipated patients. A prescription is not always necessary.
For further info see latest version of NSPCT Drug Formulary (www.northsomerset.nhs.uk)
Drug Information Side-effects Dose Pack size /
Increase weight and water absorbency of the stool
Ispaghula husk o Suitable for stool Bloating, 1- X 30 sachets
type 5,6,7 (Bristol abdominal sachets/day £2.12
o Can be used long
discomfort with at least
term. 1 glass of
o NOT suitable for water
or existing bowel
Stimulate nerves to produce colonic contraction and decrease fluid re-absorption
Senna o Suitable when Abdominal 7.5mg tabs: 20 tabs 29p
transit time cramping 2-4 at night
impaired due to
o Secondary to
o Suitable for acute
o NOT for long term
Docusate Up to 100mg tabs
sodium 500mg daily £2.40 (30)
Co-danthrusate o ONLY for use in 1-3 caps at 50mg/60mg
terminally ill night caps £13.61
patients of all
Work by retaining fluid in the bowel or changing water distribution within the faeces –
they are not absorbed from the gastrointestinal tract.
Lactulose o Suitable for stool Flatulence, 15ml twice a 500ml £2.43
types 1,2,3 cramps, day
o For chronic distension
Drug Information Side-effects Dose Pack size /
Movicol o Suitable for stool Abdominal 1-3 sachets 20 sachets
types 1,2,3 distension, daily for £4.63
pain, nausea chronic
o For chronic or
Enemas & Suppositories
Micolette micro- o Caution in the - 5-10ml 5ml single dose
enema 5ml elderly and disposable pack
Glycerol o Suppository - Adult: 4g 12 x 4g
supposotories should be £1.83
water before use
Advice on Faecal incontinence
(From NICE Guidelines on Faecal Incontinence 2007**)
** www.nice.org.uk CG49 issued June 2007
Anti-diarrhoeal medication should be offered to patients with loose stools and
associated faecal incontinence, when other causes of loose stools have been
Loperamide is the anti-diarrhoeal of first choice and can be used long term in
doses from 0.5-16mg daily, or as required. Patients who are unable to tolerate
loperamide may be offered codeine phosphate or co-phenotrope. Loperamide
should not be used in the following circumstances:
o Hard or infrequent stools
o Acute diarrhoea without diagnosed cause
o An acute flare up of ulcerative colitis
When used it should be:
o Introduced at a very low dose and the dose escalated as tolerated and until
desired stool consistency is achieved.
o Taken as required by the patient with faecal incontinence
o Advised that patients can adjust the dose in response to stool consistency and
If a finer modification of doses is required, loperamide syrup could be considered.
Disposable Continence Products
The continence service manages the product contract. Hartmann Ltd currently
supplies products to North Somerset patients. The criteria for issuing products may
be found in Appendix 3. All patients will have a continence assessment and the
appropriate treatment plan commenced. Where this fails or is inappropriate,
products MAY be supplied. The only exception to this is patients within their final
weeks of life who require urgent products.
Products are supplied on a named patient basis; therefore patients may need to
supply their own products whilst awaiting assessment and delivery.
Patients who are able to attend a clinic may be referred or refer themselves to the
service, they will then be offered an appointment in one of a number of clinic
locations in North Somerset. Patients who are housebound should be referred to
the District Nursing service for assessment.
NSPCT Continence Service Team
The team can be contacted at:
Pill Health Clinic
3 Station Road
Pill BS20 0AB
Phone: 01275 373104
Cath Williams Continence Service Service manager and
Manager continence advice for
adults and children
Hannah Braine Continence Advisor Continence advice for
adults and children
Trish Smith Continence Advisor Continence assessment
in residential homes
Mary Oaten Continence Service Continence product
Manager – Nursing management nursing
Sue Liddeatt Clerical Officer Bookings, administration
for continence service
Catheter Blockage Management
Catheter in situ
Establish history & usual time in situ
Persistent blockage –
On removal, cut catheter open
2. Occasional blockage
4. If blockage visible e.g.
1. Draining well o Eliminate simple 3. If internal lumen clear crystals
mechanical o Eliminate simple o Obtain CSU – State if
o Conservative obstruction mechanical obstruction urethral/ supra-pubic
management E.g. Constipation (1, – see box 2 Request culture
o Encourage 2); Kinked tubing; o Presume bladder o Commence appropriate
fluid intake Crossed legs (3, 4); spasm. (3, 5, and 6) antibiotics
2000ml Restrictive clothing; o Consider o Change catheter midway
o Avoid Over full drainage anticholinergic e.g. through course of
constipation bag. oxybutynin providing antibiotics, regardless of
o Position bag higher or patient does not have perceived need.
much lower than glaucoma. o After antibiotics finished,
bladder (5) commence daily pH test.
(Try to keep to the same
6. Problems time of day)
persist o pH < 6.7 – no washout
5. If blockage persists consider: required.
Liaise with pH > 6.8 – “G” washout
continence /urology o Silicone catheter (wider internal lumen to allow pH > 7.7 – “R” washout
team. greater drainage) check manufacturers (5, 7)
recommendations for Supra-pubic use
o Short term PTFE catheter- change every 28days
o Silver coated catheter- change every 28 days
Catheter Blockage Management
Catheter management makes up a significant part of a community nursing caseload, particularly emergency callouts. In order to solve the
problem an understanding of the cause is necessary. The flow chart is designed to provide a brief overview of the likely causes and
suggested ways to manage the catheter which persistently blocks. The flow chart is not exhaustive, and further reading is recommended.
1. Wells M. (1996) the development of urinary continence and management of incontinence. In Norton C ed Nursing for Continence 2nd
2. Rigby D. (1998) Long term catheter care. Professional Nurse Study Supplement Feb 13(5) s14-15
3. Lowthian P (1998) The dangers of long term catheter drainage. Br J Nurs 7(7) 366-79
4. Bard Ltd (no date) A guide for Nurses Management and Care of Catheters and Collection Systems Bard Ltd Crawley
5. Williams C, Tonkin S (2003) Blocked urinary catheters: solutions are not the only solution. Br J Com Nurs 8(7) 321-326
6. Pomfret I (2000) Catheter care in the community. Nurs Stand 14(27) 46-51
7. Morris NS, Stickler DJ (1998) Encrustation of indwelling urethral catheters by Proteus mirablis biofilms growing in human urine. J Hosp
Infect 39(3) 227-234
Bladder washouts (Catheter Maintenance Solutions) commercially available:
Solution G – Citric acid 3.23%, magnesium oxide 0.38% sodium bicarbonate 0.7% disodium edetate 0.01%
Bard Optiflo G, Braun Uro-Tainer Suby G.
Solution R – Citric acid 6%, gluconolactone 0.6%, magnesium carbonate 2.8%, disodium edetate 0.01%.
Bard Optiflo, Braun Uro-Tainer Solution R.
For further help or advice please contact North Somerset PCT Continence Service 01275 373104, or Weston General Hospital Urology
Dept 01934 647149
Appendix 3 Criteria for issuing Disposable Continence Products
Guidance for Provision of Continence Products- Clients living at home and in Residential Care and Nursing Care
Clients in Nursing Care are assessed by nursing home staff, with support from the Funded Nursing Care Team. Housebound
clients in their own homes are assessed by district nurses. Clients able to reach a clinic are seen by the Continence Advisor.
The only patients eligible for products without first undergoing assessment and treatment are palliative patients, with an anticipated
life expectancy of less than 16 weeks.
For all other patients, please follow the guidelines below.
This guideline is to be used in conjunction with the Continence Product Requirement Form (PRF), available from the continence
All patients must have an assessment prior to pad provision, and must be commenced on an appropriate care pathway. Pads
should only be provided at the appropriate time as indicated in the care pathway; namely for intractable incontinence.
For patients in their own homes and residential care there is an upper limit of 3 products in 24 hrs.
Eligibility Criteria for Pad Supply
Pads are provided only after assessment and commencement on an appropriate care pathway.
There is an upper limit of products
o Adults – own homes & residential homes – no more than 3 pads per day
o Children (>4yrs old) – no more than 4 pads per day
Pads will not be supplied:
o Post-surgery, unless stated by their consultant that no further improvement is likely. (Usually 6 mths post-op)
o Stress incontinence, unless compounded by other problems i.e. inoperable prolapse.
o Rectal or vaginal bleeding
o Anyone leaking less than 150mls per day
Patients who do not fit the criteria are expected to buy their own pads. Advice can be given on where to buy products, treatments
and management options.
Name of Description of Pad Usage Working Cost per
Hartmanns Pad Absorbency Pad
Stramplepeter This is a straight product with Soft-Solid faecal problems only, or faecal problems 150mls 5p
no plastic backing. and catheter.
White If a patient uses “Kanga” pants they can use these
products, although the pants are not provided.
Couche This is a straight product with Soft-Loose faecal leakage, with mild urinary leakage. 160mls 5p
plastic backing, sticky strip.
Molimed Midi Shaped pad, plastic backed, Heavy stress leakage with other disorders, eg 210mls 7p
sticky strip. White inoperable prolapse. (Patients with uncomplicated
stress leakage should purchase their own products)
Frequency volume chart indicates leakage greater
than 250mls per day (not in one episode)
Molimed Maxi Shaped pad, plastic backed, Urge incontinence, or complete functional or 400mls 10p
sticky strip. White neuropathic bladder emptying of 200-400ml per void
Moliform Normal Large shaped pad, no sticky. Urge incontinence or complete functional or 540mls 15p
Yellow neuropathic bladder emptying of 350-500ml per void.
May also be used for large faecal incontinence of
Close fitting pants must be worn
Moliform Plus Large shaped pad, no sticky. Urge incontinence or complete functional or 703mls 16p
Green. neuropathic bladder emptying of 500-750 ml per void,
or 2 or more voids between pad changes (eg
overnight). May also be used for large faecal
incontinence of soft-solid stool.
Close fitting pants must be worn
The measurement of hips/waist is vital for good fitting of the following products
Molicare (comes as extra All-in-one, (nappy Loose frequent faecal leakage, with or without Working
& plus) type) urinary leakage. capacity
Urinary incontinence of more than 300mls where depends upon
Waist/Hip Blue the patient size
Extra Small 40/70cm a)Removes other pads
Small 50/80cm Must have correct b) Is not successful with a toileting regime Ex Sm 475ml
Medium 70/120cm waist/hip Small 551ml 21p
Large 100/150cm measurements These products fit around the waist and hips so Med 802ml 21p
Extra Large 140/175cm these measurements must be included on the Large 993ml 22p
form. If measurements are between sizes, go Ex Lge1400ml 26p
Ensure purple tabs are pulled to activate stretch
before application. Point bottom tab up, top tab
down. Do not tug white material too hard.
Moliflex All in one (suspender Urinary incontinence of more than 300mls per void
Hip belt type) pad. Blue where the patient can sometimes be encouraged 600mls
Medium 70 -110cms to use the toilet. The patient should be able to Med 34p
Large 85-125cms stand, with one carer to adjust the clothing to help
These products fit with toileting. Large 39p
around the hips so These products are also useful when patients
this measurement need changing in the hoist, or are bedbound.
must be included on
Molinea Plus Underpad Disposable Bed Should only be ordered for palliative patients, or 387mls 11p
Sheets following discussion with the Continence Advisor.
57x60cm If products are required as procedure pads, eg for
giving enemas, or under leaking leg oedema then
this should be purchased separately from the
district nursing budget, or by the individual home.
All other products which are shaded on the PRF are for use where other products have failed and only following
individual discussions with the Continence Advisor
All the products above are available (as appropriate for size and amount of leakage) for children aged 4 and over who have a
physical or learning disability where it is unlikely they will achieve dryness. Mild delay is not an eligible criterion.
Children are entitled to no more than 4 products per 24hrs.
Children will be eligible for pull-ups during the day for a 6 month period, only if the following criteria can be met:
1. The child is developing toileting skills – and on a structured toileting programme
2. The child has no callipers
3. The child is continent of faeces
(Ref Petterson L. et al, A multicentre evaluation of disposable pads for incontinent children. Short Report, International Continence
Society UK 2004)
Name of Pad Description of Pad Usage Working Cost per
Fixies Unisex disposable Children with urinary and faecal incontinence.
Nappy Children with urinary incontinence only may prefer Maxi 597ml 15p
Maxi 7-18kg the Molimed/Moliform range which can be inserted Maxi + 637ml 16p
Maxi Plus 9-20kg in normal pants Junior 711ml 16p
Junior 12-25kg XXL 693ml 19p
XXL 16kg +
Fixies Training Pants Unisex Disposable See criteria above 466 ml 23p
One size 12-25kg