In 2013 I had an accident resulting in spinal injury at the base of my neck with paralysis from there down, spasticity (muscle contractions and spasms) and double incontinence. Both my anus and my urethra have been left closed except with manual intervention.  I hardly ever pass urine via the usual route (I have a suprapubic catheter passing directly into my bladder about 2 inches below my navel); nurses give me bowel evacuations on alternate mornings in bed before two carers come to get me up; one nurse holds me on my left side while the other takes my knickers down and pokes her gloved finger up my bum to get out as much faeces as possible.    

I am lucky to have some lovely nurses who make this very pleasant.  For example, this morning the first one greeted me with 'Good morning my lovely' as she gave me a hug and kissed me on the cheek.  She combed my hair with the comb on my bedside table, while the other nurse rolled back the bed sheets, helped turn me over and took down my knickers.  'You've got a lovely bottom.  It's a pleasure to do my job for you'.   'Not half as much as it is for me' I thought to myself.   

Several of my nurses show similar affections.  Some take off their uniforms in hot weather.  I guess my nurses see me as an old, broken wreck needing to be cheered up and safe from having any romantic ideas about their kindness.           

Knickers  and Pads                         

Many people are reticent to talk about bodily leakage. Many kinds of underwear, both male and female, have a double layer or gusset where there is likely to be a small amount of leakage.  I don't know why the gusset in men's underwear does not extend as far back as the gusset in many kinds of ladies' panties.

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82633431_010_4516.jpg (602×900) (allpantypics.com)

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There is some imprecision in defining what is incontinence.  How much leakage makes someone incontinent?  I have used pads for both outlets since long before I was diagnosed as incontinent at the time of my injury. 

For those who are more heavily incontinent, protective wear is often thought of as being in two groups: pull-ups and diapers. Pull-ups are those which are held in place by a continuous waistband like normal underwear; diapers are those which open at the waist. Each of these two main groups have many varieties. Some of those with a continuous waistband are sometimes referred to as 'diapers'.  Whether they open at the waist makes some difference to how they are put on and changed and to their appearance: pull-ups are closer in appearance to normal underwear, a significant consideration to some users. It is also related to their capacity and level of protection: low capacity pants are usually pull-ups whereas high capacities can be accommodated by either pull-ups or diapers.

Finding the best kind of protection is a big concern. Brand names are often used instead of generic names; even generic names are not always used precisely with the same meaning.  

There are several types of incontinence with different amounts and regimes of leakage which partly accounts for the variety of protection. A good way to start the search for suitable protection is the Internet. Typing 'How to choose incontinence wear' into your search engine will reveal much useful advice but it will be as well to remember that most of it is posted by firms who sell incontinence products.  A click on incontinence pants will reveal some of the enormous variety. This can be followed by choosing a few of what look the closest to your needs; then a click on these sites to follow through with your requirements - size, level of absorption, appearance, cost ....

  but be aware that the illustrations are, in many cases, not very accurate.

Types of Incontinence Knickers: PULL-UPS

There are many kinds of adapted pants and knickers on the market for light incontinence. There are many brands of washable or disposable pants and knickers adapted to take pads or with absorbent areas. Some are intended to be single-sex. The pads when sold separately can be single-sex or unisex (for both males and females). Fixation pants and knickers are non-absorbent; it is the incontinence pad that they 'fix' (hold in place) that is absorbent.  Many are unisex and have no front exit. The manufacturers often just refer to them by their brand name chosen to give a hint of what they are.

They are more stretchy than is usual for ordinary underwear and so take a pad more readily. The pad can be unisex or female according to the length at the front. Ladies who have heavy incontinence might prefer a longer front as for unisex pads.

0_176.jpg (441×590) (pornpicsamateur.com)  pull-up with large pad

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Most kinds of knickers for light incontinence are pull-ups but some can be used for much heavier leakages up to about 2000ml.

Whether the pad is fixed to the knickers, such as in a pocket, or just covered by them might be significant for those who have an active lifestyle. Some fixation knickers allow the pad to be moved a little inside them.

Our knickers are a reminder of our thrills and spills, a reminder of precious erotic moments such as an unexpected ejaculation.  I choose white because it looks less like outerwear than coloured or patterned underwear.  I find men's underwear with the gusset in the form of an inverted Y difficult for peeing.  Ladies' knickers, with a more stretchy waistband to allow peeing in the sitting down position, help with this problem.  I wear white unisex fixation briefs (Abena Abri-Net Large 9251 or Allanda iD Expert Ultra large).  Both are washable.  They cost around £1 each, including delivery charges, depending on type and quantity bought.  I wear an Abri San 5 Premium pad, big enough to extend from the entry of my catheter to the top of my bum crevice, capacity 1,200 ml.  Usually I use only one pad per day, costing about 45p.  Other pads with capacities up to 2000 ml. are available.   

I find that they tend to be tight around the boundary between the top of my leg and my pubic area and bum cheeks, so I buy a size larger than my waist measurement indicates (I am about 37-33-39).  They can be pulled up to my waist, when the sides are about 8 inches or rolled down to around 3 inches.  They are woven as a continuous strip then cut and sewn vertically to make side seams; also a strip of about an inch and a half sewn in the middle to form the crotch and the leg holes

Since I was given some by a lady friend, nurse and knicker connoisseur, I have also been wearing unisex Abri Fix Pants super large 90693, similar to boy shorts ladies' knickers without the gusset.  Like ladies' boy shorts, they have a cuff round each leg rather than a flat crotch, as do briefs.  They are made of thicker material than nets, which makes the pad hardly visible; the sides are about 9 inches deep when pulled up and can be rolled down to about 4 inches.  This kind of boy shorts made of thicker material cost up to about £12 for a pack of 3, but last longer.   

Types of Incontinence Knickers: DIAPERS

These open out flat. A large absorbent pad to covers the area likely to be affected by urine or faeces. Usually they have plastic sides with one or two adhesive tabs, or in some kinds of diaper, 3 or 4 studs on each side to hold them securely around the body between the groin and the waist. Diapers can be bulky: some users would feel that they would not like to wear close-fitting trousers or other outer wear which would reveal the outline. They can also make a crinkling sound as the wearer moves.   

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Cloth diapers (USA)/nappies (UK) are made of square, absorbent, washable material held in place by safety pins or something more modern. There are many brands of cloth diapers/nappies shaped like plastic ones with fastening studs at each side. Occasionally they are referred to as 'napkins' but in the UK, this is more usual for smaller squares of lighter material used at the dinner table to clear up stray bits of food from around the mouth or fingers or to prevent the soiling of clothes - similar in purpose to nappies but at the other end of the alimentary canal. In the UK, 'nappies' usually refer to babies: some adults would be offended if their incontinence wear were referred to in this way.

 Some kinds of incontinence wear consist of a waistband to which a pad with adhesive patches fixes to it. I am unsure whether these are pull-ups or diapers or neither; they are just pads with a means of holding them in place but not covering them. I was issued with some on an overnight hospital stay: on returning home I got rid of them as soon as possible.

For extra protection, pants made of plastic, rubber or other waterproof material can be worn over any of these types of incontinence wear.   

Diapers, pull-ups, fixation pants, nets or knickers with many brand names are really all variations of ways to hold a pad of absorbent material in place and to be able to get access to it as needed. The differences between the variety of incontinence wear amount to a few features: amount of absorbency; whether they open with tapes or studs (diapers), usually at the sides or whether they are sufficiently stretchy so that no opening is needed (pull-ups or fixation pants); material used: waterproof (usually plastic or rubber) or textile; washable or disposable.  

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My sincere thanks to all the sporting ladies who have posted their photographs on the Internet.