Pad, pants or brief: which product is right?

Key facts at a glance

• The German register of medical aids knows three levels: normal, increased and high absorbency
• Not only the amount counts, but the dynamics – how much urine is lost in what time
• Pads need fixation pants, pants are pulled on, briefs have adhesive tabs
• Mobility is a selection criterion in its own right – bedridden, wheelchair-dependent or working leads to different products
• Medical aids are care, not therapy – curative treatment options should expressly be pointed out

Pad, pants, brief, fixation pants system – the choice is confusing, and the droplet symbols on the packs help only to a limited extent. This article classifies the product types according to the official German system and names the criteria on which the choice is based.

How severe is the incontinence?

The International Continence Society deliberately defined the term broadly in 2003. Urinary incontinence can, as the clinical guideline describes it, mean a few drops in 24 hours – or the uncontrolled loss of the entire day's urine.

What matters is not only the total amount. The guideline emphasises the dynamics: whether urine is lost continuously in drops or whether larger amounts come at intervals in a short time. Both require different products, even with the same daily amount. The difference between day and night counts as well.

This can be measured objectively with the pad weighing test – the ICS short pad test or the 24-hour pad test. If such values are available, the guideline says they should be taken into account in the supply. For self-assessment, the guideline names the ICIQ-SF questionnaire.

The product types according to the official classification

The German register of medical aids lists incontinence aids under product group 15. The subgroups important for absorbent care:

15.25.30 – absorbent incontinence pads

Divided into anatomically shaped pads and rectangular pads, each in the absorbency levels normal, increased and high. Pads are held in place with fixation pants.

15.25.02 – fixation pants for incontinence pads

In two sizes. They hold the pad in place and are washable.

15.25.31 – absorbent incontinence pants, non-reusable

Here the register groups incontinence briefs and incontinence pants together, in three absorbency levels and three sizes each. Colloquially, these are the briefs with adhesive tabs and the pants that are pulled on.

15.25.32 – reusable absorbent incontinence pants

Washable variants, also in three absorbency levels.

What the droplet symbols are worth

The official classification knows exactly three absorbency levels: normal, increased, high. The droplet symbols on the packs, by contrast, are scales of the individual manufacturers – they are not part of the register and are not readily comparable between brands. Four drops from one manufacturer do not necessarily correspond to four drops from another.

More reliable is therefore the absorbency level as contained in the medical aid number – you will find it on every product page in our shop.

Why more absorbency is not better

A more absorbent product is bulkier, sits less discreetly and costs more. Above all, it tempts people to change less often – and long wear times on moist skin are a cause of skin problems in their own right.

The right level is the one that safely absorbs the actual loss between two planned changes. No more.

Mobility plays a part in the decision

The guideline recommends recording mobility in categories and names as examples:

• fully or partly bedridden
• wheelchair-dependent
• mobile with walking aids – crutches, walker
• mobile within the room, ward or floor
• fully mobile
• working
• special activities such as sport

A lot follows from this for the choice. For someone cared for in bed, a brief with adhesive tabs is easier to change lying down. Someone who goes to the toilet independently usually gets on better with pants, because they can be pulled on like underwear. Someone who works tends to pay more attention to discretion under clothing.

A point that often gets lost

The guideline is unusually clear on this point, and we reproduce it here even though it argues against selling medical aids:

“Although any urinary incontinence can in principle be managed with medical aids, this only constitutes ‘care’ and not ‘therapy’.”

There are treatment options: pelvic floor physiotherapy, electrostimulation, bladder training and drinking training, drug treatments and surgical procedures. The guideline demands, with strong consensus, that all those affected be informed about curative treatment options depending on their prognosis.

Absorbent products make everyday life possible. They do not replace a urological or gynaecological assessment.

Frequently asked questions

Pad or pants – which is more discreet?

Usually pants, because they fit like underwear and do not need fixation pants. With very high loss, however, an anatomically shaped pad with high absorbency in a fixation pants system can absorb more.

Can I use different products during the day and at night?

Yes, and often that is exactly what makes sense. The guideline expressly names the pattern over day and night as a separate criterion.

How often should I change?

Often enough that the skin does not stay permanently moist. There is no universally valid number – it depends on the loss and the product.

What does the health insurance fund pay?

Absorbent incontinence aids are medical aids under Section 33 SGB V. For consumables, the co-payment is capped at 10 euros for the monthly requirement, from 2027 at 15 euros. Details are in our article on medical aids on prescription.

Your next step

We stock pads, pants, briefs and fixation pants from HARTMANN, TENA and SENI in all absorbency levels and sizes. With a prescription, we handle the coordination with your health insurance fund.

Sources

• S2k guideline “Advice on medical aids for urinary incontinence”, AWMF register number 043-054, version February 2025 (in German)
• Register of medical aids, product group 15, GKV-Spitzenverband (in German)