Why this piece exists
In part 1 we wrote up a day in the life: pads and washable briefs stress-tested against real cubicles, real commutes, real leak events. That piece was based on our own experience, timed with a phone stopwatch, and covered the operational reality no one advertises.
While writing it we did what most consumer articles don't: we checked whether the science backed us up. It did. In fact it goes further than we did, and it's been sitting in peer-reviewed journals for twenty years, largely unread outside academic and clinical circles.
This is the piece that translates it.
The short version: there is more UK research on absorbent product performance than on almost any other category of medical device sold direct to consumers, most of it from one research group at the University of Southampton, and almost none of it is cited in the marketing you'll see for either category. That gap is what part 2 is about.
Before we started writing this section, we reached out to the researcher whose work anchors it, to ask her directly about the questions it raises. We didn't hear back. That happens, researchers are busy people and we're a small independent site with no track record to point to yet, so we've written the piece the other honest way: entirely from her published, peer-reviewed findings, with nothing attributed to her that she didn't put in print herself. If that changes, we'll update the piece and say so plainly.
Section 1: The Southampton file
Twenty years of clinical trials on absorbent continence products, led by Professor Mandy Fader at the University of Southampton, with collaborators at UCL and internationally.
Here's what that body of work actually found.
Fader et al 2005 (Neurourology and Urodynamics, multi-centre trial, men with light UI) ran a head-to-head test of four product designs for men with light urinary incontinence: pouches, leafs, pantegrals (a washable pant with an integral pad) and pads. The winner was the leaf design plus a TENA Level 2 disposable pad. The pantegral, the washable-pant design closest to what's sold today as a "washable brief," came out described as "most suitable only for very light incontinence." The trial won the International Continence Society's best abstract award in Montreal that year.
Fader et al 2008 (NIHR Health Technology Assessment 12/29) ran three linked clinical trials on absorbent product designs for moderate-heavy incontinence, and established something the market still mostly ignores: men and women have different absorbent-product preferences. The "one product fits all" assumption behind a lot of unisex product design doesn't hold up under trial conditions.
Cochrane review CD007408 (Fader, Cottenden, Getliffe, 2008), the systematic review of absorbent products for moderate-heavy incontinence, found only two trials that met its inclusion criteria for washables at that leak volume. Cochrane says so plainly: the evidence base for washables at higher leak volumes is thin. Not absent, thin.
Macaulay, Clarke-O'Neill, Fader et al ran the only pilot study to directly compare reusable products against equivalent disposables at moderate-heavy volumes. The sample was 14 people. The paper itself flagged this as a gap needing a larger trial. As far as we can find, that larger UK trial still hasn't happened.
Fader et al 2024 (Proceedings of the Institution of Mechanical Engineers, Part H, research priorities paper) is the most recent statement from the group on where the field needs to go next, and names the unmet needs in current products directly. We come back to this in Section 4.
Fader et al 2025 (Taylor and Francis, washable absorbent products in India, Papua New Guinea and Romania) is Fader's most recent published work on washables, from this year. Its conclusion: "washable products have the potential to improve the lives of many people with long-term continence problems, but the designs tested do not work for everyone." Contemporary, hedged, honest. It's also, more or less, our editorial position in part 1, arrived at independently and with a phone stopwatch rather than a research grant.
Section 2: What the science actually says, in plain English
On washable products in general: they have a real place in the toolkit, for light leakage, home use, and users who value the psychological difference of "wearing underwear" over "wearing a medical device." At moderate-heavy volumes the evidence base is thin, and the pilot data that does exist shows performance dropping off faster than for equivalent disposables. This isn't our opinion. It's what a twenty-year research programme found.
On male-specific product performance: the 2005 Fader trial is still, as far as we can establish, the definitive published head-to-head for men with light urinary incontinence in the UK. Its ranking (leaf, then pad, then pantegral, then pouch) isn't something you'll see cited on a commercial product page, because it doesn't flatter the currently-fashionable underwear-style category.
On gender-specific needs: the 2008 HTA programme found men and women have different preferences and needs for absorbent products. That matters, because most washable-brief brands sell essentially the same product to both, with a Y-front graphic added for the men's version. The data suggests that's a design shortcut, not a solution built around how men's bodies and leak patterns actually differ.
On what "adequate" means: the NHS Supply Chain's own literature on the Wearever washable range describes washable pants as suited to "light to moderate bladder leakage, or those who experience only occasional light leakage, perhaps just after urinating, and want some form of protection just in case." Read plainly, that's the NHS's own supply chain saying washables aren't designed for the leak profile most post-prostatectomy men actually have in year one.
Section 3: Why this hasn't reached consumers
None of the research above is secret. It's published, peer-reviewed, and in several cases has won awards inside the field. So why does almost nobody buying a washable brief or a pad in 2026 know any of it?
A few reasons, none of them conspiratorial.
Clinical journals aren't written for the public, and they aren't read by the public. A trial published in Neurourology and Urodynamics or an NIHR Health Technology Assessment report is written for continence nurses, urologists and other researchers. It isn't indexed anywhere a man Googling "best incontinence pants for men" is going to find it.
Charity content, understandably, prioritises accessibility and reassurance over comparative product data. A charity's job is to help someone feel less alone and point them toward support, not to run a product-ranking exercise.
Retailer content is, by definition, promotional. A brand's own site is never going to lead with "our pilot data at moderate-heavy volumes is thin."
Independent review sites that do comparative testing well in other categories, Which?, Wirecutter, Consumer Reports, haven't gone deep on male-specific continence products. Which? has a brief buying guide but nothing close to head-to-head testing.
And the one resource that was actually built to close this exact gap, the Continence Product Advisor, a public tool led by Fader's own group specifically to translate this research into product-selection guidance, is genuinely excellent and genuinely under-known. It deserves far more traffic than it gets.
Put together, that's a systems failure rather than anyone hiding anything. But the practical effect is the same either way: a man buying his first post-prostatectomy product today has almost no realistic path to encountering any of this evidence unless he goes looking for it in an academic library, or reads an article like this one.
Section 4: What the research says the market still doesn't offer
Fader's 2024 research-priorities paper is the most useful document in this whole file for one reason: it doesn't just review what exists, it names what's missing. Six gaps stand out.
Products that work well for men with moderate-heavy leakage without being infantilising. This is the gap part 1 kept running into. The market splits into "medical-beige pad" and "underwear-style washable," and the underwear-style option is the one that solves the infantilising problem while, per the trial data above, being the design least suited to moderate-heavy leakage. Nobody has yet built the product that solves both halves at once.
Better waterproof-yet-breathable outer materials. Every pad on the market makes a trade-off here. A fully waterproof outer stops leaks reaching clothing but traps moisture and heat against skin; a more breathable outer is more comfortable over a long day but narrows the safety margin on a heavy leak. Fader's group flags this as unresolved, not solved-and-marketed-as-solved.
Improved skin-health outcomes. Incontinence-associated dermatitis is a significant, under-discussed problem for long-term pad or brief users, covered in detail in Cottenden, Fader et al 2015. Neither category has fully cracked prolonged skin contact with absorbed fluid, which is one reason change frequency (the subject of most of part 1) matters clinically, not just for comfort.
Products that address night-time leak profiles specifically, rather than the same daytime product simply worn overnight. Night leakage has a different volume and timing pattern to daytime leakage, and the paper flags dedicated night design as underdeveloped.
Sustainable options that don't compromise on performance. We covered the environmental side of disposables in a separate piece, including the early-stage biodegradable-core research out of Leeds and Waterloo. Fader's priorities list makes the same point from the clinical-research side: sustainability work needs to happen without quietly downgrading real-world performance, which is exactly the trade-off a lot of "eco" product marketing glosses over.
Products that fit different body types, rather than one standardised average. This is where part 1's own field notes line up almost exactly with the published priorities: carry size, bulk under clothing, and fit across different body shapes were the practical friction points we hit repeatedly, and they're the same friction points the research names as unsolved at a design level.
Mapped against what's currently on the shelf: the pad category has, broadly, solved fast changes and high-volume containment, at the cost of looking and feeling medical. The washable category has solved the "feels like underwear" problem, at the cost of capacity, change speed, and (per Section 2) an evidence base that's genuinely thin above light leakage. Neither category, on the published research, has solved for both at once. That's not a marketing failure to fix with better copy. It's an open design and materials-science problem.
Section 5: What to do with this
If you're at the light-leakage or occasional-leak end, washables are a legitimate first port of call, and the evidence broadly supports them.
If you're post-prostatectomy in the first six to twelve months, or otherwise dealing with moderate-heavy or surge/urge leakage, the evidence points toward disposables, probably pads, as your operational core, with washables as a supplement rather than a replacement.
Whatever you choose, the Continence Product Advisor is worth ten minutes of your time before you spend any money. It's built by the same research group covered in this piece, specifically to put evidence-based guidance in front of the person actually buying the product, not the person marketing it.
And ignore any advert, for either category, that implies its product is going to restore your dignity. The research in this piece is about absorbency, fit and skin health. Your dignity was never the product's to give back.
Methodology footnote: This piece is built from the published, peer-reviewed record only. We contacted Professor Mandy Fader for comment ahead of publication and did not receive a response; nothing in this article is presented as something she told us directly, and every claim attributed to her research links to the underlying paper. If she responds after publication, we'll update the piece and note the update.