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By Dr. Michael R. Harrington, MD
Last Updated Apr 24, 2026
For years, men with urinary leaks had only one option: disposable diapers. And those very diapers often became the real source of their suffering. The chafing, the smell, the shame of buying them. Things have changed. A discreet revolution is giving men their lives back. I'll share the solution I trust most at the end of this article.
If you're a man over 50 dealing with leaks, read this before you buy another pack of Depend or TENA.

Most men assume the odor from disposable diapers comes from urine itself. It doesn't. After two to three hours of wear, the warm, occlusive environment created by the diaper promotes the growth of urease-producing bacteria, which break down urea and release ammonia. The smell you and others detect isn't waste — it's a bacterial reaction occurring directly on the skin. This is why no amount of changing pads or deodorant can neutralize it for long. The disposable diaper doesn't mask the problem. It creates it.

Dermatologists have a name for the rash adult diaper users develop: Incontinence-Associated Dermatitis, or IAD. The plastic backing prevents airflow. Acidic urine sits against the skin. Friction does the rest. The result is chronic redness, raw patches, and in serious cases, open wounds that won't heal as long as the diaper is worn. Studies show that 40% of long-term adult diaper users develop IAD within six months. Most learn to live with it because they don't realize the diaper is the cause.

This is a point rarely discussed, and yet it is essential. When a man wears a disposable diaper continuously, his pelvic floor gradually stops working. The brain eventually registers that retention is no longer necessary: the diaper handles everything. Within twelve to eighteen months, what began as light leakage frequently progresses to moderate, and sometimes heavy, leakage. The diaper hasn't protected your body. It has trained it to leak more. This is precisely why recommendations are now shifting toward modern absorbent underwear, which keeps the pelvic muscles actively engaged.
The shift toward absorbent underwear
The clinical consensus has been moving in one direction for some time now: away from disposable diapers and toward modern absorbent underwear. The reasoning is straightforward. Underwear keeps the pelvic floor engaged, allows the skin to breathe, and, perhaps most importantly, preserves the patient’s sense of normalcy, which has measurable effects on recovery and long-term adherence.
Among the products currently on the market, the one I have seen produce the most consistent results in my own practice is a brand called Orykas.
What makes them clinically interesting is the choice of bamboo fiber rather than synthetic blends. Bamboo is naturally antibacterial and hypoallergenic, which significantly reduces the dermatitis cases I used to see constantly with disposable users. The absorbent core is properly engineered — up to 10 fl oz — and the cut is genuinely indistinguishable from a regular boxer, which matters more than people realize. Patients who do not feel like patients tend to stay active, and active patients have better outcomes.
I will add one practical observation: their stock is genuinely difficult to obtain right now. Bamboo production does not scale the way synthetic fabric does, and the brand frequently runs out of common sizes for weeks at a time. If you decide to try them, I would suggest doing so promptly rather than waiting.

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