To explore the environmental harms of incontinence pad use and to quantify the reduction in their use using three urological procedures as examples. The hypothesis is that this work will encourage treatment for urinary incontinence and to reduce the environmental harm secondary to the use of incontinence products. The secondary objective is to contribute to reducing the impact of climate change and therefore the lives and wellbeing of incontinent people.

An online literature search was completed to review the carbon footprint of incontinence pads. Lifecycle analysis of the product was explored, from raw material acquisition, manufacture, storage, transport, use and disposal. Evidence of the environmental harm associated with their use was reviewed. Surgical approaches to reducing or treating urinary incontinence were discovered via conventional educational texts, current literature, and expert surgical opinion. Three common urological incontinence surgical procedures have been investigated for their efficacy in reducing incontinence and quantified regarding reduction in incontinence pad use.

The three urinary incontinence treating operations investigated for reduction in incontinence pad use were proven to be efficacious in studies. The quantity of incontinence pad use invariably reduced over time. The overall carbon footprint of pad use pre and post operation proves variable. Numerous factors confound a comparative analysis of pad use versus the operations carbon footprint. Some variables include renewably sourced electricity for theatres, local or general anaesthetic, surgical equipment reusability and recycling policies in difference centres.  The energy used to perform surgery in an operating theatre in Australia is from grid electricity, currently fossil fuel derived in majority of centres. Water is largely unrecycled or recaptured, and waste is unnecessarily high secondary to inadequate recycling facilities and use of products which are unrecyclable.

This study has proven that operations for urinary incontinence are efficacious in reducing pad use and therefore the environmental harm associated with them. However, the operation itself has a carbon footprint which needs to be compared to ensure from an ecological perspective this approach is superior. Different health centres will have a different carbon footprint for the same operation on a similar patient. Variations in energy, water use, and recycling account for the discrepancy.

The urologist has an important role to play in reducing the carbon footprint from incontinence pad use. This project has reviewed three urological operations which reduce pad use. The reduction in pad use is compared with the carbon footprint of the operating theatre episode. Urological practice moving into the future should involve pursuing renewable energy sources for operating theatres, better catchment and recycling of water and more diligent recycling of theatre waste to aim to further reduce the carbon footprint of treating people with urinary incontinence. By reducing the carbon footprint of incontinence as whole will contribute to reducing the impact of climate change affecting the quality of lives of people with incontinence.

4.	Khoo SC, Phang XY, Ng CM, Lim KL. K, Lam SS, Ma NL (2019). “Recent Technologies for Treatment and Recycling of Used Disposable Baby Diapers”. Process Safety and Environmental Protection. 123 (1): 116-129.  DOI: 10.1016/j.psep.2018.12.016