Noninvasive Voiding Devices for Bedridden Women With Urinary Continence; Usability, Acceptability and Safety: A Scoping Review.
Ana Mesa La Guardia, Maria Teresa Prats Valls, Mónica Micó Cabedo, Pablo Juan Verdoy, Jaume Gual Ortí
Abstract
Open AccessBackground: Noninvasive female urination devices are widely used for bedridden women with urinary continence, yet concerns persist about usability, dignity and safety-especially in the supine position. Objective: To map and synthesise evidence on usability, acceptability and safety of noninvasive devices for supine female urination and to contextualise safety with handling/reprocessing practices. Methods: A scoping review following JBI and PRISMA-ScR used a PCC framework and comprehensive searches (MEDLINE, CINAHL, Scopus, Embase, CUIDEN; Google Scholar/OpenGrey; March 2025), plus handsearching. Records were screened in duplicate; data were charted with a piloted form and narratively synthesised by device type and experience/safety domains. Results: Twenty-one records met inclusion criteria: 17 core device-focused studies and 4 contextual safety/handling sources. Core studies consistently reported discomfort, awkward posture, pain, embarrassment and dependence with traditional bedpans, alongside caregiver burden. Comparative evidence showed a clear preference for female urinals in eligible patients and greater acceptability for some alternative designs (e.g., disposable or inflatable variants); interventions that mobilised to the toilet or promoted respectful, skilled bedpan use were associated with reduced catheterisation. Safety findings indicated low adherence to education/reprocessing protocols and mixed signals regarding manual wiping versus automated disinfection. Contextual evidence documented persistent metal bedpan use in some health systems, wide variability in washer-disinfector/macerator availability and validation, and frequent manual emptying/rinsing-conditions linked to environmental contamination and antimicrobial-resistant organism risk. Conclusions: Improving care for bedridden women requires a dual approach: (1) woman-centred device redesign explicitly for supine use (fit, comfort, leakage control, dignity) with robust clinical validation and (2) system-level implementation that minimises manual handling and assures validated, documented reprocessing (or fit-for-purpose disposable pathways), supported by staff training, zoning, PPE and auditing. Implications: Standardised outcome measures for comfort, dignity, leakage and contamination proxies, along with comparative effectiveness studies in supine populations, are needed to guide safe, dignified and sustainable practice.