First off, let me say that these diaper pants are a godsend for caregivers dealing with bedridden or incontinent elderly patients. The three-layer design (cotton outer, TPU waterproof middle, absorbent inner) genuinely works—no leaks during nighttime use, even with moderate leakage. The stretchy waistband is a nice touch for adjusting fit.

However—and this is a BIG however—the sizing is wildly off. The XL fits more like a medium adult sweatpants. My 150lb patient couldn’t comfortably wear these without constant readjustment. Manufacturers: PLEASE update your size chart!

On the plus side, the breathability surprised me. Unlike plasticky alternatives, these didn’t cause skin irritation after 8+ hours of wear. They’re also machine-washable (survived 10+ cycles without losing absorbency). Perfect for home care but questionable for active seniors due to the sizing issue.

Final verdict? 3.5/5 stars. Fix the sizing and these would be perfect for paralyzed/elderly care—until then, measure carefully or size up twice!