If you wear your washable incontinence underwear at night, you may want to slip in an extra pad to absorb overflow or line your mattress with a quality incontinence underpad. If not, just be sure to choose the reusable underwear with the right level of absorbency for your personal situation and you should not need to add in an extra pad. If you are heading to an event and are worried about having an accident, you can also use an extra pad inside the panty for added protection. If you change your reusable incontinence underwear frequently enough, this shouldn’t be an issue for you.