UNDERSTANDING EXTERNAL CATHETERS
What is an External Catheter?
External catheters are noninvasive devices worn on the outside of the body to manage urinary disorders like incontinence. These catheters are gender-specific, and for some, provide a welcomed alternative to the indwelling catheter.
Male external urinary catheters, also known as condom catheters, Texas catheters, or urinary sheaths, collect urine through a sheath that fits on the penis. The sheath attaches to a tube that relies on gravity, or in some instances suction, to drain urine into a collection bag. To avoid leakage or restriction, proper fit is essential. Male external catheters are available in both reusable and disposable forms and in multiple sizes and styles. Female external catheters are not as readily available, although recent technological advances have been made in manufacturing suction-based versions for women.
Relevant Terminology*
Catheter - a tubular, flexible instrument, passed through body channels for withdrawal of fluids from (or introduction of fluids into) a body cavity.
Condom Catheter - an external urinary collection device that fits over the penis like a condom; used in the management of urinary incontinence.
Texas Catheter - a two-piece catheter used to treat urinary incontinence in men; trademark for a commercially made condom catheter.
*Sourced from https://medical-dictionary.thefreedictionary.com/
TYPES OF EXTERNAL CATHETERS
Because the male anatomy is naturally conducive to using external catheters, many options are available for men utilizing a combination of three factors: construction style, adhesive type, and material.
The most popular male external catheters are the Texas catheter and the molded condom catheter. Although both function similarly, the Texas catheter is typically a two-piece device made up of a latex or silicone sheath designed to be unrolled over the penis and a semi-hard removable drainage tube insert. The molded external catheter system is constructed with the sheath and drainage tube in one continuous piece. Both styles must be secured to the penis with either built-in adhesive or a separate liquid medical adhesive, straps, collars, or adhesive strips to avoid leakage.
Most Common Materials
- Latex: A soft, comfortable material; flexible nature makes it easy to roll on the penis.
- Silicone: A great alternative for those with latex allergies; translucency allows for easy inspection of the skin and breathability reduces skin irritation.
- PVC & Polyurethane (PU): A thin synthetic material sometimes used in place of latex.
Construction Style
- One-Piece External Catheters: Also known as molded condom catheters, the catheter sheath and funnel are one continuous piece of material.
- Two-Piece External Catheters: Also known as Texas catheters, the sheath and drainage funnel are distinct pieces and can be separated as necessary.
Adhesive Types
- Non-Adhesive Condom Catheters: Requires skin glue or adhesive strips to hold in place. Skin adhesive is applied first followed by the sheath. Reusable foam and elastic strips are available when frequently replacement is necessary.
- Self-Adhering Condom Catheters: This style is made with adhesive built into the sheath. To use, unroll onto penis and press gently to affix.
PARTS OF AN EXTERNAL CATHETER
Tube
Flexible silicone or latex tubing drains urine from bladder. Catheter extension tubes are available for attachment to leg bags or bedside drainage bags.
Sheath
The sheath of a condom catheter, commonly made of silicone or latex, adheres to the penis to collect urine. When part of a two-piece catheter system, additional sheaths can be purchased separately.
Drainage Tip
Depending on the style of the catheter, the drainage tip may be a part of one-piece molded catheter construction or a separate part that can be removed and cleaned.
Urinary Drainage Bags
Drainage bags attach to the tubing to collect urine. Made of durable plastic, leg bags and belly bags usually have a fabric backing for comfort against the skin. Other styles include bedside and night-time bags available in multiple sizes.
EXTERNAL CATHETER INDICATIONS, BENEFITS, & RISKS
External Catheter Indications
The best candidates for external catheters are typically men who are capable of draining urine but may not be able to control the timing. This condition is commonly seen in patients with incontinence, overactive bladders, dementia, injuries limiting mobility, alcohol withdrawal, or in situations where an internal catheter is ill-advised like chronic urinary tract infection or those with bladder stones. External catheters are not recommended for patients with urethral blockages, bladder retention issues, or nerve-related injury or disease.
- Condom Catheter Benefits
- Reduced risk of catheter-associated urinary tract infection (CAUTI);
- More comfortable than indwelling or intermittent catheters;
- Provide more freedom of movement;
- Inconspicuous design is concealed in everyday clothing;
- Noninvasive;
- Easy to use without professional intervention;
- An alternative for patients prone to bladder stones or spasms.
- Condom Catheter Disadvantages & Risks
- Dependent on proper sizing & adherance to avoid leakage;
- Potential skin irritation, rash, or other damage resulting from prolonged contact with urine;
- May fall off or shift more frequently than indwelling catheters;
- Greater potential for allergic reaction to latex or adhesives;
- Can be painful to remove;
- Although much less likely, possible risk of catheter-associated urinary tract infection (CAUTI).
MALE EXTERNAL CATHETER SIZE CHART
Condom catheter sizes are typically measured in millimeters. For the best fit, use a measuring tape to find the circumference of the penis just behind the head. If you do not have a soft (or sewing) measuring tape, use a string, shoe lace or any other flexible item to find the length and hold it up to a ruler or rigid measuring tape. Divide the length in centimeters by 3.14 to find your size in millimeters and compare to your preferred brand's sizing guidelines or chart.
Tip: If between sizes, use the smaller size available. An external catheter will stretch to provide a good fit but a loose external or condom catheter will not properly adhere.
Please note: While many men will find a standard size that will fit properly, not all manufacturer's use the same guidelines. Check your preferred manufacturer's sizing recommendations before purchasing.
QUALITY MALE EXTERNAL CATHETERS
ULTRAFLEX® Male External Catheters
UltraFlex catheters are made from soft, breathable silicone to promote greater patient comfort, while essentially eliminating the risk of latex-related skin irritation. The clear nature of silicone also allows for an inspection of the skin without removing the catheter. To inspire confidence and maximize wear time, a built-in, non-sensitizing adhesive band creates a secure bond; and a kink-proof funnel ensures a steady flow of urine. Ultraflex external condom catheters come in 5 sizes for proper fit and greater reliability.
WIDEBAND® Male External Catheter
Setting a new standard for condom catheters, Rochester Medical Corporation patented an advanced manufacturing process to add adhesion into nearly the entire sheath wall of the WideBand Condom Catheter. In 2013, Bard acquired both Rochester Medical and this innovative technology. The adhesive design of the Rochester Wideband Catheter involves extended length as well as forward placement to prevent urine migration and undesired catheter detachment without requiring more aggressive adhesion. Inspiring confidence and reliability, the Wideband External Catheter is 100% latex-free, breathable, odorless and comfortable.
SPIRIT™ Male External Catheters
The Bard Spirit™ Condom Catheter is a revolutionary latex-free device that combines silicone’s breathability with the moisture-wicking properties of hydrocolloids. The built-in adhesive is integrated into the Spirit catheter’s soft, breathable sheath to comfortably conform to the skin. To help ensure a secure fit, this condom catheter is available in multiple sizes and offers three different adhesion styles including traditional placement, forward placement to minimize unintended detachment, and forward placement with 70% more adhesion.
EXTERNAL CATHETER ACCESSORIES
Bard Leg Bags
Bard leg bags, like the dependable Dispoz-a-Bag, set the industry standard for quality. Made of heavy-gauge vinyl with an anti-reflux valve, these urinary drainage bags are durable, leak-resistant, and odor-free. Bard leg bags are available in 9 oz., 19 oz. or 32 oz. capacities with optional Flip-Flo drainage valves and latex or fabric straps. For added convenience, Bard Dispoz-a-Bags are sold individually or in bulk and as sets with extension tubing and clamps.
Bard Drainage Bags
Bard urinary drainage bags are designed to be used with either external catheters or Foley catheters for the collection of urine. Unlike a leg bag, Bard catheter bags are not meant to be worn but rather hung or held somewhere below the level of the bladder on a bedside or wheelchair seat. These plastic devices, like the Bard Bedside Drainage Bags, are larger in capacity than leg bags and are available with a variety of features like urine sample ports, meters, antimicrobial outlet tubes for infection control, and one or two hanging hooks.
Bard Reusable Leg Bag Straps
Although every Bard Leg Bag is packaged with a way to hold the bag in place, leg bag straps are also sold separately and offer added comfort, security, and flexibility. The Bard Wide Leg Bag Strap features a 1.75” width to virtually eliminate slippage. This reusable strap is made from a soft, stretchable fabric with an adjustable hook and loop closure. One of the most popular options, the Bard Soft Foam Catheter Strap is financially friendly, adjustable, minimizes skin irritation, and secures both Foley catheters and leg bags.
Bard Catheter Extension Tube
While Bard Leg Bags and urinary drainage bags are designed with attached tubing, an extension tube is often essential for proper placement and overall comfort. Leg bags worn on the calf will require longer tubes than those worn on the thigh. When used with a bedside drainage bag, extension tubing is often necessary for proper bag placement and sleep comfort. Bard Catheter Extension Tubes are available in multiple lengths and materials including latex rubber or latex-free, flexible plastic in both sterile and non-sterile forms. Simply cut to the preferred length and attach.
