For people who suffer from urinary conditions related to illness, injury, or disease, catheters can be a necessary part of life. They are used to eliminate urine from the bladder through the urethra or a small incision in the abdomen. The type of catheter required depends largely on the medical reason for needing one, the patient's gender, and the length of time it will stay in place.

Types of Catheters

Indwelling catheters, or catheters that enter the body, are used in a medical facility or home setting for those who are temporarily bedridden or in situations where the urge to void is not obvious. These types of catheters, known as Foley catheters, are inserted by a medical professional and stay in place for two to twelve weeks.

For those who only use catheters upon sensing the need to urinate, a physician will prescribe an intermittent catheter for self-insertion. These catheters are available for men, women, and children with different features to suit many medical conditions. Instead of Foley or intermittent catheters, some people are candidates for external catheters.

What is an External Catheter?

As the name implies, an external catheter is worn on the outside of the body. As such, they are gender-specific and provide a welcomed alternative to the invasive, and oftentimes uncomfortable, indwelling catheters.

How Do I Choose the Right External Catheter?

Step One: Determine if you are a good candidate.

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.

Step Two: Consult with your physician.

Always consult with your physician about your unique circumstances before choosing a self-catheterization product.

Step Three: Research the available styles and features.

External catheters are designed with gender in mind. While the female anatomy is not as conducive to external catheterization, alternative products such as the portable female urinal, are readily available. Options for men, however, are plentiful; and comfort, convenience, and reliability should be at the center of your decision. Male external catheters, or condom catheters, are typically made from silicone or latex with self-adhering and non-adhesive options.

How Does an External Catheter Work?

The most popular male external catheters are the Texas catheter and the molded condom catheter. When worn over genitalia, they use gravity to drain urine from the bladder. The urine is then transferred by a flexible tube to a leg bag or an overnight drainage bag. Although both function similarly, the Texas catheter is a three-piece device with a latex sheath designed to be unrolled over the penis, a hard silicone drainage tube, and a catheter insert. To avoid leakage, the sheath should be secured with liquid medical adhesive or foam adhesive strips. For your convenience, condom catheter kits are available.

The molded condom catheter is a rigid, one-piece device made of latex or silicone. The silicone version is softer, more flexible, and breathable. Like the Texas catheters, these devices also attach to a urinary drainage bag with flexible tubing. Options include self-adhesive and non-adhesive versions.

Other options include a self-adhering male external catheter applied just to the tip of the penis. While some men find this smaller device more comfortable, the size of this type of catheter is ideal for small or retracted penises.

How Long can Male External Catheters be Worn?

To prevent urinary tract infections and skin irritation, it is important to change an external catheter regularly. Experts suggest replacing it every 24 hours. In cases where a catheter must be worn indefinitely, extended-wear catheters are proven to be more comfortable and durable over long periods. For those who can control the release of urine, consider wearing a catheter only as needed or for overnight use.

What Size Male External Catheter Do I Need?

Condom catheter sizes are typically measured in length by millimeters. Most men will find a standard length that will fit them. Check with your supplier to see available sizes. If necessary, measure accordingly to ensure that you get the correct fit.

What is a Female External Catheter?

Female external catheter options are somewhat limited because of differing anatomy; however, products with innovative suction designs and collection advancements are available. External catheters for women typically feature absorbent material designed to be worn over the genitalia. A tube is attached to the absorbent material to capture and collect urine in a bedside or leg bag. These need to be changed regularly to prevent infection, odors, or leaks as the absorbent material begins to wear.

What Catheter Accessories Will I Need?

Some catheter accessories may be necessary. External catheters will require sanitary supplies like sterilizing wipes or deodorizing sprays. Lubricants may also prove useful to help slide on sheath-style catheters. You will also need a catheter leg bag or bedside drainage bag. For ease of movement, leg bag straps with enhanced comfort features and extension tubing are highly recommended.

Does Medicare Cover External Catheters?

When used by patients with permanent urinary incontinence as an alternative to indwelling catheters, Medicare will cover external catheters for both men and women. Men are limited to 35 external catheters per month and female collection devices are limited to one metal cup per week or one device per day.

Do I Need a Prescription for External Catheters?

For Medicare to cover an external catheter, you are required to have a physician's order describing the products needed. Although this document is not officially a prescription, this Medicare form is necessary for incontinence supply coverage.

To learn more about external catheters, be sure to speak with your healthcare professional. If you have Medicare, don't forget to ask for a physician's order to ensure full coverage for your urinary incontinence supplies.