External catheters are a safe and reliable way to manage male urinary incontinence. An external catheter is worn like a condom, which reduces the chances trauma and infections associated with other types of catheters that are inserted into the body. With proper sizing, products, and techniques, external catheters can be an easy and comfortable way to control urinary incontinence.
External Catheter Options
There are many different styles and sizes of external catheters. You can choose to use external catheters made from latex, or for those with latex allergies, latex-free or silicone external catheters are a good option. Most are disposable and should be worn for 12-48 hours, however, manufacturers do recommend removing the catheter daily for cleansing and skin inspection.
There are also different options for the way an external catheter is attached. Some are self-adhesive; they come with an adhesive on the inside, while others use an adhesive strip or a strap to keep the catheter in place. It may be overwhelming to have so many options, but there's a good chance that you will find an external catheter that is just right for you.
Finding the Right Size
Before you get started, it's important to get an external catheter that fits properly. If it's too small, it will be difficult to put on and can cause discomfort or injury. An external catheter that is too large, however, will not provide a secure fit that will result in leakage or problems saying on. Sometimes, a man will be between two sizes. In this case, it's a good idea to choose the smaller size, as long as it's still comfortable and will not cause any constriction. Below are sizing guides that can be downloaded and printed at home to see which size would work best. Please Note: Once printed out, the guide must be cut along the edges.
Mentor /Coloplast External Catheter Sizing Guide PDF (26 KB)
Hollister Sizing Guide PDF (78 KB)
Rochester Sizing Guide PDF (198.97 KB)
How To Measure
When measuring for external catheters, it's important to measure the penis in its relaxed state. If using the Mentor/Coloplast or Hollister sizing guide, place the round cut-out portion over the shaft of the penis at the widest point to see which size will work the best. The Rochester sizing guide will need to be cut out and placed around the shaft (as if you were using a measuring tape). Use the guide to find the appropriate size.
Gather Your Supplies
Before applying the external catheter, you'll need to have the right supplies. You'll need an external catheter, collection device (leg bag or night drainage bag), tubing, scissors, mild soap and water, washcloth, and a protective skin barrier dressing. A skin barrier is not always necessary, but it can protect the skin from adhesive trauma, friction and also provides a barrier of protection from urine while helping the external catheter stay on.
It is helpful to trim any pubic hair near the base of the penis. This will be helpful for both comfort and keeping the catheter
securely in place. Shaving, however, is not recommended because it can cause irritation. Once all hair is trimmed, use a mild, lotion-free soap to wash the entire penis and dry thoroughly. External catheters will adhere better to a clean surface, so use of lotions or soaps that leave a residue are not advised. If using a skin barrier, apply it to the skin that will be in contact with the external catheter and allow to dry.
Putting On an External Catheter
To use the external catheter on a circumcised male, simply place the catheter over the tip of the penis and slowly unroll. Make sure
to leave a small amount of space (about 1/2") between the tip of the penis and the funnel end of the catheter to avoid irritation due to friction. When using on an uncircumcised male, however, be sure to leave the foreskin over the head of the penis while putting the external catheter on. Once the external catheter is comfortably in place, smooth out any wrinkles. If there are too many wrinkles, it may be an indication that the external catheter is too large.
If the external catheter is self-adhesive, the inside will be coated with a sticky adhesive. After it is on, gently squeeze around the external catheter to ensure that there is a good seal between the adhesive and skin. Remember, if there are any gaps or wrinkles, that could lead to urin leakage.
External Catheters that do not have adhesive on them will need to be held on with an medical adhesive, an adhesive strip or external catheter strap. Skin adhesive comes in liquid, wipes, or even spray. Simply coat the shaft of the penis with adhesive prior to applying the external catheter, smooth out any wrinkles and squeeze to ensure a good seal.
If a liquid adhesive is not desired, there are a variety of adhesive strips and straps available. There are 2-sided adhesive strips that are applied around the shaft of the penis prior to putting on the external catheter. The external catheter sticks to the adhesive keeping it securely in place. Another option is a strip that is placed around the outside of the external catheter. These are available in both disposable foam strips with and reusable, adjustable versions.
Removing the External Catheter
Once it's time for the external catheter to be removed, care must be taken to ensure a trauma-free removal. A good way to loosen the adhesive before removal is to take a warm, wet washcloth and place around the catheter until the adhesive loosens from the skin. The external catheter should then be able to be removed. If there is any adhesive residue left behind, simply wipe away using an adhesive remover.
Avoiding Common Problems
It is important to follow manufacturer guidelines and inspect daily for potential problems. The most common problem associated with external catheter use is skin irritation. Skin irritation can be avoided by using a protective skin barrier product before applying the external catheter. Always be extra alert to any sign of ischemia (restricted blood flow) and penile obstruction as these may be caused by wearing the wrong size external catheter - going to the next larger size may solve these problems. If problems persist, always seek the advice of your healthcare provider.