How to Get External Catheters to Stay On

External catheters are preferable to in-dwelling ones.

External catheters channel urine into a collection bag. Health professionals prefer external catheters over internal dwelling devices, because they are less invasive, according to the Wound Ostomy and Continence Society, thereby reducing the risk of complications like urinary infections. External catheters, while useful for protecting clothing and skin, occasionally slip off a man's penis. There are a few tricks to getting your external catheters to stay on.

Things You'll Need

• Measuring tape

Instructions

1. Assess the patient's medical, sensory and cognitive status. A person with reduced sensory abilities is less likely to sense wetness or the urge to urinate. Evaluate your patient's awareness of his surroundings to determine if there is a risk he will become confused and pull the catheter off. A proper assessment of your patient's condition aides you in choosing and positioning the external catheter.

2. Choose the optimal catheter. Manufacturers have introduced a wide variety of external catheters. Measure the girth of his penis and note the length to determine the correct size. Proper size and fit is key to keeping the external catheter on.

3. Unwrap the external catheter and place it on the inside of the packing to keep it clean. Cut a piece of Elastikon tape to match the girth of his penis. Assemble the rest of the tools you will need in a convenient place near the patient's bed. Ask the patient to lie down in the bed, if he is in a wheelchair or up walking around. Applying an external catheter in an organized fashion will improve its chances of staying on.

4. Wash your patient's entire genital area, then rinse well. Pat his skin with a clean, soft towel. Examine his genital area for rashes or other signs of irritation. Allow the skin to air dry.

5. Apply skin prep to his penis to protect it from moisture. Moisture causes external catheters to fall off prematurely. There are spray-on adhesives available, which prevent external catheters from slipping off.

6. Roll the external catheter onto the penis. Push uncircumcised foreskin to the tip of his penis. This will prevent the catheter from pushing it back, acting as a tourniquet. There should be two inches of space between the head of his penis and the end of the external catheter, to give urine a place to collect as it drains down the tube.

7. Place the tape just beneath the rolled-up ends of the catheter, so the ends of the tape meet and do not overlap. A properly applied external catheter stays in place, allowing penile erection and proper circulation.

8. Use the clip ring provided on most urinary tubing to secure the urinary drainage bag. Spiral the tubing into a loop before clipping, which allows the patient to move more freely without tugging at the urinary drainage system.

References

• Wound Ostomy and Continence Society: External Catheter Fact Sheet
• Louis Calder Memorial Library of the University of Miami: Urinary Tracty Management in Spinal Cord Injury; 2009