Many patients don't require an indwelling urinary catheter to manage their incontinence. For male patients, a male incontinence device reduces the risk of urinary tract infection (UTI) from catheterization, promotes bladder retraining when possible, helps prevent skin breakdown, and improves the patient's self-image.
The device consists of a condom catheter secured to the shaft of the penis and connected to a leg bag or drainage bag. It has no contraindications, but it can cause skin irritation and edema. Most are made of soft silicone, but there are still latex catheters available.
Condom catheter kit (condom sheath of appropriate size) drainage bag or leg bag and straps extension tubing hypoallergenic tape or incontinence sheath holder commercial adhesive strip or skin-bond cement elastic adhesive or Velcro, if needed gloves scissors, if needed basin soap washcloth towel optional: solvent.
Fill the basin with lukewarm water. Then bring the basin and the remaining equipment to the patient's bedside.
Assess the condition of the skin of the patient's penile shaft.
Determine if there is a latex allergy.
If a female nurse is responsible for the patient, consider asking if the patient would prefer having a male nurse or NAP perform the procedure.
Explain the procedure to the patient, wash your hands thoroughly, put on gloves, and provide privacy.
Follow the manufacturer's directions for applying and securing the condom catheter.
If the patient is circumcised, wash the penis with soap and water, rinse well, and pat dry with a towel. If the patient isn't circumcised, gently retract the foreskin and clean beneath it. Rinse well but don't dry because moisture provides lubrication and prevents friction during foreskin replacement. Replace the foreskin to avoid penile constriction.
If necessary, clip the pubic hair at the base of the penis to prevent the adhesive strip or skin-bond cement from pulling pubic hair. Some manufacturers provide a hair guard that is placed over the penis before applying the catheter. It is removed once the catheter is placed.
If you're using a precut commercial adhesive strip, insert the glans penis through its opening and position the strip 1'' (2.5 cm) from the scrotal area. If you're using uncut adhesive, cut a strip to fit around the shaft of the penis. Remove the protective covering from one side of the adhesive strip and press this side firmly to the penis to enhance adhesion. Remove the covering from the other side of the strip. If a commercial adhesive strip isn't available, apply skin-bond cement and let it dry for a few minutes.
Position the rolled condom catheter at the tip of the penis, with its drainage opening at the urinary meatus. Allow 1'' to 2'' (2.5 to 5 cm) of space at the tip of the penis to prevent erosion and to allow for expansion when the patient voids.
Unroll the catheter upward, past the adhesive strip on the shaft of the penis. Then gently press the sheath against the strip until it adheres. (See How to apply a condom catheter.)
After the condom catheter is in place, secure it with hypoallergenic tape or an incontinence sheath holder.
Using extension tubing, connect the condom catheter to the leg bag or drainage bag. Remove and discard your gloves.
Put on gloves and simultaneously roll the condom catheter and adhesive strip off the penis and then discard them. If you've used skin-bond cement rather than an adhesive strip, remove it with solvent. Also remove and discard the hypoallergenic tape or incontinence sheath holder.
Clean the penis with lukewarm water, rinse thoroughly, and dry. Check for swelling or signs of skin breakdown.
Remove the leg bag by closing the drain clamp, unlatching the leg straps, and disconnecting the extension tubing at the top of the bag. Discard your gloves.
If hypoallergenic tape or an incontinence sheath holder isn't available, secure the condom with a strip of elastic adhesive or Velcro. Apply the strip snuglybut not too tightlyto prevent circulatory constriction.
Inspect the condom catheter for twists and the extension tubing for kinks to prevent obstruction of urine flow, which could cause the condom to balloon and eventually dislodge. (See Documenting use of a male incontinence device.)