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Complete Guide to Catheters for Male Anatomy: External, Indwelling, Intermittent Catheters
Male anatomy catheters are longer in length to accommodate for the anatomy, and longer urethral length, and range from 16” to 25”.
Male anatomy length catheters are available in a variety of materials and have varying features and benefits. It is important to trial different products to ensure your choice best matches your functional abilities and bladder management needs.
Some individuals with female anatomy may also prefer to use a male anatomy length catheter as it allows for an extended length of catheter to manage. When cathing from a wheelchair, the 25” length can reach to the commode for efficient bladder management, without managing a urinal or bag, and also promoting energy conservation since a transfer is not required.
Understanding Male Anatomy Catheter Types
External catheters (condom catheters):
A catheter worn externally on the penis, like a condom. The catheter connects to a tube attached to a urine collection bag. The collection bag is emptied as needed. This option is commonly utilized for individuals who are incontinent, or who are able to control their bladder, but physical limitations are present. This may include functional mobility and transfers, clothing management, balance, coordination, and more.
PROs:
– Indicated for incontinence, or continent urinary voiding
– Reduced risk of infection
– Less urethral damage
– Allows for continent voiding for those with more involved functional limitations
CONs:
– NOT intended for urinary retention.
– Urine leakage
– Skin irritation/conditions
– UTI
Intermittent catheters:
IC is one of the oldest urologic procedures, dating back more than~3000 years ago, in which reeds, rolled palm leaves, straw, or bronze tubes were used. Intermittent catheterization removes urine from the bladder by placing a hollow, flexible tube into the bladder, which acts as a siphon to drain the bladder of urine. Intermittent catheterization has been deemed the preferred method for bladder management for individuals with SCI. It allows the person to maintain their autonomy while also living their life free of tubes/bags attached to their body.
Fun Fact: Benjamin Franklin invented the flexible catheter!
PROs:
– Can be performed by an individual, caregiver, or health care professional
– Intermittent catheterization is the best solution for bladder decompression of motivated individuals who can physically and cognitively participate in their care
– Preferred by men and women, over indwelling catheters
– Designed to simulate typical voiding pattern
– Can be performed anywhere
– Patient autonomy
– Freedom from catheters, tubes, or bags
– Unimpeded sexual relations
CONs:
– Candidates for IC must have the motivation, physical and cognitive abilities to perform ISC.
– UTI
– Urethral trauma
– Urethral inflammation
– Stricture
– If urethral stricture is present, there ARE catheter options available to accommodate.
Indwelling (Foley) catheters:
An indwelling urethral catheter is typically used short term, less than 30 days; if it is required for longer, it must be changed after 30 days. An indwelling catheter is a hollow tube inserted through the urethra to the bladder; a balloon is inflated within the bladder to allow for continues drainage. The catheter is connected to a tube, and a urine collection bag which is drained as needed. An indwelling catheter my be inserted directly through the urethra, or surgically for a supra-pubic option.
This option may be suitable for someone with significantly mobility limitations, not able to independently perform intermittent catheterization, or have a caregiver perform IC.
*There is a capability for a power wheelchair to be programmed to empty a leg bag, as well; promoting ultimate independence, reducing the risk of UTIs and autonomic dysreflexia.
PROs:
– Decreased caregiver burden.
– Continuous drainage.
CONs:
– Long-term used is discouraged, as indwelling catheters are more prone to infection. 70-80% of infections are attributed to indwelling catheters. The daily risk of bacteria in the urine is 3-7%, with bacteria being universal after the catheter has been in place for 2 weeks.
– Sexual intimacy is not impossible; however, certain considerations and precautions must be implemented.
– May cause encrustation of the catheter, urethral erosion, bladder stones, or other health complications.
Suprapubic catheter:
Suprapubic catheter is a tube inserted through the lower abdomen into the bladder to drain urine, used when the urethra is blocked or unsuitable. It’s often preferred for long-term use, offering more comfort and reduced infection risks compared to urethral catheters.
PROs:
– Attractive alternative to long-term urethral catheter use
– Most commonly used in folks with SCI
– Changed monthly
– Eliminate risk of urethral damage
– Less bladder spasms
– Suprapubic tubes are more sanitary (genital hygiene/bowel incontinence)
– Less traumatic to the urethra
– Less likely to become dislodged
– Allows patient to engage in intercourse with less caution and preparation, and few complications
CONs:
– Prone to infection, since indwelling
– May result in leakage around the catheter, bladder stones, UTI, cellulitis and hematoma around the tube, and catheter obstruction
– Exit hole will seal and close within 24 hours
Intermittent Catheter Sizes and Materials
– French size: French is the diameter of the catheter. This may change through adolescence, and with age. It’s important to work with your healthcare professional to determine the appropriate French size.
– Common sizes for male anatomy (14Fr to 16Fr)
– Materials used (silicone, latex, PVC):
– Polyurethane: VERY rigid!!!
– Polyvinyl chloride/PVC: minimally rigid
– Silicone: moderately flexible
– Latex: VERY flexible.
Each manufacturer provides a variety of products with varying features and benefits. It is important to work with a provider who is not only knowledgeable on the products, but also understands the caveats of insurance and can recommend the best product mix to meet the need, promoting the optimal long-term outcome.
Insertion Techniques for Different Catheter Types:
How to apply a condom catheter using a medical adhesive
1. Apply the condom catheter as usual
2. Flip (i.e. turn inside out) the base of the catheter
3. Apply several drops of adhesive to the exposed catheter
4. Immediately spread adhesive with a fingertip. Optionally apply adhesive to the skin as well, although this is not necessary for most users
5. Wait 3-5 minutes for adhesive to fully dry
6. Flip the catheter back into place
7. Apply pressure to set adhesive
Intermittent catheterization process:
Foley catheter insertion (typically done by healthcare professionals): Foley insertion
Tips for comfortable and safe insertion:
– Relax and BREATHE! Ensure your position is comfortable and optimal for insertion and drainage.
Catheter Care and Maintenance:
Cleaning and hygiene practices:
Storage recommendations: Store catheters in a convenient location: closet, bathroom cabinets, etc. Consider temperature: do NOT leave catheters in your car in the summer, or in your garage in the winter. Temperature changes will impact the chemical compounds of the lubricant, thus affecting the integrity of the catheter. Catheters should remain at room temperature in a dry environment.
Catheters have expiration dates; be sure to monitor!
Managing Common Catheter-Related Issues:
– Addressing leakage problems
– Dealing with discomfort or pain: Catheterization should not be painful; ISC technique and products should be re-evaluated if there is discomfort. Talk to your healthcare provider if your have concerns, and to learn more about your options.
– Recognizing signs of infection:
Frequent urination, burning with urination, discolored urine/heavy sediment, foul/strong smelling urine, fever, generalized feeling of illness, incontinence, increased spasticity (those with SCI) and autonomic dysreflexia (those with SCI T6 and above).
When to seek medical help: UTIs can last days to weeks without antibiotics; if symptoms continue for more than a week, antibiotics are usually necessary, fever chills, nausea/vomiting, back pain, blood/pus in urine, pregnant with a UTI or diabetic with a UTI.
Lifestyle Considerations for Catheter Users:
Traveling with catheters: Pro Tips: Traveling with Medical Supplies
Sports and physical activities: Intermittent catheterization allows for participation in sports and physical activities without catheters, tubes, or drainage bags, which may be pulled or become a burden/cumbersome.
Intimacy and relationships: Be sure to maintain proper hygiene practices; ensure bowel and bladder are both emptied prior to sexual intimacy, and empty bladder and perform hygiene after intimacy (especially those with female anatomy!).
Work and social situations: If an indwelling catheter is utilized, the tubing and drainage bags can be hidden under your clothes so as not to limit work performance and social participation. There are also some adaptive clothing options on the market that conceal catheters and bags.
Intermittent catheterization allows for participation in work and social activities without catheters, tubes, or drainage bags. Adaptive clothing is available to help make the process easier and more efficient.
Additional Prevention Strategies:
– Hydration importance: A consistent fluid intake will help to dilute the urine, and flush harmful bacteria out of the bladder.
– Proper nutrition for urinary health:
– Any type of probiotics: yogurt, sauerkraut, kombucha, pickles, garlic, blueberries, green tea, water, bananas, foods high in fiber, cranberry juice. avoid foods and drinks that have a high sugar content (i.e, energy drinks, sodas, candy), avoid coffee, caffeine, alcohol, avoid spicy food, avoid high acidic foods: oranges, lemons/limes if you have an active UTI as it can further irritate your bladder; however, foods high in vitamin C (strawberries, green peppers, spinach) can help prevent future infections.
– Regular medical check-ups: Regular visits with your medical provider will help to properly manage bladder health, and minimize complications.
– Knowing what is “normal” for you will be a crucial component is recognizing what is “abnormal”.
Speak with a Numotion catheter specialist today to find the right catheter solution for your needs. Call or browse our catheter selection.