A condom catheter, also known as external urinary catheter or urinary sheath, consists of a flexible sheath that fits over the penis, much like a condom, and is connected to tubing that lets urine flow to a drainage bag. This provides a safe and non-invasive way to commonly manage urinary incontinence or involuntary loss of urine in clients with penises.
Common care tips
Condom catheters should be changed on a daily basis. Before we talk about how to apply or remove a condom catheter, here are some general considerations.
- First, ensure that you select the appropriately sized device.
- If it’s too small, it may compress or traumatize the urethra, restricting the flow of urine or blood; if it’s too large, it could leak or slip off.
- Clip the hair at the base of the penis or put on a hair guard (Fig. 2a) before applying the catheter to prevent hairs from getting in the catheter.
- Check the type of condom catheter used.
- Some are held in place by a self-adhesive coating on their inside, while others need an external strap of elastic tape.
- Close the room’s door and bedside curtain and respect the client’s privacy.
- Before beginning the procedure, unclip the tubing from either the bedsheet, the bed linens, or the client’s leg.
- Once you are finished replacing the condom catheter, secure the tubing again. Make sure that it doesn’t have any kinks and that the condom is not twisted because that will obstruct urine flow.
- Place the drainage bag below the level of the bladder to prevent the urine from flowing back into the bladder.
Removing and replacing a condom catheter
First, gather the supplies you will need, including:
- paper towels
- a wash basin
- soap, towels, and washcloths
- a waterproof bed pad
- a bath blanket
- a new condom catheter
- elastic tape (if the condom catheter is not self-adhesive)
Removing a condom catheter
- Cover the over-bed table with paper towels. Then fill the wash basin with water and check that the temperature is comfortably warm. Place the basin together with soap, towels, and washcloths on the over-bed table.
- Ensure that the wheels on the bed are locked and raise the bed to a comfortable working height. Lower the side railings on the working side of the bed.
- Put your gloves on.
- Slide a waterproof bed pad under the client’s buttocks to protect the bed linens.
- Cover the client with the bath blanket, exposing only the genital area.
- Ask the client to spread their legs and bend their knees, if they can. If not, help them to do so, as much as possible.
- To remove the condom catheter, pull the tape off - if there is any - and gently roll the condom down the penile shaft.
- Disconnect the tubing from the condom sheath, cap the tube, and discard the whole system.
- Wash the penis thoroughly with warm water and soap and dry it with a towel to prevent skin breakdown.
- Remove your gloves, practice hand hygiene, and put on clean gloves.
Replacing a condom catheter
- Hold the penis tightly along its shaft with your non-dominant hand. Then, smoothly roll the condom sheath onto the penis using your dominant hand.
- Remember to allow a distance of 2.5–5 cm, or 1–2 inches, between the tip of the glans penis and the end of the condom catheter.
- Secure the condom.
- If it’s self-adhesive, apply gentle pressure on the penile shaft for approximately 10–15 seconds.
- If not, apply an elastic tape strip in a spiral rather than a circular manner. This allows the tape to expand, preventing it from compromising blood flow to the penis.
- If the client has a foreskin, return it to its normal position.
- Connect the end of the catheter to the drainage tubing.
- Remove the waterproof bed pad and the bath blanket and help the client go back into a comfortable position.
- Return the side rails to the raised position and lower the bed to the proper height.
After removing or applying a condom catheter, you should notify the healthcare provider if:
- you notice areas of redness, swelling, or skin irritation on the penis; any changes in the color, clarity, or odor of the urine; or the presence of blood or particles in the urine
- the client reports feelings of pain, burning, or irritation during urination that persists after the procedure
Document these findings, along with:
- the date and time
- the amount of urine present in the drainage bag