Incontinence Products and Devices for the Elderly

Diane K. Newman, MSN, RNC, CRNP, FAAN

Disclosures

Urol Nurs. 2004;24(4) 

In This Article

External Catheter Systems

External catheter (condom) systems, referred to as penile sheaths, direct urine into a drainage bag and are used most commonly by men who use a wheelchair and those who have moderate to severe UI. Adhesive strips (see Figure 24A) and other fixation devices have now largely been replaced by self-adhesive sheaths, which are safer and more popular with users (see Figure 7A). Sheaths have changed little in appearance over the last 20 years, although the material of newer sheaths is more likely to be silicone than latex (Edlich et al., 2000) (see Figures 7B, 7C, 8, & 23). Men at a VA medical center found the condom catheter more comfortable, less painful, and less restrictive on their activities (Duffy et al., 1995). The only complaint was from urinary leakage (Saint, Lipsky, Baker, McDonald, & Ossenkop, 1999). It is very common for elderly men to have a "retracted" penis. An external catheter that adheres to the glans penis may be an option in these men (see Figures 8 & 24C). There are adhesive urinary pouches that are similar to ostomy appliances that may be more appropriate (see Figure 9). If an elderly patient has difficulty with dexterity and manipulation of small objects, the ease of application and removal of an external catheter may be an issue. Identification of a caregiver or family member who will apply the catheter must be considered. In an institution, the staff can be taught to apply these catheters.

Latex External Catheter. Photo courtesy of Coloplast.

Latex Self-Adhesive External Catheter. Photo courtesy of Hollister.

Self-Adhesive External Catheter with Removable Tip to Allow for Intermittent Self-Catheterization. Photo courtesy of Hollister.

Self-Adhesive External Catheter. Photo courtesy of Coloplast.

External Retracted Penis Pouch. Photo courtesy of Hollister.

Self-Adhesive External Catheters. Photo courtesy of Mentor.

Latex External Catheter (2-Piece) With Adhesive Strip. Photo courtesy of Coloplast.

Reusable External Catheter System. Photo courtesy of Arcus Medical.

External Condom Catheter. Photo courtesy of BioDerm.

Because there are several sizes of condom catheters, it is important to use a measuring or "sizing" guide supplied by manufacturers. When choosing a size, allow for nocturnal erections in the sizing of the device. A medical adhesive (commonly used when applying ostomy bags) can be applied around the circumference of the penis to ensure that the catheter "adheres" to the penis (Newman, 2000). The adhesive must be dry before rolling on the catheter. A skin barrier product can be applied to the penis to protect penile skin from breakdown secondary to repetitive application and removal of an adhesive device.

There are external collection devices for women that funnel the urine via a pouch to a tube and collection bag (see Figure 10). However, none have proven to be totally useful for elderly women in wheelchairs or those who are bedbound.

External Female Pouch. Photo courtesy of Hollister.

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