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Let me start by reminding everyone – I’m not a doctor, I can’t/won’t diagnose your conditions, I leave that work to the actual experts.
What I can say is that urinary incontinence is a common, debilitating, and embarrassing symptom associated with many conditions, including many diseases of the central nervous system like multiple sclerosis, Parkinson’s, and dementia, but is also common as men age.
According to the United States Department of health and Human Services, as many as 14 million men in the United States are living with benign prostate enlargement, which affects 50 percent of men aged 51-60.
These conditions, and others, may cause feelings of urgency, resulting in uncontrolled leakage, and incontinence. It is especially complicated to manage this condition discretely, especially if the person living with incontinence is a man. While women with minor leakage may be able to conceal their condition with feminine hygiene products, men do not have the same discrete options unless they are willing to wear adult diapers.
There are many options when it comes to managing incontinence and your physician may recommend behavioral therapies, exercises, prescription medications, electrical stimulation, interventional therapies, or even surgery.
External catheters are a popular option for men whose incontinence is not well controlled, even while engaged in therapies to help. Additionally, some men may not tolerate therapeutic options well or they may be more inclined to manage the condition in the most minimally invasive manner.
Best External Catheter Options
External catheters, for the most part, are divided into three buckets – self-adhesive condom catheter, strap-worn condom catheter, and “other” external catheter. Each product has its own benefits and challenges.
Best Strap-Worn External Condom Catheter – Rochester Natural Condom Catheter
A strap-worn condom catheter, or “natural” condom catheter, is one that does not attach to the penis with adhesive. Rather, it attaches with (usually) a foam and Velcro strap that fastens the catheter in place so that it doesn’t roll off throughout the day with movement or shrinkage. It is made from silicone, not latex, so it’s ideal for anyone with a latex allergy. This condom catheter works well for those who do not tolerate adhesive well, or for those who need to remove the catheter throughout the day. While the strap helps keep this catheter in place, it is ideally used in those who have limited movement throughout the day. The cost for the Rochester Natural Condom Catheter is reasonable, under $1.50 U.S. per unit out-of-pocket. However, this condom catheter must be attached to a leg or drainage bag with tubing, which come in a variety of sizes but at an additional cost. Common leg bag sizes range from 500ml to 1000ml, and are usually sold with leg straps and tubing to connect the catheter to the bag. Drainage bags (different than leg bags) are typically used at night or for those who are bed bound and will be able to hold more urine than a leg bag.
Best Self-Adhesive External Condom Catheter – UltraFlex 29” (Medium), UltraFlex 32” (Intermediate), or UltraFlex 36” (Large)
This self-adhesive catheter is one of the most popular on the market for a variety of reasons – it is successful in protecting against leaks, relatively inexpensive, comfortable to wear, and may be worn for up to 24 hours. These condom catheters are also made from silicone. The most common challenge is that the adhesive on this device strong and may be uncomfortable to remove. Another challenge is that users may have to try different sizes before deciding on which length to use. It is recommended that men between sizes select the smaller size. UltraFlex condom catheters must be worn attached to a leg or drainage bag. UltraFlex condom catheters are highly rated and worth trying, especially since the item itself is not cost prohibitive.
Best “Other” External Catheter – Men’s Liberty
When you search for “external condom catheters men” on the internet, a product called Men’s Liberty pops up. While the goal – to protect against leakage and embarrassment is the same – the Men’s Liberty does not function in the same way. Other external catheters look and are worn the same way a man would wear a condom, and fits the length of the whole penis. Men’s Liberty is different – it self-adheres to the head only, reducing the chances of leakage due to shrinkage and can be worn for between 24-48 hours. Men’s Liberty may be worn without a leg bag because a small repository holds up to 8 oz of fluid, but it is recommended that the bag is drained when it reaches between 5-6 oz to prevent leakage. You read that correctly – the leg bag may be optional. In the world of male catheters, these advances are revolutionary. A challenge is that out-of-pocket the device will run over $15 per unit. If you have insurance that covers items like catheters, it is worth trying this device (I recommend trying them out for 3-4 days over a long weekend) and then requesting a prescription for them from an urologist.
Necessary Accessories for Men with External Catheters
Urine Containment Bags – Leg and Drainage Bags
Rusch (Teleflex) 500ml Leg Bags are the perfect size if you are looking for a few hours of wear before having to drain, and a leg bag that isn’t the size of a large balloon when it is full. This leg bag is easily hidden on one’s thigh under long shorts or on the shin under long pants. These bags are reusable and may be washed out with warm water and bleach.
MedLine 2000ml Drainage Bags are large enough for overnight use, may be hung on a hook, or secured to bed sheets with a clamp, and prevents urine backflow into to the drain tube. The only concern to be mindful of when using these bags is that the drain tube may crack with overuse.
Adapt Adhesive Remover Spray is an absolute must, in my opinion, when using a self-adhesive catheter. This product helps even the toughest adhesives loosen off of skin, helping to prevent skin irritation. As with any product used on the skin, a patch test is recommended.
External catheter use may help improve quality of life for you and your loved one, but don’t toss those urinals away. Draining leg bags and overnight bags will happen one of two ways – disconnecting the bag and walking the whole thing over to the toilet, or draining the bag into a urinal and pouring that into the toilet. The second option is much less cumbersome. The best urinal is the McKesson Male Urinal for this reason – the handle is a hollow tube that fills and drains with the rest of the urinal. Other brands pinch the hollow handle at the top and urine gets trapped in the handle which makes reusing them gross.
If the overnight drain bag isn’t being hung on a pole, I highly recommend the bag be placed on the floor in a large Rubbermaid Plastic Dishpan. Mistakes happen. Leaks happen. Nobody wants to wake up to a mess on the floor – so save that energy for something more important and keep the drain bag in the tub.
I hope that you have found this information helpful – incontinence is quite damaging to quality of life for those living with it and for those helping them cope.