A male external catheter – also known as a condom catheter or texas catheter – is a simple, widely used product for managing incontinence. Unlike the internal catheters often used during hospital stays, external catheters for male incontinence do not enter the urethra. These carefully-designed latex and latex-free devices are applied over the penis like a condom, and urine drains through tubing into a collecting bag. They can be worn discreetly under clothing, and may be used throughout the day or only at night, if preferred.

Not all male external catheters are the same, and you may need to try several different types before deciding which style best meets your needs. They come in different materials and sizes, and with different features – such as with and without adhesive.

Male External Catheter Application

For the best experience, it is important to have the right size and fit.  It’s also very important to prepare the skin and apply the condom catheter correctly. The following information will help you wear the device more comfortably and help you get the most wear time from each catheter.

Here are the five steps for male external catheter application:

1. Prepare Skin.  Wash your penis and blot dry.  Skin must be clean and dry before application, free from oils and moisturizers.  A skin protectant spray or skin protectant wipe is optional, and may be used for added protection and comfort. If a skin protectant is used, allow it to fully dry until it is slick and smooth.  If necessary, trim any pubic hair that might get caught as the condom catheter is rolled to the base of the penis.
2. Select a Size.  Make sure you are using the correct size by measuring both circumference and length.  All manufacturers of male external catheters have a measuring guide to help you select the appropriate size.  With Hollister’s condom catheter sizing guide, place the notch area just behind the glans and select the size that most closely fits. If you measure between two sizes, choose the larger of the two.  For best results, ask your primary care physician to recommend a nurse specialist with experience in sizing and teaching men to use condom catheters.
3. Leave a Gap.  Use your non-dominant hand to grasp the penis at a 90-degree angle along the shaft, and with your dominant hand place the rolled condom sheath over the tip of the penis. Be sure to leave a small gap (at least 1/2 inch) at the end of the condom catheter to allow for free flow of urine.  The end of the condom catheter should not touch the tip of the penis.
4. Apply the Catheter. Unroll the sheath slowly and smoothly, pressing the condom against your skin as you roll.  When the condom is completely unrolled, gently squeeze the catheter around the penis shaft for ten to fifteen seconds to eliminate air bubbles and ensure adhesion.  If there are many wrinkles in the sheath, the condom catheter may be too large.  In some instances, the condom catheter may not fully unroll, leaving a roll of the condom at the base of the penis.  To prevent pressure sores and to keep the catheter on securely, you should carefully snip the unused roll in several places, or remove it completely.
5. Connect the Bag.  Connect the catheter to the urine collection system, such as a leg bag.  Insert the plastic connector of the drainage tubing into the full length of the catheter tip. Make sure the condom catheter is not twisted while connecting the tubing. There should be a small pocket of air in the urine bag to prevent a vacuum from forming, which can cause backflow and leakage.  When used during the day, empty the leg bag on a regular basis, when it is approximately two-thirds full.  Smaller bags may be used during the day, for comfort and mobility, while a large capacity bag may be preferred overnight.

Male External Catheter Removal:

Condom catheters should be changed daily, and should not be worn for more than 24 hours.  After each removal, inspect skin thoroughly to ensure skin integrity.  To reduce the risk of skin irritation, allow skin to breathe for short periods between condom catheter changes.

To remove, detach the catheter from the urine collection system and carefully roll the catheter off.  If needed, use warm water or adhesive remover to aid in the removal process.  Wash skin thoroughly with warm water and soap.  Dry skin thoroughly, inspect skin for irritation, then re-apply a new catheter when ready.

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