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Also known as
Condom catheter, Texas catheter, Male external catheter, Urinary sheath, External urinary collection device (EUCD), Penile sheath, External catheter, Urisheath, Male incontinence device, External urinary management system, Condom-type urinary collection device, Non-invasive urinary collection device, External urinary drainage system
Definition
An External Collecting Device is a non-invasive medical apparatus designed to collect urine in incontinent males without the need for bladder catheterization. These devices adhere to the external genitalia or pubic area and collect urinary output, directing it to a drainage bag.1 They are distinguished from indwelling catheters that are inserted into the bladder vesicle using a transurethral or suprapubic route.1
External collecting devices can be categorized into several types, including condom catheters (also known as Texas catheters), reusable body-worn urinals, and nonsheath glans-adherent devices.1 Most condom catheters are constructed from materials such as silicone, which have replaced the original latex versions.1 These devices adhere to the penile shaft via an adhesive applied to the interior surface, a double-sided adhesive strap, or through an internal ring that is inflated with air.1
For men with obesity or retracted penile shafts, specialized penis pouches are available that attach to the pubis via a hydrocolloid wafer barrier.1 The nonsheath, glans-adherent external collecting device is a one-size-fits-all option that can be applied to both circumcised and uncircumcised males, as well as those with smaller penile circumferences.1
These devices are primarily used to manage urinary incontinence while reducing the risk of catheter-associated urinary tract infections (CAUTIs) that are common with indwelling catheters.2 The anticipated wear times for condom catheters are typically 24 to 72 hours, while penis pouches may be worn for 2 to 7 days depending on the system type.1
Clinical Context
External Collecting Devices are primarily used in clinical settings to manage urinary incontinence in male patients while reducing the risk of catheter-associated urinary tract infections (CAUTIs).1 These devices are particularly valuable as part of CAUTI prevention bundles, with multiple evidence-based guidelines recommending their use as alternatives to indwelling catheters.1
The clinical application of External Collecting Devices is appropriate for cooperative male patients without urinary retention or bladder outlet obstruction.1 They are especially beneficial for patients with functional incontinence, where the individual has normal bladder function but cannot reach the toilet in time due to mobility limitations, cognitive impairments, or other functional barriers.3
Patient selection criteria include:
- Male patients with urinary incontinence but without retention issues1
- Patients at high risk for CAUTIs with indwelling catheters1
- Cooperative patients who can manage or have assistance with the device1
- Patients with intact penile skin (free from wounds, lesions, or dermatitis)3
The application procedure varies by device type but generally involves measuring the penile diameter, cleansing and drying the penile skin, and applying the device according to manufacturer instructions.1 For condom catheters, proper sizing is essential to prevent complications such as skin breakdown or constriction.1 For nonsheath, glans-adherent devices, application involves adhering the device to the glans penis rather than covering the entire shaft.1
Expected outcomes include reduced CAUTI rates compared to indwelling catheters, improved patient comfort, and maintained skin integrity when properly applied and monitored.2 However, complications can occur, including skin irritation, maceration, or allergic reactions to adhesives or device materials.3 Regular assessment and device changes (typically every 24-72 hours for condom catheters) are necessary to prevent these complications.1