Urologicals

Men and Their Catheters: A Quick Tutorial

Reviewed by Christine Kijek, Registered Colorectal Nurse, on September 6, 2022

Intermittent Catheters     |    Indwelling Foley Catheters     |    External Condom Catheters

In America, there are millions of men who need to use catheters every day. The reasons for this are plenty and so are the options available to male patients. The two main causes for the need for a urinary catheter are the inability to completely empty one's bladder (urinary retention) and the emptying of the bladder at inappropriate times (incontinence). The anatomical differences between men and women create some unique circumstances for males. Many men have felt the stigma of a bladder that doesn’t work properly so they may withdraw socially and derail from  experiencing a fulfilling lifestyle. What men need to understand is there is no shame and there are numerous options available that allow them to regain their freedom and lifestyle.

Why would a man need a catheter?

I’m sure if you were to ask men if they prefer to use a catheter, they would say no, but there are many reasons as to why they need this for a healthy lifestyle. The reasons for catheter use can vary from man to man but all have one thing in common: they prevent the proper emptying of the bladder. The National Institutes of Health have identified several factors that can lead to catheter use.

• Urinary incontinence or retention (inability to control your urine and the inability to completely empty your bladder, respectively) is a leading cause.
• Also, surgery for the prostate or genitals can lead to catheter use.
• Medical conditions such as multiple sclerosis or dementia.
• Another common reason for the need for catheters is spinal cord injuries, where you can’t sense the need to empty your bladder nor do you have control over it.

The act of male urinary catheterization is relatively simple, the eyelid side of the catheter is inserted into the urethra (taking care not to touch it with anything that is not sterile) until the tip reaches the bladder and the urine starts draining. Whether the cause is bladder/prostate cancer, diabetes, or an injury there are many options for patients to accommodate just about everyone’s lifestyle.

Types of Catheters for Men

As you can imagine men have different needs as well as different lifestyles. With this in mind, there are many different options to accommodate most men when it comes to their catheterization needs. The first step in determining what might work for you is to identify what specific medical needs you may have. Your urologist can help with this process by giving you the pros and cons of each catheterization system. WebMD.com notes that there are basically three different types of catheters for men. They are:

• Intermittent Catheter - Intermittent catheter is a thin hollow tube that is inserted into the bladder through the urethra to drain urine. It is used for intermittent self-catheterization.
• Indwelling Foley Catheter - These stay in place continuously and are held in place by a balloon that is inflated inside the bladder. While convenient, the risk of urinary tract infections (UTI) is higher with indwelling catheters than intermittent catheters.
• Condom Catheter - Also known as a Texas catheter, it is a special type of condom attached to a special tube to collect urine. It is for short-term use only since long-term use can increase the risk of UTIs, urinary blockage, and skin irritation.

even silicone coated PVC in order to give patients a variety of options. Another factor that can influence your decision of catheter style is the extent of your injuries. For instance, somebody affected by a spinal cord injury that won’t allow the patient to self-catheterize might opt to use a Foley catheter since they cannot self-cath. For an enlarged prostate, the use of a Coude tip (curved tip catheter) may allow for easy insertion around an obstruction.

Even among these types of male catheters, there are variations that allow patients to choose what might fit them the best. Many of them can be carried discreetly in a man’s pocket and are known as male pocket catheters.

• Bard offers users many variants of their intermittent catheters. The Bard Bardex Robinson Red Rubber Urethral Catheter features two opposing eyes with a hollow round tip while the Bard Bardex Whistle Tip Latex Urethral Catheter has a single drainage eye that maximizes flow and an open whistle tip. Both are meant for single use and are sterile to minimize the risk of infection.
• For those who are sensitive to latex, Bard offers the Bard Clean-Cath PVC Intermittent Catheter. It is individually packaged in a sterile easy open package and has a smooth round tip for easy insertion.
• Another option is to use a catheter made of silicone. The Coloplast Self-Cath Plus Soft Intermittent Catheter is completely latex free and reduces the risk of urethral trauma.
• Many patients experience difficulty inserting a straight tipped catheter and therefore may require a Coude curved tip in order to get around some kind of obstruction. The Coloplast Self-Cath Coude Tip Intermittent Catheter features a guide strip to assure proper alignment of the curved tip.
• Another option that combines the benefits of PVC and silicone is the Rusch ERU Siliconized PVC Intermittent Catheter. It is flexible with a curved tip and a stiffer shaft to help ease male catheter insertion.
• Some standard catheter systems are enclosed. This means that the urine is collected in a closed bag that is attached to the tube. The Coloplast Self-Cath Closed System Intermittent Catheter is a good example. It features an introducer tip that reduces the risk of bacterial contamination during insertion and comes with a 1100ml collection bag.
• Another closed system that reduces the risk of UTIs is the Rusch MMG Closed System Intermittent Catheter. Its soft silicone introducer tip is lubricated with a non-allergenic water-soluble lubricant which minimizes the risk of bacterial infection.

Some men may need to use an indwelling catheter such as the Foley catheter. These stay in place and are held by an inflated balloon in the bladder to prevent slippage. Just like with intermittent catheters for males, there are many different variations of male Foley catheters in order to accommodate just about every patient's needs. A two-way Foley catheter has two separate “branches” to allow for balloon inflation and urine drainage.

• One example of this system is the Covidien Two-Way Hydrogel Coated Latex Foley Catheter that is coated with a slick hydrogel coating for easy insertion and less trauma to the urethra.
• The Bard Bardex Lubricath Two-Way Foley Catheter is another latex-based catheter that uses a hydrogel coating to create a hydrophilic cushion between the catheter surface and the urethra. This enhances patient comfort and resists the buildup of urine salts.
• Some patients may have sensitivity to latex and therefore may opt for a silicone catheter. A good example of this is the Coloplast Folysil Two-Way Indwelling Catheter. It features a larger lumen to reduce obstruction and the larger diameter eyelets allow for better drainage. Its silicone coating provides smoothness to ease catheterization.
• The Kendall Dover Two-Way Silver Coated 100% Silicone Foley Catheter is a silicone catheter that has a bullet shape for easy insertion and less tissue trauma as well as a 30% larger inflation lumen.

Foley catheters are also available in three-way variations. These allow for a third option of irrigation, in addition to urine drainage and balloon inflation.

• These catheters, such as the Bard Bardex Three-Way Infection Control Foley Catheter, reduce catheter associated UTIs and can inhibit the migration of pathogens into the bladder.
• To minimize collapse due to the vacuum of draining, the Bard Bardex Lubricath Three-Way Hematuria Foley Catheter utilizes a wound nylon coil to reinforce the shaft of the catheter.

Male external catheters are unique to men since the condom fits over the male penis. They are easy to use, but should only be for short-term use. While convenient, over time skin irritation and urinary blockage can occur. Much like Foley catheters and intermittent catheters, they also offer many options to patients, such as silicone or latex.

• Coloplast offers several options including the Coloplast Freedom Clear Advantage Male External Condom Catheter which is a premium latex-free, silicone, one-piece catheter designed for maximum wear time. The thin silicone sheath increases comfort and breathability while the adhesive features aloe. The kink-resistant nozzle ensures a free flow at all times.
• If you choose latex, the Coloplast Active-Cath Male External Catheter combines a comfortable sheath with a wide comfortable seal which is easy to apply and is color-coded for user-friendly sizing.
• Another option available is the Hollister Everyday Male External Catheter which resists tearing with durable latex and is available in four different sizes to accommodate most men.
• For men who have a retracted or small penis, the Rochester Pop-On Self Adhering Male External Catheter offers soft breathable silicone and forward placement adhesive technology with a 1-½ inch sheath for their specific catheterization needs.
• The Coloplast Freedom Clear Sport Sheath Male External Condom Catheter also addresses any latex allergies as well as roll up at the base of the catheter with a thin brief silicone sheath.

No matter what the reason is or what the injury or illness might be, there are options for men so that incontinence does not dictate your lifestyle. It may take some trial and error or mixing and matching, but overcoming the stigma of using catheters is your first step towards regaining your independence.
 

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