Another form of treatment that you might prefer is a condom catheter. A condom catheter is a sheath-like device that is placed around the penis and secured with adhesive or a strap. The other end of the sheath is connected to a small tube, which leads to a drainage bag, which may be strapped to the leg. Like the penile clamp, it is possible to put the condom catheter on too tightly and damage the penis and, accordingly, you should exercise the same precautions.
The least desirable alternative is the use of an indwelling bladder catheter. The catheter is a plasticlike tube which is inserted through the penis into the bladder and retained in place by an inflatable balloon at the end of the catheter. Urine drains from the bladder to the tube into a leg bag in a similar fashion as the condom catheter. You might find the indwelling catheter preferable to the condom catheter because it is much more secure, and, believe it or not it is usually quite comfortable. Most of the time, you aren’t even conscious of it being there. However, of all the forms of treatment, the indwelling catheter poses the greatest risk to your health. The chances of a serious kidney infection are much greater with a Foley catheter than with the other forms of treatment and there is a possibility that you will develop a urethral stricture. A urethral stricture is a circumferential scar in the urethra which causes a blockage and can make subsequent treatment of the incontinence much more difficult. Further, the catheter can become blocked and cause severe pain and infection. For practical purposes, the longer the catheter is used, the greater the chances that you’ll develop on of these complications.
If you do choose to use an indwelling catheter, there are a number of precautions you can take to minimize the likelihood of complications. Firstly, you should change the catheter frequently, no less often that every two or three weeks. Blockage of the catheter, manifest by the absence of urine flow for more than an hour or so, is a medical emergency that requires your immediate attention. The first thing you should do is check to be sure that the tubing from the drainage bag is not simply twisted; if it is, when you straighten it out, urine should start to flow immediately. If the tubing is not twisted, the next thing that you should do is to irrigate the catheter. This means that you take a large syringe, fill it with water or an irrigating solution of saline (salt water) and squirt it through the end of the catheter, after disconnecting it from the drainage bag. If this doesn’t clear the blockage, it’s best if you just change the catheter. We think that it is very important that you, yourself learn to do these things so that you can be as independent as possible and not have to rely on family members, nurses, doctors, or, worst of all emergency rooms.
Since men have a penis, among other things, a penis is good for is holding appliances to drain the urine if you are incontinent. One kind of appliance is called a condom catheter. A condom catheter looks like an ordinary condom, but it has a hole in the end near the tip of the penis (I don’t recommend that you use this for contraception). The condom is pulled over the penis to which it is attached with an adhesive or a strap. At the tip of the catheter where the hole is, there is a tube that connects to a drainage bag which is worn on the leg. Urine flows through the condom, through the tube and into the bag and is emptied periodically. Condom catheters are most often used in patients with neurologic disorders but occasionally may be used in men with severe sphincteric incontinence. If the condom catheter is applied too tightly, which is particularly a problem if there is a neurologic disease that impairs sensation, they can cause irritation and even severe infection or gangrene of the penis. Another complication of condom catheters, particularly in neurologic patients, is a blockage to the flow of urine. The pressure builds up in the urethra behind the blockage and a diverticulum or out pouching of the urethra can occur. Accordingly, the condom should be checked periodically throughout the day to be sure that they’re not too tight, and the condom should be changed daily.
Another type of appliance for men is a small pouch made of an absorbent material that goes around the penis, but it is not secured to the penis. When urine leaks out, it is absorbed by the pouch which is discarded periodically throughout the day.
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