Using Condom Catheters: Guidelines for Use

Learn how and when to use condom catheters.

Condom catheters are external urinary catheters that are worn like a condom. They collect urine as it drains out of your bladder and send it to a collection bag strapped to your leg. They’re typically used by men who have urinary incontinence (can’t control their bladder).

External urinary catheters are less invasive than internal catheters, which drain urine from your bladder via a thin tube inserted into your urethra (Foley catheter) or via a small incision in the skin above your bladder ( Intermittent Catheter ).

Men often prefer condom catheters over internal urinary catheters because they’re easier to use, can be changed at home, and are noninvasive (that is, nothing is inserted into their body).

Keep reading to find out who’s a good candidate for an external condom catheter, how to use one, benefits and disadvantages, and more.

Who’s a good candidate for a condom catheter

Condom catheters are designed for men whose bladders are able to drain urine but who have trouble controlling when it’s released. Some of these conditions are:

• Urinary Incontinence. This condition happens when you no longer have control over your bladder and can’t prevent urine from leaking out of your urethra.

• Overactive bladder (OAB) An OAB causes sudden urges to urinate that you can’t control.

• Dementia. Incontinence may develop in the later stages of dementia.

• Mobility issues. Some injuries or conditions make it difficult to get to the bathroom on time or at all.

Condom catheters are also used in special situations, such as when:

• a doctor needs an accurate measurement of the amount of urine that is passed to determine an appropriate dose of diuretics or other medications

• an internal catheter can’t or shouldn’t be used (due to issues such as urinary tract infections , bladder spasms , or bladder stones)

Condom catheters can be used by both circumcised and uncircumcised men.

When an internal catheter is more appropriate

Condom catheters aren’t helpful if urine can’t drain out of your bladder. In that case, an internal catheter is needed to bypass whatever is stopping the urine flow.

Conditions where an internal catheter is used include:

• Urinary retention. This condition prevents you from completely emptying your bladder.

• Neurogenic bladder. A nerve problem, like a spinal cord injury or multiple sclerosis, can also prevent your bladder from emptying.

• Urinary tract blockage. Bladder stones and urethral strictures (scar tissue that narrows the urethra) can block urine flow.

What are the benefits of a condom catheter?

Condom catheters have several benefits over internal catheters. For example, they:

• are less likely to cause a urinary tract infection

• are more comfortable

• cause less movement restriction

• are noninvasive (nothing is inserted in your body)

• are available for home use (can be put on without a doctor or nurse)

What are the disadvantages of a condom catheter?

Condom catheters also have some disadvantages. For example, they:

• can leak if you’re using the wrong size and the fit isn’t correct

• can cause skin irritation and breakdown from urine leakage

• are more likely to fall off or leak than internal catheters

• can potentially cause an allergic reaction (from the latex condom or the adhesive)

• can be painful to remove

• can be easily removed (which is not good for those with dementia)

• can still cause a catheter-associated urinary tract infection (CAUTI) , but this is less likely than with an internal catheter

What size of Condom Catheter should I use?

Condom catheters come in various sizes and have different features.

Each condom catheter page includes a sizing chart.

To determine the correct size for an external catheter, it's important to follow some guidelines to ensure a snug fit without causing leakage or skin damage. For male external catheters (MECs), proper sizing is crucial to prevent leakage and/or skin damage. A catheter that is too loose may result in leakage, while one that is too tight could lead to constriction. Here are the steps and tips for measuring and selecting the right size:

1. Measure the Circumference: The circumference of the penis should be measured in its relaxed, flaccid state at the widest part, using a size guide or metric measuring tape. If the measurement falls between two sizes, it is generally recommended to choose the smaller size for a more secure fit without causing discomfort or constriction​.

2. Use a Size Guide or Stencil: Some methods include using a measuring tape or a sizing stencil. A measuring tape can directly measure the circumference, whereas a sizing stencil, often star-shaped with different measurements marked at its crests, is placed over the flaccid penis to find the fitting size. Brands may have different size ranges, so it's beneficial to check with the specific manufacturer's guidelines

How to put on a condom catheter

1. If necessary, remove the old condom by rolling — not pulling — it.

2. Using soap and warm water, wash your hands and your penis. Be sure to retract the foreskin (if present) and clean the head of the penis. Pull it back over the head when done.

3. Rinse your penis, and then let it dry completely.

4. Check your penis for irritation or open sores.

5. If you’re using a sealant, apply it to the skin on your penis and surrounding pubic area and let it dry. It should feel smooth and slippery when it’s dry.

6. Place the condom over the tip of your penis and slowly unroll it until you get to the base. Leave enough room at the tip (1 to 2 inches) so it won’t rub against the condom.

7. If the condom contains adhesive, hold it against your penis for about 15 seconds.

8. Place the sheath holder around your penis at the base, keeping it slightly loose so it doesn’t stop blood flow.

9. Connect the tubing on the collection bag to the condom.

10. Strap the collection bag to your leg (below your knee) for proper drainage.

How to care for a condom catheter

Condom catheters should be replaced every 24 hours. Throw away the old one in the trash.

The collection bag should be emptied when it’s about half full or at least every three to four hours for a small bag and every eight hours for a large one.

Collection bags are typically reusable. They should be cleaned before they’re reused.

To clean a collection bag:

1. Empty the bag.

2. Add cold water and shake the bag for about 10 seconds.

3. Pour the water into the toilet.

4. Repeat once.

5. Using a mixture of 1-part vinegar to 3-parts water, or 1-part bleach to 10-parts water, fill the bag until it’s half full.

6. Let it sit for 30 minutes, and then pour the mixture out.

7. Rinse the bag with warm water, and let it air dry.

Tips for avoiding complications

Here are some tips to help avoid complications.

Infection

Always wash your hands and penis well when putting the condom on or emptying the bag. Don’t let the open tubing touch anything when draining it.

Leakage

Be sure you’re using the correct size of condom catheter. A doctor, nurse, or healthcare supply provider can help determine what’s the best size for you to use.

Irritation/skin breakdown

• Use a nonadhesive condom catheter to help prevent irritation from adhesive. An inflatable ring holds it in place.

• Use nonlatex condom catheters to avoid irritation from latex allergy. They’re clear so you can easily look for skin irritations or breakdown.

Catheter bag or tube problems

• Keep the bag lower than your bladder to avoid backflow of urine from the bag.

• Securely attach the tube to your leg (below your knee, such as your calf), but leave a little slack so it doesn’t pull on the catheter.

Pain with removal

If removing the condom is painful, a warm washcloth wrapped around your penis will loosen the adhesive in a minute or so.

When to call a doctor

Some things to watch for that should be evaluated by a doctor are:

• severe foreskin swelling called, phimosis which can develop if you wear the catheter without pulling your foreskin over the head of your penis

• severe skin irritation or breakdown from the catheter components or urine that may have leaked onto your skin

• significant pain during or after use

• flank, lower abdominal, or uretheral pain, which could indicate an infection

• fevers, especially if you have open sores or other signs of an infection

• urine that is cloudy, blood-tinged, or has a bad smell

• lack of urine collected for six hours or more

The takeaway

Condom catheters are a convenient and easy-to-use alternative to internal catheters.

They’re designed for men whose bladders are able to drain urine but who may have difficulty controlling when it’s released or getting to a bathroom in time.

To avoid leakage, always use a condom that’s the correct size. Practicing good hygiene, not reusing single-use catheters, and keeping the collection bag clean can help you avoid UTIs.