Condom Catheter?

[johndough]

I just have some few concerns about condom catheters. Is it really okay for a patient to wear them 24/7? The patient is a quad paralysis and uses a condom cath rather that a urostomy or foley. Also, at the base of the member, a wound has already formed because the rim of the condom is digging into the skin. There is a bandage covering it but still all the moisture and no air circulating is slowing the healing process.

I have read multiple posts and article about putting on a condom cath. I didn't feel comfortable doing it at first because my patient always gets erect when it's washed and all the skin prep is wiped on his skin. He is a "grower" so when it is erect, it was easier to put. I've read on multiple posts that I should just hurry and put it on ASAP. That's what I've been doing. He had a natural reaction and I just do my job ASAP, period.

I mean, I don't do any excessive effort to make sure the patient gets erect, but he has been ill for a couple of days, and is unable to get erect when he is washed, etc. He is smaller and shorter and he isn't happy on how the condom fits, and there is a lot of excessive condom rolled at the base of the member. He wants the condom replaced when he is mildly erect, etc. He doesn't say it like that but that's were he is going when he asked me to redo the condom catheter.

At this point, a friend/family member was the one who placed it for me since they are more familiar with this and have been doing it a lot before home health was on board and are okay with erection, etc. I just don't like the idea that I have to do "intentional" stimulation. It made me feel unsafe and I don't want to get in trouble.

I have been okay with natural bodily functions, such as incontinence, sudden passing of gas, pt erection of genitalia or nipples, body odor, etc.

I have known this pt for quite a long time. He is a quad, and I am 100% sure that this is not a "suspicious" activity coming from him. He has had multiple accidents when his cath fell off and had to sit in his pool of urine, which is why he is scared and angry.

Thanks.

NJ, USA

[brillohead, ADN, RN]

Our hospital recently started using Reliafit external catheters instead of Texas/condom catheters.

The out-of-hospital version is the Men's Liberty -- maybe check to see if your client's insurance will cover these instead?

[Swellz]

How do you like them in comparison to texas caths? I just find our texas caths frequently don't fit properly, and if they don't, what's the point?

[brillohead, ADN, RN]

How do you like them in comparison to texas caths? I just find our texas caths frequently don't fit properly, and if they don't, what's the point?

I'm assuming you're referring to my post with the Reliafit?

I personally like them. They form a nice seal only around the glans, so the size of the whole "unit" (or the "grow-er versus show-er" issue) isn't a factor.

The only thing you have to watch out for is because it's a hard plastic beyond the actual adhesive part (which is very similar to a hydrocolloid dressing), you can end up with some rubbing/abrasion if the guy is particularly "turtled". But for a guy whose anatomy is completely external, it works like a charm.

I also had a VERY small amount of dripping on a patient whose meatus was a bit off. It almost had the appearance of someone who had worn a Foley for entirely too long, with the flesh splaying open on the front from wear and tear. For that reason, I wasn't able to place it on the "end" so much as on the "front" (in order to cover as much of the meatus as possible), so the fit was just a bit off.

But the few drips that resulted from the not-quite-perfect fit was a HUGE improvement over what would have occurred if we hadn't used any device at all. This was a CHF exacerbation with a nasty pressure ulcer on his coccyx getting IV Lasix -- we got about 4L through that catheter without having to change a brief (or the Mepilex) once. I just put a washcloth in the front of the brief and that caught the few drips from the weird fit without ever getting his skin wet. And because he had an uncircumcised turtle-style anatomy, there would have been no way to get a Texas catheter to work on him. The Reliafit was a lifesaver!