Condom catheters!! Getting them to stay on !!!

[passing thru]

How do you get these things to stay on? What do you think of the ubber band thing with a button on it and holes in it??

[NurseDennie, BSN, RN]

Condom caths - *sigh*

Portland_guy - sometimes they "hide." (not the caths - the target) I actually took care of a 30-something post-op that needed to be cathed, and his completely withdrew up inside!!!! I think he had to have ALMOST conscious sedation in order for it not to do its little disappearing trick!

Love

Dennie

[Dr. Kate, BSN, RN]

You mean someone really can get the things to stay on?

The only thing I'd advise is to clip hair if necessary. If any hair at all is pulling even the slightest bit the guy is going to mess with it. Heck they mess with them anyway. There are times I think they can make willie retract at will.

All I can say to anyone who has only put one on the model in skills lab--it an't nothin like that in real life.

[teeituptom, BSN, RN]

Dermabond works very well. You just cant get them off for a while

[duckie]

Originally posted by portland_guy

I am still just doing my pre-reqs, but somehow I find it hard to imagine not being able to find "that little varmit", aka the button. Please explain....at least on the anatomy that I am familiar with it is right there.

Having worked LTC all my nursing years, I have seen many that were inverted and the scrotum grows so large it is overpowered...make sense now? I know, not much for a fellar to look forward to but these guys were 90ish, so it takes a while!

[baseline]

Sometimes you have to press on both sides of the little gizmo to get it to stand up and fight......condom caths......hate 'em!

[Kale]

I wonder if your urosheaths (thats what we call them rubber toys)

come in a packet inclusive of a thick double sided tape ??....However I do experience great difficult putting them on for my pts...what I sually do is get permission to "de-forest" the pubic region....then just apply the double sided tape ( somesort like a duoderm like dressing) and slip the sheath down....hope that helps

[emily_mom]

Originally posted by kids-r-fun

a stapler is the first thing that came to mind

sorry, looks like its going to be one of *those* days...

I can laugh because I don't have a member.

We use tincture of benzine or another skin prep. They still shoot off though.....

I had to cath a guy once who wee willy winky was about 1/4 inch long (not an old guy either). I had to pull a little to get a handle on it, and he said, "It don't come out much more than that." Poor guy.....

[sehbear]

my question is this... how do you put them on without them sticking to your glove or do you all use the one glove technique???

[nursegoodguy]

First of all:

External catheters are great for some clients!

How active is your patient?

Do they move in such a way that will pull at the external cath?

Why do they have to wear an external cath?

Medicaid will usually only pay for about 35 per month and most men will probably need to change it about twice a day!

Are you using {extension tubing} to ensure that urine is not backing up into the cath disolving the adhesive and backing up into the bladder promoting UTI's?

Extension tubing is very important!

Here's the technique I've found to work the best!

Prepare the area! That means shave it or trim it short with a beard trimmer! Next WASH and DRY thoroughly!

Most importantly be sure the skin is DRY!

Use skin prep over the shaft of the member and let that dry.

*consider circumcized vs uncircumcized...

for the uncircumcized client I would wash and dry as you normally would but I'd pull the foreskin back over the glans member before skin prepping...

Now you're ready to apply the "external catheter"

Keep in mind that size does count here!

External catheters come in "sizes" Try not to use one that is too big or you won't get a good seal.

So take out your external cath and stuff the glans member into the tip and start rolling it down.

Once it's on give it a squeeze to make sure it is well adhered to the shaft of the member.

Insert your extension tubing and then hook that to the leg bag.

There are a lot of elements that have an effect on the external cath...

How clean is the area?

What is the temperature like? Hot and humid?

Does your patient get erections? It'll expand it and loosen the adhesive.

Is the tubing secured to the leg to allow gravity drainage or are you going to deal with backflow?

I hate that two way tape stuff and best of luck trying to apply it with gloves on... maybe you could wear gloves for the first part of the procedure, the cleaning? even with all that they still come off! Gotta look into that dermabond stuff...

[grneyes676]

Touching some ones d#$% without gloves...OMG, I am so used to wearing gloves for everything I feel strange touching my DH's weenie w/o gloves.....LOL, that is gross!!!!!!! I would rather my pt pee the bed and change them than put on some silly condom cath w/o gloves. BTW, the only time I have seen condom caths work really well is when the pt had a penile prosthesis.

[Diamond Nurse]

I had a guy once who was exceptionally small in the Mr. Willie zone. I asked once if he got stimulated when the nurse was applying the catheter condom. He said no beacuse he was trained on a island to be a monk. And there were only males there, they didnt even let chickens on the island only roosters!!!! The eggs were actually brought in on boats. He said he had trained himself against any reaction to stimulation there.

I did wonder though, if his training could withstand a woman who knew what she was doing in the "Mr. Willie Zone"....

sorry ....just a thought.

[caroladybelle, BSN, RN]

Originally posted by portland_guy

I am still just doing my pre-reqs, but somehow I find it hard to imagine not being able to find "that little varmit", aka the button. Please explain....at least on the anatomy that I am familiar with it is right there.

Some guy's wee willies are tiny to say the uhhhh least. There some that a finger cot would work for.

In patients with extensive abdominal ascites, generally secondary to liver failure (hepatitis, drug abuse, ETOH abuse as well as other problems), the member literally shrinks up and retracts into the abdomen. Pair that up dependant edema in the pelvis and neither regions, and it makes the member difficult to find, apply adequate grasp and unroll the condom cath onto the nonexistant member. You really can't unroll something onto a button that won't peek out of an opening in the edema.