Texas catheter help

  1. I did a search before I started this thread . . I'm a student and had to put one of these on a pt today. In class we saw a video where you put an adhesive strip around the body part in a spiral pattern and then apply the catheter. Today in hospital I was given a packet that looked like an alcohol prep and had an adhesive substance on it. I was to rub it on the skin, then wait for it to dry and then apply the catheter so that it would stick to the adhesive. This pt did not have much tissue to work with if you know what I mean, and it was very very difficult to make a secure fit. The cath had a green hard plastic ring around it that I was supposed to use to help extend the catheter upwards but it was useless, and actually went over the edge of the rolled up part, and onto the patient's skin and might have pinched him. The end of the catheter was also made of a harder type of plastic-- not like the traditional kind I saw in class that look like a regular condom but with the tube on the end. I asked the RN for help and she also had a hard time and the pt was uncomfortable and embarrassed as we struggled with this. The way it looked, it probably would just fall off again soon. I want to prevent this in the future. The RN said they are not that common. Maybe this pt was just not shaped right, I dunno much about that kind of thing. Another pt was using one last week but was able to apply it himself and seemed to be okay with using them. I really just want to know if there are any tips to applying these more smoothly next time. Are some people just not able to wear these? Thanks!

    ETA: I found the kind they were using at the hospital today

    Should be studying for my pharm exam . . not posting so much on this board.
    Last edit by AmericanChai on Jan 29, '10
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    About AmericanChai

    Joined: May '06; Posts: 273; Likes: 166


  3. by   mamamerlee
    The main problem with condom caths is getting the right size for the patient. I learned the hard way (poor choice of words!) to always take a few of them into the room, of various sizes. As you have learned, there are different brands, and slightly different methods.
    And there will be some men that do not have enough length to get a good seal.
    From the illustration, you use the hard plastic ring to help you unroll the catheter onto the penis, then you remove the hard plastic ring.
    If the patient is obese, you may have to have someone help you by pushing down on the fatty tissue surrounding the base of the penis to expose more of the shaft.
    Best wishes!
  4. by   AmericanChai
    Thank you!

    There was only this one kind and size available. From what I gathered the nurse had to put in an order for his personal supply of these and they were not taken out of regular stock (there were none in the supply area). I didn't know to ask for other options. Next time I will see if I can get a variety to try if it's clear their current one is not working well.
  5. by   RedhairedNurse
    No adhesive should be put on a penis, that can impair skin integrity, the condom cath alone is enough to cause some skin issues, don't use adhesive!! I usually have no problem with condom caths staying on as long as I have the right size, unless the genital is super small it's hard for them to stay on. I've never used an adhesive. I've seen genitals with very bad skin irritation just from the condom cath alone, I can just imagine what an adhesive could do.

    The plastic ring helps extend the catheter downwards, over the penis....not upwards. The only reason the plastic ring is there is to keep an opening there for you until you get it rolled down in place. You probably should have use a size small. You need to get a good grasp on the penis and hold it as erect as you possibly can in the palm of your hand, the bottom part of your hand (the same hand your using to firmly grasp the penis with) can be used to push down the fatty tissue at the base to help make the penis a little taller. And with your dominant hand you place the catheter on.

    You'll learn not to be shy and just get it done. If you act embarrassed or hesitant, that in turn makes the pt embarrassed as well. Once you've done a few, it gets a lot easier.
    Last edit by RedhairedNurse on Jan 29, '10
  6. by   ohgoodnessgracious
    Yeah.... for me, putting texas catheters on patients is more uncomfortable than putting in a foley, haha. We use Cavilon No Sting Barrier Film on the patients first to help with adherence to the texas cath. That blue piece of plastic that looks like a ring, I usually just get rid of that. To be honest, I hate that kind of condom cath like the one you have in the picture. It's usually too big for patients. We usually just stock up on the pediatric condom caths!! It works everytime.
  7. by   Hoozdo
    This is one of my nursing pet peeves. Nobody ever stocks small. I have NEVER ever seen one in size small. I never knew that size small was even manufactured. (Figured the manufacturers never thought of a SMALL penis)

    Usually my patients have foleys, but in the rare instance I need a SMALL size - I have to get a pediatric size stocked.
  8. by   AmericanChai
    That's a great idea to find the ped sizes! I think this particular patient was just really small and probably could have used the ped size.
  9. by   proudnurseRN
    I agree with those that said try a pediatric size. Also, I've found that putting on a Texas catheter is a 2 person job. One to hold the penis and another to really get it on good.
  10. by   ItsTheDude
    as a guy, if a male patient is laying down/sitting a lot some of their noodle can basically sink into the body a bit and the noodle is stretchable, so i just pull it outwards (u aren't gonna break the noodle), usually get enough to work with and as it sinks back in, it can form a very good seal. sometimes, u just have to use a ped size though, if available.
  11. by   WalkieTalkie
    I've always wondered why it is called a TEXAS cath... everything is definitely not bigger in Texas!
  12. by   loriangel14
    Quote from WalkieTalkie
    I've always wondered why it is called a TEXAS cath... everything is definitely not bigger in Texas!
    I had to read this thread to find out what you were talking about.lol
    I am in Canada and I had never heard the term before. We call them condom catheters and ours don't look like the one pictured in this thread. Ours just look like catheter tubing with a condom on the end and we just roll them on like a condom. One poster mentioned using Cavillon No Sting barrier Spray, it does work well in this case. Great stuff and doesn't irritate.
  13. by   leslie :-D
    ugh, i hate those things.
    we seldom use them, so any stock we have, is geared towards the one-size-fits-all...
    which we know how that works.

    i had this pt who was also quite small and i couldn't get the cc on.

    i got creative by getting a biohazard plastic bag, cutting 2 holes on top and threading a roll of kerlix through.
    i placed his penis in the bag, and tied it on top.
    my pt was only semi-conscious and didn't move around, but it worked for this type of population.

  14. by   BreeLPN2RN
    NOODLE?? hahahaha