Reasons for using a urinary catheter in men its types and when to be concerned

Urinary Catheterization for Men is a medical procedure that doctors may recommend in certain health situations, such as urinary retention or after surgery. Although it’s a simple procedure, there are different types of catheters, and it must be done correctly to avoid complications or infections. In this article by Dalily Medical, we will discuss the indications for using a urinary catheter in men, the different types available, and the potential risks if the procedure is done improperly. If you’re looking for clear and reliable information about urinary catheterization, this article is for you.

What is a Male External Urinary Catheter?

The Male External Catheter (MEC), also known as a condom catheter, is a special type of catheter that resembles a condom and is applied externally over the penis without any surgical intervention or insertion inside the body. This catheter is connected to an external bag that collects urine and is primarily used for men who suffer from urinary incontinence or inability to control urination.

However, it’s important to know that the external catheter is not suitable for men who cannot empty their bladder by themselves, meaning it’s not recommended for urinary retention cases.

It is also advised to change the external catheter every 24 to 48 hours to reduce the risk of infections or skin irritation.

Components of a Urinary Catheter

Generally, a urinary catheter consists of three main parts:

Flexible tube: This is the part inserted into the urethra to allow urine to flow from the bladder out of the body.
Internal balloon: Located at the end of the tube, it is inflated with a small amount of water after insertion to keep the catheter fixed inside the bladder and prevent it from slipping out.
Drainage end: Connected to a urine collection bag or valve to control urine flow as needed.

Catheter Materials: What’s the Difference?

Urinary catheters come in different materials, each with its pros and cons. The choice depends on the duration of use and patient condition:

Silicone:
Considered the safest option as it’s soft and biocompatible, causing less irritation or infection. Suitable for long-term use.
Latex (Rubber):
Flexible and easy to use, but some people may be allergic to latex, making it unsuitable for everyone.
Plastic (PVC):
Usually used for short-term periods like post-surgery or emergencies. It’s less soft but practical for temporary use.

How Long Does a Catheter Wound Take to Heal?

The healing time depends on the type of catheter used:

Urethral catheter (inserted through the urethra):
No obvious external wound, but mild discomfort or burning sensation after removal may last for a day or two.
Suprapubic catheter (surgically inserted above the pubic area):
Leaves a small skin wound which usually takes 7 to 10 days to heal.
Healing may be slower in patients with chronic diseases like diabetes or wound healing problems.

Is It Permissible to Pray While Having a Urinary Catheter?

Yes, it is permissible to pray with a urinary catheter since it is a medical condition beyond one’s control. However, some guidelines are recommended:

Try to empty or change the urine bag before each prayer if possible.
If continuous urine leakage occurs and cannot be controlled, this is considered similar to urinary incontinence. In this case, one can perform ablution (wudu) once per prayer time and pray all obligatory and voluntary prayers with the same ablution.

Are There Any Risks or Side Effects of Using a Urinary Catheter?

Despite its important role in managing certain conditions, urinary catheterization can have some side effects, especially with long-term use:

Urinary tract infections (UTIs):
Bacteria can enter through the catheter causing infection.
Catheter blockage:
Due to salt deposits or urine accumulation, preventing normal urine flow.
Irritation or pain in the urethra:
Usually temporary and caused by the presence of a foreign body.
Minor bleeding:
May occur during insertion or removal but usually stops on its own.

Does a Urinary Catheter Affect Erectile Function?

Generally, urinary catheters do not directly affect erection or sexual function. However:

Long-term catheter use may cause discomfort during erection, which is normal and usually resolves after removal.
Some men may experience psychological stress or anxiety due to having a catheter, which could affect sexual performance.
After removal, the body gradually returns to normal, and erections typically restore to their previous state.

Can Urinary Catheters Cause Kidney Stones?

Urinary catheters do not directly cause kidney stones, but in some cases, they may increase the risk due to secondary issues such as:

Incomplete bladder emptying:
When urine stays in the bladder for long periods, salts can accumulate and form stones.
Recurrent infections:
Long-term catheter use can increase infection risk, and repeated infections may promote mineral deposits in the bladder.

Important tip: To reduce the risk of stones, drink plenty of water daily and maintain catheter hygiene and regular emptying.

Is Urinary Catheter Insertion Painful?

Many people worry about catheter insertion, but generally, it is not painful because:

Urethral catheter insertion is done under local anesthesia, so the patient usually doesn’t feel pain during the procedure.
Suprapubic catheter insertion (through the abdomen) is performed under general or local anesthesia, so there is no pain during the procedure.
After insertion, mild discomfort or burning for a day or two is normal and usually fades gradually.

How to Use a Male External Urinary Catheter (Condom Catheter)

The male external urinary catheter, also called the condom catheter, is an easy and comfortable way to collect urine, especially for patients with urinary incontinence. It is applied similarly to a regular condom.

Steps to use:

Prepare the skin:
- Wash your hands thoroughly with soap and water.
- Clean the penis and surrounding area well, then gently dry the skin before starting.
Apply the catheter:
- Roll the catheter onto the penis just like putting on a condom.
- Leave a small space (~0.5 inch or 1.27 cm) at the tip to allow urine to flow freely without pressure on the glans.
Secure and connect:
- Make sure the catheter isn’t too tight to avoid urine retention or cutting off flow.
- Attach the catheter to a urine collection bag or suitable drainage valve.
Fix in place:
- Wear comfortable, snug underwear to keep the catheter secure and prevent movement.
- Ensure the area is dry before applying adhesive tape if used, so it sticks properly.

Important Tips When Using an External Catheter:

Clean the skin daily and replace the catheter every 24–48 hours.
If you feel itching, irritation, or notice any leakage, change the catheter immediately.
Do not use creams or oils on the skin before applying the catheter, as they may reduce the adhesive's effectiveness.

Types of Urinary Catheters:

A urinary catheter is a medical device used to help patients drain urine when they are unable to urinate naturally. There are different types depending on the patient's condition and the intended duration of use. Here are the 4 most common types of urinary catheters:

1. Indwelling Urethral Catheter (Foley Catheter)

This is one of the most common types, inserted through the urethra into the bladder. It’s held in place with a small balloon that’s inflated with sterile water.

Uses:

After surgical procedures
In cases of weak bladder muscles or urinary tract obstruction
For patients with spinal cord injuries

Advantages:

Effective for long-term urine drainage
Helps prevent urine retention and its complications

Disadvantages:

May cause urinary tract infections (UTIs) if not cleaned properly

2. Male External Catheter (Condom Catheter)

This type is specifically designed for men. It looks and works like a condom and is applied externally to the penis, then connected to a urine collection bag.

Uses:

For men with urinary incontinence or difficulty controlling urination
For patients with paralysis or dementia

Advantages:

Comfortable and easy to use
Lower risk of infection compared to internal catheters

Disadvantages:

May cause leakage or skin irritation if not applied properly
Not suitable for men with urinary retention

3. Intermittent Catheter (In-and-Out Catheter)

This type is used for short periods. It’s inserted only when needed to drain urine and then removed immediately. Patients or caregivers can be trained to use it at home.

Uses:

Temporary urine retention after surgery
Neurogenic bladder or spinal cord injuries
For patients who need frequent bladder emptying without a permanent catheter

Advantages:

Reduces risk of infection
Gives patients more control over urination

Disadvantages:

Requires proper training
May cause discomfort or irritation with repeated use

4. Suprapubic Catheter (Inserted Surgically Through the Abdomen)

This catheter is inserted directly into the bladder through a small incision in the lower abdomen, bypassing the urethra. It’s done in a hospital by a healthcare professional.

Uses:

In cases of urethral blockage
For long-term catheterization in patients with frequent infections from urethral catheters

Advantages:

Reduces urethral infections
Often more comfortable for long-term use

Disadvantages:

Requires a surgical procedure
Needs regular care and cleaning to avoid infection

How to Reduce the Risks of Long-Term Urinary Catheters?

If you have a long-term urinary catheter, there are important steps you must follow to reduce health risks and protect yourself:

Clean the catheter and surrounding area daily using medical soap and water to prevent germs and infections.
Drink plenty of water throughout the day to keep your urine diluted, which helps reduce the risk of infection.
Empty the urine bag regularly and don’t let it stay full to avoid urine backflow into the bladder, which can cause complications.
Change the catheter as instructed by your doctor to prevent blockages or contamination.
If you notice any strange symptoms like fever, pain, or a change in urine color, contact your doctor immediately.

By following these tips, you can significantly reduce the complications of chronic catheter use and maintain your comfort and health.

How Do Catheter-Related Urinary Tract Infections Occur? Causes and Risk Factors

Using a urinary catheter for a long time increases the risk of developing urinary tract infections (UTIs), mainly due to bacteria entering the bladder easily. Here are the top reasons and risk factors:

Bacteria entering the bladder: The catheter acts as a pathway for bacteria, especially during insertion or when hygiene is neglected.
Poor urine flow: If urine doesn’t flow properly, bacteria can build up, leading to infections.
Unclean catheter and equipment: Failing to clean the catheter and surrounding tools regularly allows bacteria to grow and cause infections.
Prolonged use without changing the catheter increases the chance of bacterial buildup.
Insufficient water intake: When you don’t drink enough water, urine becomes concentrated, which helps bacteria multiply. Always aim for light-colored urine as a sign of good hydration.
Low-fiber diet: Constipation from lack of fiber puts pressure on the bladder, which may cause leaks or issues with the catheter.
Incorrect catheter placement: If the catheter is twisted or the urine bag isn’t positioned properly, it can lead to blockage or leakage.
Poor skin and equipment hygiene: Not cleaning the skin around the catheter and related equipment allows bacteria to spread easily. If you can’t do it yourself, ask for help from a nurse or caregiver.

How to Safely and Easily Empty a Urine Catheter Bag

Emptying your catheter bag properly is essential for maintaining hygiene and preventing infections. Whether you're at home or in a hospital, following these steps correctly can help you avoid many issues.

Steps to Empty a Urinary Catheter Bag:

Wash your hands thoroughly
Use soap and water or hand sanitizer to avoid transferring germs.
Prepare a clean container
You can use a designated container or empty the bag directly into the toilet.
Keep the urine bag below the bladder level
This prevents urine from flowing back into the bladder.
Open the drain spout gently
Be careful not to let the spout touch anything to avoid contamination.
Direct the urine flow
Let the urine flow easily into the container or toilet without spilling.
Wait until the bag is completely empty
It’s important to empty it fully to avoid urine buildup.
Close the drain spout tightly
Make sure it’s sealed well after draining.
Clean the drain spout
If possible, wipe it with an alcohol pad for disinfection.
Lift and reposition the bag
Ensure the bag remains below the bladder level to prevent backflow.
Wash your hands again
Always clean your hands afterward to maintain hygiene.

Common Catheter Insertion Mistakes and Their Health Impact

Urinary catheter insertion requires great care and precision. Even small errors can lead to serious health issues. Here are some common mistakes to avoid:

Not properly disinfecting tools and the area
If the catheter or surrounding skin isn’t properly cleaned, bacteria can enter and cause UTIs.
Forcing the catheter in
Inserting the catheter roughly can cause bleeding or injury to the urethra, leading to pain and complications.
Choosing the wrong catheter size
A catheter that’s too big or too small may cause discomfort, irritation, or urine leakage.
Improper catheter fixation
If the catheter isn’t secured correctly, it may move or come out, reducing its effectiveness and causing complications.
Not emptying the catheter bag regularly
Letting the bag fill up can cause urine to flow back into the bladder, increasing infection risk.
Skipping the use of medical lubricant
Lubricant eases catheter insertion and reduces irritation. Not using it can make the process painful.
Leaving the catheter in for too long without replacement
A catheter left for too long can become blocked or contaminated with bacteria, raising infection risk.
Not ensuring balloon inflation inside the bladder
The balloon keeps the catheter in place. If not inflated properly, the catheter may slip out or malfunction.

Alternatives to Urinary Catheters: Comfortable and Safe Urine Collection Options

You don’t always have to rely on an internal catheter. There are many external urine collection alternatives that are safer and easier to use at home.

Why consider alternatives to urinary catheters?

They reduce the risk of UTIs that often come with internal catheters.
They’re easier to use and don’t enter the urethra.
You can change them at home without needing constant medical assistance.
They’re more comfortable and reduce irritation.

Popular Types of External Urine Collection Devices:

Male External Catheter (Condom Catheter)
This device looks like a condom, made of silicone or latex, and comes in various sizes. It fits over the penis and connects via tubing to a urine bag.
- Ideal for men who don’t have urine retention but may have cognitive conditions like dementia.
- There’s a disposable version called the “Texas catheter.”
- It can be worn for 24–72 hours, with the bag emptied every 8 hours.
Female External Catheter
This device includes a small tube wrapped with an absorbent wick. Urine is gently suctioned away, keeping the area clean and comfortable.

Choosing the Right Type of Urinary Catheter and When It Should Be Changed

Choosing the right urinary catheter isn’t a random decision. It’s made carefully by the doctor based on many factors that suit each patient’s condition precisely.

How does the doctor choose the right catheter?

The doctor takes into account several important aspects, including:

The reason for using the catheter: Is it needed for short-term or long-term use?
Expected duration of use: Will it be used for a few days, weeks, or even longer?
The patient’s lifestyle: Is the patient active or in need of special care?

Factors that affect catheter choice:

Material of the catheter: Materials like silicone, Teflon, rubber, or a mix of them matter in terms of comfort and durability.
How it is secured: The catheter should be well-secured to avoid slipping or blockage.
Internal space (lumen size): Should be small enough for comfort but big enough for proper urine flow.
Length and drainage bag size: Should match the patient’s mobility and ease of use.

When should a urinary catheter be changed?

Usually, a catheter is changed every two weeks, but this can vary depending on the material it’s made from. It might last longer or shorter based on the patient’s condition and doctor’s instructions.

For external catheters like condom catheters, they should be changed daily or whenever the urine bag fills up, as they are meant for short-term use.

How to Install an External Male Catheter Easily

External catheters for men are a safe and comfortable alternative to internal ones. Here’s a step-by-step guide to how they’re typically installed:

Wash hands:
The nurse should wash their hands thoroughly with warm water and soap to prevent infections.
Clean the urethral area:
The tip of the penis should be gently cleaned with a disinfectant to maintain hygiene.
Prepare and apply the catheter:
The flexible catheter is carefully placed over the penis and secured with an adhesive strap or elastic band.
Check for comfort and security:
The catheter must be snug but not too tight to avoid pressure or irritation.
Connect the urine collection bag:
The catheter tube is connected to the urine bag, and the nurse ensures there’s no leakage.
Open the valve:
The bag valve is opened to allow urine to flow without pressure.
Secure the urine bag in a proper place:
The bag is attached to the upper leg or around the waist with a comfortable strap to keep it stable.

Important Tips

Always keep the area clean to prevent infections.
If you feel any pain, redness, or discomfort, contact your doctor right away.
Empty the urine bag regularly to avoid overflow.

Why Are Urinary Catheters Used? Main Medical Reasons

A urinary catheter may look simple, but it plays a big role when a patient can’t urinate naturally. It helps drain urine from the bladder, whether for a short or long period depending on the case. Here are the most common reasons a doctor might recommend it:

Urinary retention:
When the bladder can’t empty properly due to blockage or nerve issues.
Severe urinary incontinence:
In cases of complete loss of bladder control, a catheter helps prevent leakage.
Post-surgery needs:
After surgeries involving the prostate, bladder, kidneys, or abdomen.
Spinal cord injuries:
When nerves controlling the bladder are damaged.
Neurological disorders:
Like multiple sclerosis, stroke, or Parkinson’s disease, which affect bladder control.
Male urinary problems:
Such as enlarged prostate that blocks urine flow.
Immobile patients:
Like the elderly or chronically ill who can’t reach the bathroom easily.
Sterile urine sample collection:
When a clean sample is needed for accurate urine testing.
Emptying the bladder before procedures:
Like imaging or endoscopy that require an empty bladder.
Managing severe bedsores:
Catheters help keep urine away from wounds to prevent worsening infections.

How to Live Comfortably with a Long-Term Catheter

Living with a urinary catheter long-term can be challenging, but with proper care, you can live safely and comfortably. Here are some essential tips:

Hygiene matters:
- Always wash your hands before and after handling the catheter.
- Clean the catheter area daily with unscented soap and water.
- Change the urine bag regularly and avoid letting it get too full.
Stay hydrated and eat well:
- Drink 1.5 to 2 liters of water daily to flush out bacteria.
- Eat fiber-rich foods like fruits and vegetables to prevent constipation.
- Reduce caffeine, fizzy drinks, and spicy foods.
Body position and movement:
- Avoid sitting in one spot for too long. Try to move often.
- Always keep the urine bag below bladder level to prevent backflow.
- Use cushions to support your back when sitting for long periods.
Watch for warning signs:
- Monitor urine color and smell. Any changes? Call your doctor.
- If you feel pain or abdominal cramps, don’t ignore it—get medical advice.
- Follow your doctor’s schedule for changing the catheter.
Get support from family and community:
- Teach family members how to help with catheter care and hygiene.
- Try to maintain a normal routine and not let the catheter limit you.
- Ask for help when needed—don’t go through it alone.
Take care of your mood and mental health:
- If you feel anxious or depressed, talk to a mental health professional.
- Stay social and connected with friends and family.
- Focus on activities that make you happy and relaxed.
Regular follow-ups with the doctor:
- Visit the doctor regularly or arrange for home visits if possible.
- Ask about alternatives if the catheter becomes hard to manage.
- Always follow medical instructions carefully to avoid complications.