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External Catheters: A Convenient Alternative to Adult Diapers

There are many changes you can expect to experience as you grow older; one of the more common is urinary incontinence or the unexpected leakage of urine, with approximately 5-15% of men and 23% of women over 60 years of age experiencing urological issues.

Causes of Urinary Incontinence

Among other causes, some of the most common causes include overactive bladder muscles, weak pelvic floor muscles, damage to nerves that control the bladder, or blockage from an enlarged prostate in men.

The good news is that managing urinary incontinence can be quite simple, especially once you find the best-fit option for you and your lifestyle. Perhaps the most commonly recognized intervention is an adult diaper or incontinence pads.

But, while adult diapers are commonly available, there are several disadvantages to using them. The most common disadvantages include:

  • Insurance doesn’t cover diapers: Medicare and most commercial insurances do not cover adult diapers or incontinence pads, so you’ll have to pay for them out-of-pocket, unless you have Medicaid or supplemental private insurance that does cover them. Depending on the severity of your urinary incontinence and the quality of the adult diapers, you can expect to spend anywhere from $50 to upwards of $300 per month. This may be challenging if you are working with a fixed budget.
  • Generic option: Diapers are not custom made for you or your loved one; even if you find one that is comfortable and seems to fit well, it is possible they may leak.
  • Discomfort: Skin irritation, rashes, and odor may result if diapers are not changed frequently enough. 
  • Should you wear a diaper to bed and are incontinent at some point while asleep, a wet diaper may cause some discomfort and make it difficult to fall back asleep; it may also be unpleasant to change in the middle of the night.
  • Difficult to use: Diapers tend to be fairly bulky which may be aesthetically displeasing to you, and they may be noisy as you move around. 
  • If you are determining whether to use adult diapers for a loved one who may be bed-bound, it is also appropriate to think about how difficult it may be for you or another caregiver to change the diaper, not to mention the routine discomfort this process may cause your loved one.

What most people don’t realize, however, is that external urinary catheters can be a safe, non-invasive, convenient, and reliable alternative to diapers for both men and women. Read on to learn more about external catheters and whether they might be the right option for you.


Are external urinary catheters right for you?

External urinary catheters are a proven alternative to adult diapers and can actually be less disruptive to your normal routine than diapers. Although individual preferences may vary, there are certain advantages that external urinary catheters provide. External catheters are:

  • Skin-friendly
  • Non-invasive as they do not need to be inserted like intermittent catheters
  • Significantly decrease the risk of urinary tract infections
  • Can be worn easily and discreetly
  • Easier for caregivers to manage than adult diapers.

What is a male external catheter?

male external catheter

An external urinary catheter is a device that helps to catch the urine that leaks, without actually inserting it into the urethra. Male external catheters, also called external condom catheters, come in different sizes and shapes, in one piece or two pieces, and can be self-adhesive or non-adhesive.

One of the most common types of a male external catheter is a condom catheter as it consists of a flexible sheath that can pop-on over the penis, just like a condom. Male external catheters are easy to use and are a great alternative to adult diapers or penile sheaths for managing urinary incontinence.  

There are many advantages of using an external catheter, including:

  • The varying catheter sizes available ensure that you can find the correct size for you. 
  • Latex-free external catheters are available for those that may have a latex allergy
  • Condom catheters drain into a collection bag that can be strapped to your leg (referred to as a leg bag), a bed frame, or a wheelchair, and can be easily emptied.
  • Depending on the manufacturer and the brand, the urinary collection bags can be disposable or reusable. 
  • The collection bag limits the contact between urine and your skin which reduces irritations and infections, as well as limits the odor that you and others may smell when using an adult diaper. 
  • Male external urinary catheters don’t restrict movement and can be more discreet than a diaper or an indwelling catheter.
  • Male external catheters are covered by Medicare if these are deemed medically necessary by your healthcare provider. If you suffer from permanent urinary incontinence and are using catheters, you should be able to have insurance cover the cost of your medical supplies.

There are some things that are important to know when using male external catheters, in order to avoid discomfort. 

  • For men who are uncircumcised, it is crucial to leave the foreskin over the head of the penis while putting the external catheter to avoid potential tearing. 
  • It’s essential to find the correct size and to wear the catheter correctly. Doing so will help prevent skin irritation
  • If your external catheter isn’t properly sized, it can result in urine leakage and corresponding skin irritation, or it can simply fall off. If this happens, contact your medical supplier to ask for a different size or model.

What is a female external catheter?

female external catheter

Female external catheters are becoming increasingly available. These fit between the vagina and anus (also known as the perineum) and are connected to vacuum-like devices that provide low, continuous suction to collect urine. Improvements are continuing to be made and the outlook for women who would benefit from this medical equipment is promising. 

In two recent studies, several advantages of using female external catheters were identified, including:

  • These have been found to be a feasible alternative to an internal catheter when managing urinary incontinence in bed-bound women. 
  • These have and can result in decreased catheter-associated urinary tract infections if used and cleaned properly. 
  • A pilot of the PureWick female external catheter in 12 bed-bound women at Memorial Sloan Kettering Cancer Center over one month found that three Foley catheters (a type of internal catheter) were avoided. 
  • Women involved in the pilot study experienced an increase in comfort, an absence of skin breakdown, and an increase in overall satisfaction.

There are some important things to remember if you are considering female external catheters for you or your loved one, which include: 

  • These generally should only be used when you are seated in a chair or wheelchair, in a reclined position on your back or side, or while laying in bed. 
  • These should not be used if you or your loved one are mobile or are able to use the bathroom without assistance as they can fall out of place and result in urine leakage.  
  • It is important that you or a caregiver assess the placement of the external catheter every few hours to ensure it is in the correct position and that the integrity of the skin is not compromised, and adjust the catheter as needed. Skin irritation, rashes, and urine leakage may result if this is not done routinely.

Although the capabilities of female external catheters are limited as compared to the ease and mobility that a male external catheter affords, they do provide a safe and reliable alternative to adult diapers and internal catheters.

Unfortunately, currently, female external catheters aren’t covered by Medicare and you’ll need to pay out-of-pocket.

Your next steps in managing urinary incontinence

Urinary incontinence increases with age but there are many ways it can be managed. While you should do your research to find the best solution for you, external catheters could be the safe, reliable, and convenient option you’re looking for.  External urinary catheters can maintain or restore comfort and dignity in your everyday life, and ease the burden on caregivers. Ask your doctor if an external catheter is right for you or your loved one. 

If you’re looking to try out a different type of catheter, Better Health carries a selection of reimbursable external catheters from a variety of manufacturers including Coloplast, Hollister, Bard, and more. Not sure which external catheter is right for you? Take a look at our options or get free samples to try at home.
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