Sheaths and leg bags

Brian Buckley looks at this popular form of continence care

A penile sheath (sometimes called an "external catheter" or "condom catheter") is a sleeve made of latex or soft plastic. The sheath fits over the penis and is attached by a tube to a leg drainage bag which holds the urine until it can be emptied. Sheaths can be used during the day or at night. They can be left on for 24 or 48 hours and then changed. Some men prefer this system to wearing pads, especially if they are away from home.

It is very important that you use the correct size of sheath and that you learn to apply them properly. The sheath needs to be of a size which will allow for natural movement of the penis, but not so loose that it might leak or fall off. Most sheath manufacturers provide a measuring or sizing kit - ask your doctor, continence advisor or a nurse trained in continence care for help with this.

Some sheaths are self-adhesive while others need a separate adhesive or adhesive strip. Some are fitted each time using an applicator - these may be the easier to use if your fingers are not very nimble, although recent consumer reports suggest that sheaths without applicators are more popular.

It is important to wash the penis and surrounding area thoroughly before putting on a fresh sheath. You should ensure that you learn to prepare your skin in whatever way the manufacturer of the sheath recommends. It is important to keep pubic hair trimmed so that it doesn’t interfere with the sheath. Creams and powders on the penis should be avoided as these may stop the sheath from sticking properly.

Men who use sheaths will have a more satisfactory experience if they have the correct type and size of sheath and if they have been taught how to prepare their skin properly and change the sheath regularly. Otherwise they may complain that they do not work, when the problem is not the sheaths but the type, size or way they were used. Keep a check that the skin is not becoming red or irritated. Talk to a doctor or nurse if you are having problems with your sheath.

Sheaths are connected to a leg drainage bag by a short tube. Bags come in various sizes and can be worn on the thigh or the calf, or can be supported in a pocket in a special garment or one sewn into your normal clothing. The bag will contain the urine until it is emptied through a tap at the bottom. You should try different bags until you find one which suits you and which has a tap which you find easy to use.

Drainage bags vary in size from ones which hold about ? pint to ones which hold two pints. At night the outlet tap of your leg bag can be left open and attached in turn to a night drainage bag - this can hold 3 pints, so you do not have to worry about waking up to empty it. This night drainage bag should be held on a night bag holder so that it is kept off the ground, to avoid contact with germs.

A recent report, published by the Medical Devices Agency, compared six different makes of self-adhesive sheaths. These have an area of adhesive coating on the inside of the sheath and do not need a separate glue or adhesive strip.

The six sheaths were tested by 58 volunteers, who made comments about using each one. In general, sheaths without applicators were easier to apply and more popular than those with applicators. Out of the six tested, the Aquadry Clear Advantaged was the most popular. Aquadry is produced by SSL International- for more information call 01565 624000. Two new products have been introduced since the testing took place - for full details of all the companies and products involved, call or write to the Incontact office and we’ll send you a factsheet.

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