A urinary sheath system can be an excellent method by which to manage urinary incontinence in men. There are many brands available made from different materials and in a wide range of sizes.
It is very important when using a sheath system to be assessed properly for the correct size. This should be done using a specially designed measuring guide to ensure that the sheath is neither too tight, (which could result in discomfort or even sore skin) nor too loose in which case the sheath is more likely to fall off.
If possible, use the measuring guide provided with the particular brand of sheath as the same sizes may vary with different brands. Sheaths also come in standard or shorter lengths to enable the best fit.
Once the correct size has been determined, samples of different sheaths can be obtained and the best one found for each individual. Please note; Fittleworth can only send samples with your specialist nurse approval.
Fitting a sheath
Before the sheath is applied, the penis and surrounding area should be washed and dried thoroughly. Do not use moisterising soap, any creams or talcum powder as these can affect adhesion.
It is not advisable to shave the pubic area as this can cause skin irritation, but hair can be trimmed if necessary. Some sheaths come with a hair guard provided.
Alternatively, a hole can be torn into a piece of kitchen paper then placed over the penis to push the hair back.
If necessary, a skin prep wipe may then be applied to the shaft of the penis to aid adhesion and to protect the skin.
Remove the sheath from the packet and place the end over the end of the penis. ALWAYS ENSURE THE FORESKIN IS KEPT FORWARD.
Leave a gap at the bulbous end of the sheath and unroll the sheath to its full extent along the penile shaft.
NB: please check manufacturers’ instructions and relevant fitting instructions appertaining to the specific sheath used.
You may need to extend the penis with one hand in order to roll the sheath on smoothly. Secure the sheath by firmly holding it in place for a few seconds. The warmth of the hand will help activate the adhesive.
When the sheath is in place it can be attached to a drainage bag. Once again there are many to choose from and samples are available upon request. Leg bags should be worn on the inside of the leg to aid drainage.
Removal and changing
A sheath can be worn for up to 3 days (DoH guidelines) provided that the sheath is intact and the skin appears to be in good condition. It is advisable to remove the sheath in a bath or shower. If this is not possible, use plenty of soap and warm water. Adhesive remover is also available to aid removal.
The sheath should be gently rolled off and the penis washed thoroughly again. Once the sheath has been removed it should be disposed of in a disposal bag and placed in the household rubbish.
Try to leave 10-15 minutes before applying a new sheath as the skin may be waterlogged. If this is not possible blot dry with kitchen paper/toilet roll.
Connecting a drainage bag
There is a wide choice of leg and drainage bags to use with your sheath. Your nurse will be able to advise and help you make an informed choice.
Fitting a leg bag
Open the pack and remove the dust cap from the inlet tube of the drainage bag. Insert the tip of the drainage bag into the sheath outlet. Ensure that the tip is pushed in securely.
NB: Some drainage bag inlet tubes are adjustable and can be trimmed to length, a spare connector is provided with this type of bag.
Slide the leg bag straps through the slots in the leg bag ensuring that they run behind the bag and not around the front, as this could compress the channel at the top. Adjust them so they are secure but not tight. Ensure that the `grip’ surface faces towards your leg.
Alternatively, a leg bag sleeve can be used to support the bag, follow the instructions enclosed with the sleeve.
A catheter retaining strap can also be used for extra security, this fastens the drainage bag tubing securely to the thigh for extra support and to prevent `dragging’ on the sheath.
Check the connections are secure and the tap is in the closed position. Empty when half to two thirds full. A bag can be used for 5-7 days.
Fitting an overnight bag
Overnight bags have approximately 2000ml capacity. You may choose a drainable or non-drainable version, whichever suits your needs. (NB: some areas may only provide non-drainable bags according to local prescribing guidelines).
The overnight bag can be connected to the bottom of the leg bag using the connector provided. Once connected open the leg bag tap to allow free drainage. Alternatively, the leg bag can be disconnected and the night bag attached directly into the end of the sheath.
Place the night bag on a stand by your bedside. Use the leg bag according to manufacturer guidelines.
Disposal of used drainage bags
- Always empty drainage bags down the toilet, either via the tap for a drainable bag or by tearing the perforated corner and draining for a closed bag. (Some single use night bags will have a tap for easy drainage)
- Rinse the bag in clean water then seal in a complimentary disposal bag and place in a household waste bin
- Do not flush used bags down the toilet
If you experience any problems, please contact your nurse for help and advice.