Amanda Linneman RN, BSN
Clinical Program Manager – ConSure Medical

Wow! Nurse ingenuity is amazing. When our patient faces an ailment, we go out of our way to become their advocate. When our medical center/place of work faces a challenge nurses come together, brainstorm while changing linens, discuss policy changes over lunch, investigate what’s working and what’s not. We create poster presentations in our free time to get the word out! We think, we implement, we TALK!!!

What you may not know is nurses are the MacGyver of the hospital. We have a knack for invention and problem-solving using our very limited resources in the hospital. This is the amazing NURSE INGUINITY I am talking about. Because my conversation could go in many directions, I will keep this focused on ‘incontinence care for the male retracted anatomy.’ (((ominous music-screams of fear)))

Retracted Male anatomy definition- a medical condition in which skin and fat obscure a normal sized phallus, making it appear smaller or less visible. (www.medicalnewstoday.com)

The most typical device nurses use in incontinence care for the male anatomy is a condom catheter or foley catheter. Foley catheters come with it chance of CAUTI, AKI, Sepsis & UTI. Very costly to the hospital. The benefit is accurate I/O & dry patient.

Condom catheters just don’t work. Impossible to get on an appendage you cannot visualize. Nurses tend to always choose size small because any larger falls off almost immediately. So, we glue them on to help them hold, increasing chance of HAPI or other injuries and in the end, it still doesn’t hold, and my patient is wet, has IAD, the hospital is fined and I’m changing stool and urine covered bed linens every two hours with turns.

A new type of urine collection devices has hit the market since 2020. These external devices utilize continuous suction to siphon urine away from the patient. These devices look to handle urine externally to rid themselves of the foley catheter costs to patient and the hospital itself. These are some of the most promising on the market right now but so different in their own individual way.

Let’s see how the nurses have been MacGyvering the retracted anatomy? These are the stories I have been told as of late. Great job working with what you have!!

Using an Ostomy Bag for urine collection on a male with retracted anatomy

–Nurse A– CCRN Neuro ICU- I work night shift, so staffing is always less than days. With less techs to help for linen changes incontinence is a big issue for me. I was taking care of a particular patient and we could not get a foley/Coude catheter in him due to his anatomy which was also retracted. Condom catheter just did not work. I was desperate for a solution and so was my patient. So, I placed an ostomy bag over the opening that I could open and drain the urine into a collection canister to be measured. May not have worked very long but my patient did get to sleep for 4 hours straight. He was pleased about that.

Make a TeePee for urine collection over male with retracted anatomy

–Nurse B– Staff nurse – I take 2 Purewick devices and make a teepee over the opening. I use tape or a Tegaderm to secure it down. Then I cover the area with an incontinence pad.

–Nurse C– We currently use a pouch based external catheter from a reputed brand in the hospital. It is not made to be used on the retracted anatomy. After a long brainstorming session with my nurses we came up with our own way to make it work for that population. We are putting a condom catheter on first, snipping the cc to direct urine stream towards the wicking material. Then we seal device with Tegaderm. We do this for all patients, otherwise the device would leak when the patient is lateral.

Female Catheter for male urine management with retracted anatomy

–Nurse D– We currently use the Versette designed for the female. We prep the area and place the blue line over the middle of where the glans should be. We then seal the top with a Tegaderm.

Those are some great ideas that seemed to be a quick solution for your team! Great nursing ingenuity!

As great as these ideas are, the extra effort is not needed. ConSure Medical’s QiVi MEC works and is designed to work on the retracted anatomy. It’s as easy to apply like a decal on your wall. Has a 99.6% Urine Output accuracy rate (Just as good as foley), one size fits all, derma-friendly silicone adhesive, can be used in multiple positions, Reduce CAUTI, UTI, AKI, SEPSIS, HAPI, IAD and is super easy to use. I recommend you try it!