How do you size a male external catheter/are there different sizes?

MALE EXTERNAL CATHETERS

Male external catheters are significantly less invasive and have easier catheterization than internal urinary catheters (which drain urine from the bladder by a tube inserted through the urethra). These are latex or rubber shells that encase the tip of the penile shaft and connect directly to a drainage bag commonly strapped to the inner thigh. As no part of the catheter is being inserted in the urethra, there is a reduced risk of infection. Male external catheters are broadly categorized into condom/sheath and pouch catheters. Condom/Sheath catheters contour the male anatomy through which urine flows toward the drainage bag. In Pouch catheters, the male anatomy is enclosed within the pouch, and urine is drained away from the skin using negative pressure suction.

IMPORTANCE OF SIZING

Appropriate sizing is important to prevent leakage and skin breakdown. Leakage could occur if the catheter is loosely fitted over the male anatomy, and constriction may occur if it is tight. In some scenarios the measurements will be between two sizes; preferably a smaller size should be chosen, provided it is comfortable and not causing any constriction to the anatomy. Improper size measurement could lead to sheath dislodgement within a short span of time after the device is applied. Male external catheters are flexible but the right size should be used for the best possible results. It is advised to keep a difference of 4-6cm between the foreskin and the catheter tip to minimize drainage problems.

METHODS FOR SIZING MALE EXTERNAL CATHETERS

There are two methods for measuring the size of male external catheters.

1. Sizing by measuring tape
2. Sizing by measuring stencil

Common measurements for sheath/condom catheters

1. Sizing by measuring tape
   This is a method of determining the catheter size by measuring the circumference of a flaccid penis using a measuring tape. The male anatomy is measured at the shaft, where its diameter is the largest. The patient should be positioned on the edge of a bed with a moderate distance between the legs. This is the best position and requires no further measurement of the penis. The circumference is measured in millimeters and is divided by 3.14(pi) to achieve the final measurement. For example, the circumference of a penile shaft is 112mm, so the result will be 112/3.14=35.66.

Measuring Tapes for condom/sheath catheters

1. Sizing by measuring stencil.
   In this case, a star-shaped stencil is designed with different measurements marked at its crest. The crest is placed over the flaccid male anatomy, behind the head and the crest which fits properly is considered to be the desired size measurement. There are majorly two-size stencils used for measurements. Brands such as Coloplast use stencils ranging from 24mm to 40mm whereas other companies like Hollister, and Rochester use stencils ranging from 25mm to 41mm.

Sizing guide for confom/sheath catheters

HELPFUL TIPS FOR SIZING EXTERNAL MALE CATHETER

1. For getting an appropriate fit, the size of the male anatomy should be measured by a measuring tape or a size guide.
2. The male anatomy should be measured in its flaccid state at the widest part.
3. If the measurement ranges between two sizes, then it is better to choose the smaller size provided it is not overly tight on the anatomy. A size that is tighter could lead to constriction, and restricted blood flow whereas a loosely fitted size could lead to leakage of urine.
4. Application of a skin sealant protects skin from urine absorption and prevents scraping of skin while removing the catheter.
5. Leaving enough space between the end of external catheter and the tip of the penile shaft prevents the head of anatomy rubbing against the catheter.

MALE EXTERNAL CATHETERS THAT DO NOT REQUIRE SIZING

Finding the correct size is very important otherwise body harm can be caused even by external wear. Condom catheters require sizing whereas pouch -based catheters are flexible with all sizes of male anatomy. There are brands such as Liberty, Primofit, QiVi which manufacture male catheters that do not require specific sizing of catheters and a single design can be used for all male anatomies. Liberty is a male external urine management device which is made up of seven petal faceplate that adheres to the male anatomy and diverts the urine to the pouch. The urine is drained out of the pouch from the drain plug without removing the product. Primofit is a pouch based external urine catheter for males. The adhesive base provides a customizable fit, eradicating the requirement of sizing charts. Also, these adhesive pads allow to keep device in place.

QiVi is a pouch based external urine management device having universal fit design. The pouch fits comfortably around the penile shaft and suprapubic region. The silicone-based adhesive pads attached with the device keep the device in place and conform around a wide range of male anatomies by providing a secured seal.