Urinary Catheters are required to adequately manage urinary output and reduce the risk of infections, and other possible clinical adverse events such as Incontinence Associated Dermatitis (IAD), Catheter Associated Urinary Tract Infection, Acute Kidney Injury (AKI) etc – occurring due to inadequate UI management. Urinary catheters are broadly classified into three categories-

1. Indwelling catheters– An Indwelling Urinary Catheter (IUC) also cited as Foley catheter is a closed sterile system comprising of a retention balloon that keeps the device in place, and a catheter that diverts the urine with which a drainage bag is attached. These catheters can be either inserted through the urethra or supra-pubically and can be kept inserted for 4–12-week.
   

   Indwelling Urinary Catheter

2. Intermittent catheters- These catheters are inserted in the bladder intermittently for a short duration. With intermittent catheterization, the urine is drained from the bladder typically every 4 to 6 hours.

3. External catheters – External catheters adhere at the urogenital region to collect and divert the urinary output into a drainage bag. External catheters mitigate risks associated with indwelling catheters such as Catheter Associated Urinary Tract Infections (CAUTI), Urethral injuries, etc. They are broadly categorised as condom/sheath based and pouch-based catheters

ADVANTAGES OF EXTERNAL CATHETERS

1. 75% of all Urinary Tract Infections acquired in the hospitals are due to indwelling catheters. External catheters divert the urine away from the skin and reduce the risk of skin breakdown and Catheter Associated UTI’s.
2. Improve quality of life and enhance patient comfort.
3. The discrete profile of some external catheters makes them compatible to be worn during the day-to-day routine.
4. Catheters are available in different sizes to ensure adequate fit for varying anatomic sizes. Appropriate sizing of the anatomy ensures superior product performance.
5. External catheters eliminate chances of urethral injuries and minimize discomfort by fitting snugly over the penile shaft.

Sheath based catheters- Condom catheters constitute of a sheath that contours over the penile shaft and a tube that diverts the urinary output to an external drainage bag. These catheters are an alternative for male patients with urinary incontinence.

Condom catheters come in various sizes to ensure the right fit based on varying male anatomies. To achieve the appropriate size of the catheter, circumference of the penis should be measured at the base of the shaft. There are various types of condom sheath catheters available in market by several brands such as Hollister, Bard, Coloplast, etc. These catheters are commonly made of silicon, PVC’s or latex. A typical condom kit includes –

• A condom catheter
• Adhesives for keeping condom catheter positioned in place
• A drainage/leg bag
• Drainage tubing and connectors
• Adjustable straps for attaching drainage bag to the leg

DRAWBACKS OF SHEATH CATHETERS

1. Condom catheters cause discomfort due to size misfit, affect patients’ sleep and decrease overall quality of care.
2. Inadequate sizing can lead to leakage of urine resulting in skin breakdown/IAD.
3. A tightly fit sheath/condom catheter may restrict blood flow and cause penile strangulation and necrosis.
4. Latex, adhesives or other materials used in the condom catheter may lead to skin allergies.
5. Contrary to popular belief, condom/sheath catheters may still cause Urinary Tract Infections.

Condom/Sheath Catheter

LIBERTY

Liberty external male catheter contains seven petal faceplate made of gentle hydrocolloid that adhere directly to the glans penis to create a seal around the anatomy. It contains a gravitational vent allowing the urine to move away from the skin, prevent any backflow and skin breakdown. The system contains a detachable urine collection pouch with a drain plug the allows voiding without removing the product.

LIMITATIONS OF LIBERTY

1. There is a potentially high probability that the retracted anatomy won’t stay adhered to the device due to the need for adhesion at the glans penis.
2. Inadequate adhesion increases chances of leakage which leads to skin damage and Catheter Associated Urinary Tract Infection.
3. The use of a tight adhesive faceplate around the anatomy can lead to penile strangulation

External catheter for urine management

Pouch based catheters- Pouch based catheters vary from condom/sheath catheters. Instead of a sheath wrapped tightly over the male anatomy these catheters comprise of a pouch that contours over the anatomy creating a spacious micro environment, an adhesive that secures the catheter in place, and a tube which diverts urine into a collection canister using vacuum suction.

PRIMOFIT

Primofit is a male external catheter that uses continuous suction for easy removal of urine away from the male anatomy. This catheter contains base adhesive which provides a customizable fit and eliminates the need for sizing the anatomy. The top adhesive pad keeps the device in place, and the Ultra-soft fabric diverts urine away from the skin. This catheter can be left in place for up to 24 hours.

LIMITATIONS OF PRIMOFIT

1. The hydrophilic material of the pouch retains moisture and may lead to skin breakdown and increases risk of CAUTI.
2. The device lacks adhesive all around the anatomy that could lead to incompatibility with retracted/inverted anatomy and may cause leakage

Pouch based external catheter for urine management

THE PRODUCT – QiVi

QiVi CAUTI Prevention is a Male External Catheter that constitutes of hydrophobic pouch that snugly contours the anatomy and keeps it dry, a silicone-based adhesive that keeps the device in place, and a suction tube that connects to a vacuum suction source and diverts the urine away from the anatomy.

QiVi is designed for non-ambulatory adolescent and adult male patients for urine management. The universal fit design makes it compatible with even retracted/inverted anatomy, the cranial suction tubing prevents Medical Device Related Pressure Injuries, and the non-absorbent material provides up to 99.6% accurate output measurement.

QiVi CAUTI Prevention