External Catheter - Free Drainage

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I am learning the many nuances of getting an external catheter to work correctly for my husband who has dementia and is nonambulatory. My concern is UTIs. He gets them easily and I noticed that the external catheter forms a vacuum at the funnel of the catheter after the tubing is attached to the bedside drainage bag. I understand that this is because it becomes a closed system. If I disconnect the tubing, he urinates almost immediately. Because of this, I've asked whether he is unable to urinate while it's connected and he's said it doesn't effect him, but due to his dementia, I'm not sure I'm getting an honest answer. I'm afraid the external catheter restricts his ability to urinate at times due to the vacuum.
Anyway, I noticed that a vacuum doesn't form if the bag is draining or if the tube is not connected to the bag. My question is, whether it is healthy to just let the tube freely drain urine into a small open bucket overnight, or if this would invite UTI’s?

 

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I have had an external suprapubic catheter since May 2013. Only very rarely do I pass a small amount of urine through the normal route. When this happens it is soaked up by incontinence pads which I wear day and night.
During the day I wear a 750ml leg bag which is emptied around 4pm and 9pm. Vacuums have never been a problem. Overnight, my leg bag is connected to a 2000ml night bag. Only occasionally have vacuums formed. I have been able to get the flow going despite being paralysed from the chest down. Sometimes gas collects in the night bag and impedes the flow. This can usually be fixed for the night when it happens without too much trouble and a new night bag is attached the following night. My leg bags and night bags are changed about every 10 days.
I used to get UTIs. Mine were readily cured with Nitrofurantoin. Between January and July 2016 I had a series of catheter blockages. Then I realised that the sediment causing the blockages was the same as that causing the UTIs so by taking Nitrofurantoin to prevent UTIs rather than to cure them (the dose is different) that would also stop the blockages as well as prevent the UTIs. I haven't had either since July 2016.
This site might be useful to you:
https://livingwithacatheter.com/catheter-clogged-one-way-prevent/
Best wishes, Barry.

 

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Hello, I am well versed in catheters. I've given many to males and females. By external, I assume you mean a condom type catheter. If it's a suprapubic catheter, I do not have much knowledge. In some cases, if it's a condom catheter, yes a strong enough vacuum can cause hesitation in urinating. Sometimes because of a strange sensation, or the vacuum can keep the sphincter from relaxing. It would take a large and maybe painful vacuum to cause the urethra to collapse so don't worry about that. Open draining at the end of the tube is ok if kept clean and safe but may make a mess if he rolled and it drained elsewhere. I would suggest maybe creating a relief hole in the bag. A simple hole punch sized hole near the top of the bag would stop a vacuum from forming. Place a strip of tape on the bag before making a hole. This prevents a tear from forming and spreading. If it is a hard plastic box type container, it's simple to drill a tiny hole on the top. This can all sound/be complicated if your not used to doing these things. But it has worked many times for my in-home patients. Sometimes it just takes time for him to get used to it. A foreign object on his penis will often prevent relaxing to urinate untill he is used to it. That's if his incontinence is due to his dementia and not an actual functional problem. If it's a functional incontinence, he will be fine in time. Just watch/ chart his input and output. ( This is only suggestions based on my experiences. If needed, consult his Dr. I'm not a Dr. But hope it helps) happy to help more. I am certified and have taken tons of training and thousands of hours working with patients with Alzheimer's and other mental/physical disabilities. Good luck.

 

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I use a condom catheter at night for my issues and I understand the vacuum you refer to. It took me about 1 1/2 years to get used to using this system at night. And I do not think the vacuum that collapses the condom is really a problem. However it sounds like Steven1980 has a good answer for this issue. (My doctors did not have any sort of answer...) BTW, one tip I found is using a elastic catheter strap (wide) around my thigh to hold the joint straight where the condom attaches to the hose. This keeps thing flowing freely into the bag without restriction.

 

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I have noticed on my brand of urine bags there is a vent. A little cloth like section that is supposed to let the bag breath. Of course
this vent also needs to keep microbes and germs out of a closed system if it is used with a Foley catheter. I will have to ask my doctor (if I remember) if I can put a pinhole into the vent area without compromising the integrity of the condom catheter/bag system.