What is a Male External Catheter?
A Male external catheter, also known as a condom sheath, is a medical device for managing urinary incontinence in men. It works by collecting the urine outside the body through an adhesive-lined sheath that fits over the penis, with a tube connecting to a drainage bag. Unlike standard catheters which are inserted into the bladder through the urethra, male external catheters remain on the outside of your body making extended wear more comfortable. This is a non-invasive and effective urinary management solution for men.
Why and When to Use One
External catheters are commonly recommended as a male continence solution, reduced mobility, or other functional challenges that make toileting difficult. They are also useful for men who prefer an alternative to absorbent pads or wish to avoid the risks associated with indwelling catheters. However, they are not suitable for those with urinary retention or blockage, since the device does not empty the bladder directly. Proper sizing, hygiene and regular monitoring of the skin are essential to prevent irritation or leakage.
The key benefits of an external male catheter include being less invasive than internal catheters, offering greater comfort and potentially reducing infection risk. Because the device doesn’t enter the urethra or bladder, it avoids trauma and may lower the chance of catheter-associated urinary tract infections (CAUTIs). Many men also report improved comfort and dignity compared with traditional indwelling catheters or pads. For those with limited mobility, connecting the catheter to a discreet leg bag allows greater independence and freedom of movement throughout the day.
Australian continence and infection control guidelines encourage using the least invasive method possible for urine drainage. For appropriate patients, an external male catheter can be an excellent option that supports comfort, hygiene and quality of life when used correctly. Consultation with a continence nurse or healthcare professional is recommended to ensure the right fit, proper use and ongoing skin care.
Key Features to Look For When Choosing
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Fit and sizing
When selecting an external catheter, sizing is crucial to make the catheter effective and comfortable. External catheters are made to be just as effective as internal without the discomfort that sometimes is caused by a standard catheter. Always check the manufacturers sizing guide and accurately measure your care recipient to determine what size is needed. The fit of the external catheter should be snug but not too tight.
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Adhesive / skin-friendly material
There are 2 main types of materials used for male external catheters, silicone and latex. Both materials have their benefits so it’s important you choose what works best for your care recipient. Silicone is hypoallergenic, an ideal option for sensitive skin and is often considered more durable. Silicone is cost effective but can cause allergic reactions in some people. It’s also important to consider the adhesive type when selecting an external catheter. Look for a secure, medical-grade adhesive. They can either be a separate adhesive strip or may include a built-in option.
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Drainage connection (leg bag, night bag)
During the day a smaller leg bag should be used. These bags can be strapped to the leg and concealed under clothing, making this a popular choice. For longer collection periods like overnight, night or bed bags should be used.
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Back-flow prevention & skin protection (e.g., inner flap)
Select products that can be secured comfortably below the catheter level. It’s also important to choose leg bags that can be easily emptied regularly as this prevents backflow from occurring. Skin protection while using male external catheters prevents infections and irritation which can cause discomfort and illness. Things you can look out for are catheters that contain an inner flap. This is an extra layer of material that prevents backflow.
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Ease of application & removal
Finding a male external catheter that is easy to apply and remove prevents skin issues from developing, maintains the independence of your care recipient and lowers the risks of them developing a Urinary Tract Infection.
Caring for Your Male External Catheter
Caring for a male external catheter is essential for maintaining comfort, hygiene and skin health. A simple daily routine helps prevent irritation and infection while ensuring the device works effectively.
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Daily inspection & skin hygiene
Daily inspection and skin hygiene are key. Always wash your hands before handling the device. Gently remove and clean the skin where the catheter sits at least once a day using mild soap and water, then dry thoroughly before reapplying. Check for redness, swelling, or irritation. Applying a skin-barrier film can help protect delicate skin.
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Check for leaks or detachment
Throughout the day, check for leaks or detachment. Make sure the sheath remains secure and that the seal is intact. Leaks can irritate skin and increase infection risk, while twisted or kinked tubing can restrict urine flow. If the catheter becomes loose or leaks, remove it, clean the area, inspect the skin and replace it with a correctly sized device.
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Proper bag placement (keep below bladder level)
Proper bag placement also matters. Keep the drainage bag below bladder level to prevent backflow and infection. Secure the tubing without tension or loops where urine can collect and empty the bag when it’s around two-thirds full. Support straps or holsters can help prevent pulling and improve comfort during movement.
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How often to change
As a general rule, change the catheter daily to allow for skin cleaning and inspection, even if it appears intact. Replace it sooner if there’s leakage, discomfort, or skin irritation. Consistent changing reduces infection risk and maintains skin integrity.
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Travel / mobility tips
Using a male external catheter can offer a comfortable, less invasive solution for continence management. With regular cleaning, correct placement and attentive care, most users can stay active and confident. If you experience ongoing leakage, skin irritation, or fever, consult your continence nurse or doctor promptly.
Common Mistakes & How to Avoid Them
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Wrong size → leaks
One of the most frequent errors when using a male external catheter is choosing the wrong size, which often leads to leaks. A sheath that is too large may bunch up or fail to seal properly, while one too small can constrict the penis and irritate skin. Correct sizing is a foundational step in preventing leakage.
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Poor skin prep → irritation
Poor skin preparation is another common mistake and can cause significant irritation or breakdown. The skin must be clean, dry and intact before application—moisture, adhesives, lotions or powders under the catheter can interfere with fit, increase friction and lead to skin damage.
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Tubing kinks / bag above bladder level → back-flow
Kinks in tubing or placing the drainage bag above bladder level are additional pitfalls. These can create backflow or impede drainage, increasing the risk of leakage, skin issues or infection. Keeping the system below bladder level and tubing smooth is essential.
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Leaving on too long
Finally, leaving the catheter on too long without regular change and skin inspection can cause moisture-related skin damage and adhesive breakdown. Daily inspection, removal of the sheath, cleaning of the skin and re-application with a fresh device are recommended best practices.
When to Get Professional Help
If you or the person you care for is using a male external catheter, it’s important to know when to seek professional help. Below are signs and what they may indicate, drawing on reputable Australian and international guidelines.
Even though an external catheter can be a less invasive option, complications can occur. For example, skin breakdown — including maceration, erosion or ulceration of the penile shaft — is reported in 15-30 % of users of external urinary collection devices.
You should see a health professional promptly if you notice:
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redness, swelling or soreness of the penis or adjacent skin or persistent rash under the sheath.
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broken skin, open wound, blistering or darkening of the skin under the device.
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leakage around the sheath consistently (not just occasional) indicating poor fit or detachment.
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discomfort, pain, numbness, or coldness of the penis (sign of impaired circulation).
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foul-smelling, cloudy or discoloured urine, or signs of infection such as fever, chills or malaise (this could signal a urinary tract infection).
Another key sign: the sheath or adhesive keeps detaching or sliding, or the drainage bag keeps backing up. These indicate the device may not be applied properly, or the anatomy/skin has changed. The guideline from European Association of Urology Nurses (EAUN) advises regular skin inspection and monitoring of fit, leakage, skin state and device function.
Moreover, moisture-related skin damage (known also as incontinence-associated dermatitis) may occur from prolonged urine contact or trapped moisture under the sheath. Australian skin-care protocols emphasise “cleanse, moisturise, protect, contain” and suggest contacting a specialist (wound, stoma or continence nurse) if skin damage persists.
Final Thoughts
A male external catheter is a safe and discreet option for men managing urinary incontinence. When used correctly, it can improve comfort, dignity and independence while reducing the risk of infection compared with indwelling catheters.
Understanding and exploring all continence management options and urology products that meet your care recipient’s needs is a key part of caring for someone.
Explore Our Catheter Range Here
References
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CONSA (Continence Nurses Society Australia). (n.d.). Evidence for practice: Links to clinical guidelines. Retrieved November 12, 2025, from https://www.consa.org.au/evidence-for-practice/links-to-clinical-guidelines
Eastern Health. (n.d.). Catheter care information sheet. Retrieved November 12, 2025, from https://www.easternhealth.org.au/images/services/translations/catheter_english.pdf
Elite Continence Care. (n.d.). Men’s Liberty® external catheter products. Retrieved November 12, 2025, from https://elitecontinencecare.com.au/
European Association of Urology Nurses (EAUN). (2016). EAUN guidelines: Catheterisation – indwelling catheters in adults – urethral and suprapubic. Retrieved November 12, 2025, from https://nurses.uroweb.org/wp-content/uploads/EAUN16_Guideline_complete_LR.pdf
Health NSW. (2021). GL2021_015: Continence management and urinary catheterisation. Retrieved November 12, 2025, from https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/GL2021_015.pdf
Hollister Australia. (n.d.). InView™ silicone male external catheter. Retrieved November 12, 2025, from https://www.hollister.com.au/en-au/products/continence-care-products/male-external-catheters/latex_free/inview-silicone-male-external-catheter
Independence Australia. (n.d.). Male incontinence and condom drainage. Retrieved November 12, 2025, from https://www.independenceaustralia.com.au/health-articles/continence/health-male-incontinence-condom-drainage/
Learning LWW. (2023). Male external catheter care and best practice. Retrieved November 12, 2025, from https://learning.lww.com/ovidfiles/00006939-202311000-00003.pdf
SES Local Health District (SESLHD). (2022). Incontinence-associated dermatitis (IAD) management procedure: SESLHDPR/205. Retrieved November 12, 2025, from https://www.seslhd.health.nsw.gov.au/sites/default/files/documents/SESLHDPR%20205%20-%20Wound%20-%20Incontinence%20Associated%20Dermatitis%20%28IAD%29.pdf
Shield HealthCare. (2011). Male external catheter troubleshooting guide. Retrieved November 12, 2025, from https://www.shieldhealthcare.com/community/urological/2011/10/25/male-external-catheter-troubleshooting-guide/
UroToday. (n.d.). Complications and adverse events of external urinary catheters. Retrieved November 12, 2025, from https://www.urotoday.com/library-resources/bladder-health/120650-complications-adverse-events-external-urinary-catheters.html
Wellead Medical. (n.d.). How do male external catheters work? A comprehensive guide to understanding their functionality. Retrieved November 12, 2025, from https://www.wellead.com/how-do-male-external-catheters-work-a-comprehensive-guide-to-understanding-their-functionality
ABC Medical. (n.d.). What to know about male external catheters. Retrieved November 12, 2025, from https://www.abc-med.com/abcmedicalblog/what-to-know-about-male-external-catheters