In men, EUCDs are attached in some method to the penis, the shaft or glans, and are referred to as a “male external catheter” (MEC) but other terms used to describe these devices include “condom catheter”, “urisheath”, “external drainage system”, “penile sheath”, “urinary collection device”, “body worn urinal”, and “Texas catheter”. Newer technology for men utilizes sensors that activate a pump mechanism when exposed to urine and are being used to contain voided urine (e.g. military pilots). (Figure 1)
In women, devices include a pouch or external system that “wicks” urine into a collection container. (Figure 2 and 3) In women, evolving technology are systems that use wicking fabric to absorb while suction diverts urine away from the perineum into a canister.
These EUCDs are typically effective for 24 to 36 hours before they start to leak or become dislodged. More commonly used EUCDs have 1) a structural configuration that conforms to the anatomical configuration of the penis in men or perineum in women, 2) the use of adhesive attached to an inner surface of the device that bonds securely, 3) transparency so any skin injury can be seen, 4) the ability to elongate and retract during erectile function in men, and 5) should not cause local or systemic allergic reactions. EUCDs with latex material may not be transparent and have the risk of causing an allergic reaction. Medicare and many other insurers cover 32 MECs per month with a prescription from a medical provider.
New technology for women (female EUCDs) includes a device that adheres to the external genitalia by conforming to the perineal area between the labia and the urethra. This device is connected to low continuous suction which provides a sump mechanism to collect urine in a canister.
A variety of design options are available, primarily for men who research for one that fits their needs. They can be washed and reused for weeks to months. The least expensive of these products are made of latex material. (Figure 4)
These products do not need a prescription and usually, their cost is not covered by insurers. These systems are referred to by several names: body-worn products, pubic-pressure urinals or devices.
A popular design consists of a receptacle or cone-shaped device, similar to ones used by professional athletes, fitted comfortably over the penis and held in place against the pubis with close-fitting straps, belts or cloth underwear to ensure a secure fit. Gravity promotes urine drainage. In certain EUCDs, the pressure on the pubis allows the penis to protrude into the MEC. They are used by men with slight to moderate incontinence and are designed for men who find other MECs unsuitable. (Figure 5)
New reusable EUCD technology developed for men in the militarily is a collection system used for voiding. It involves a flexible medical urethane collection cup that resides in a specially designed undergarment. The cup contains urine sensors and serves as a reservoir for urine as it escapes from the bladder. The cup fits comfortably over the penis letting the shape contour to the body. Attached to the cup is a medical grade foam ring to create a seal between the body and the device. A design of this type of EUCD system is currently being developed for women. (Figure 6)
Written by: Diane K. Newman, DNP, ANP-BC, FAAN, Adjunct Professor of Urology in Surgery, Research Investigator Senior, Perelman School of Medicine, Co-Director, Penn Center for Continence and Pelvic Health, Division of Urology, University of Pennsylvania, Philadelphia, Pennsylvania