A GUIDE FOR PATIENTS
Authors: T. McKnight (District Continence Advisor, South Downs Health) and
D. Rigby (Continence Advisor, St. Martins Hospital, Bath)
At home with your sheath
Patient's name:
Address:
Nurses name:
Contact number:
Emergency number:
Sheath code:
Leg bag code:
Bed bag code:
What is a sheath?
A sheath (sometimes called an external catheter) is a condom-like covering
which fits over the penis and has an outlet tube. It connects to a drainage bag
which collects urine (water) until it can be conveniently emptied.
When is a sheath useful?
Sheaths are used by men who are incontinent or who have difficulties in
accessing toilets, e.g. those with mobility problems.
When is a sheath not of use?
A sheath will not help you pass urine if your condition means that you
cannot empty your bladder. In order for a man to use a sheath, the shaft of his
penis needs to be at least 5 cm (2 inches) long.
Where can I get the sheaths from?
Your family doctor will prescribe sheaths for you, which you can obtain from
your chemist. Make sure you get a new prescription in good time to allow your
chemist a few days to obtain them.
How do I get the correct size of sheath?
Sheaths come in different sizes and lengths which are adequate for most men.
The most common sizes are 20, 25, 30, 35 and 40 mm diameter. Before you use a
sheath for the first time, your family doctor or nurse will measure you with a
sizing gauge to obtain the correct size.
It is important that the sheath is not too tight; room should be allowed for
changes in the size of your penis.
How does the sheath stay in place?
There are several methods of keeping the sheath on. They include using a
separate adhesive, an adhesive strip, an adhesive already applied to the
sheath, or a strap around the outside. The wide choice ensures that there is
something to suit most men.
Who puts the sheath on for me?
If you are able, you can put it on yourself. Your family doctor or nurse
will show you how. Alternatively, if your wife or carer is willing to help,
they can be taught to apply it for you.
How do I put the sheath on?
Long pubic hairs should be trimmed (you do not have to shave).
Wash and thoroughly dry your penis to ensure adhesion.
Do not use powders or creams, as these will prevent the adhesive from
sticking.
If you are uncircumcised, make sure that the foreskin is in place over the
head of the penis.
A 2-cm (3/4 inch) gap should be left between the tip of the penis and the
sheath outlet so that the sheath fits comfortably. If the gap is too large, the
sheath may twist or kink and could prevent the urine flow into the bag.
If an adhesive is used, the sheath must be firmly pressed to the penis in
the area where the adhesive is, to obtain a good seal.
Attach a drainage bag to the outlet tube.
NOTE These are general points for applying a sheath. Please read the
instructions that come with your sheath for specific details. If you have any
questions, do not hesitate to ask your family doctor or nurse.
How long will the sheath last?
A sheath can normally be left in place for 1-2 days between changes.
However, for hygiene purposes you may prefer to change them daily.
How do I remove the sheath?
Roll it down the penis gently and evenly using your thumbs and fingers. The
adhesive will normally come off with the sheath.
How do I care for the skin?
Apart from washing and drying thoroughly between changes, always check the
skin carefully each time you remove the sheath. If you see any redness or are
feeling sore, leave the sheath off until this has cleared up.
Will a sheath affect my sex life?
Using a sheath does not need to interfere with your sex life. Before having
sex, simply remove the sheath and wash your penis. Afterwards you can put on
your sheath as usual.
How should I dispose of the sheath?
Sheaths should be wrapped first in newspaper and then put in a plastic bag
and placed in the dustbin. Do not burn sheaths on an open fire.
What type of drainage bag do I need?
You need two kinds of bag: a leg bag and a bed bag. A leg bag is worn under
your normal clothing during the day. A bed bag (much larger) is attached to
hold all the urine that drains from your bladder overnight.
How do I wear a leg bag?
The leg bag is usually attached either to your thigh or to your calf with a
pair of straps. How you wear it depends on what feels comfortable.
Leg bags come in three different sizes, holding 350 ml (12 fl oz), 500 ml
(3/4 pint) or 750 ml (5/4 pints). There are also four different tube lengths,
direct (leading straight from the sheath to the bag), 10 cm (4 inches), 30 cm
(12 inches) and 38 cm (15 inches). Your family doctor or nurse will help you
choose the one that suits you best.
What happens when it fills up?
As the leg bag fills, it gradually gets heavier and you will feel a strain
on the straps. It is best not to let your bag get too full. To empty a leg bag,
open the tap at the bottom and let it drain into the toilet, if possible. If
you find this difficult, you can use a container, but you must keep it for this
purpose only. Do not forget to close the tap again after you have emptied the
bag, and always wash your hands.
What happens at night?
When you go to bed your leg bag can be replaced by a bed bag. This is larger
and can hold more urine, so that you do not have to get up at night to empty
the bag. The bed bag must not be allowed to lie on the floor. Support it on a
special hanger or floor stand.
Remember, urine cannot drain uphill, so always keep the bag lower than your
bladder.
How often should I change the bag?
The Department of Health recommends that a leg bag can be worn for a week
before it needs changing. If it gets damaged, is difficult to empty or becomes
uncomfortable to wear, you can change it sooner.
If your bed bag has a drainage tap, it can be re-used for up to a week. Wash
it through with water every morning and allow it to dry. (You can use a small
funnel to pour water into the bag to help wash it through).
If your bed bag does not have a tap, you must use a new bag each night.
How do I dispose of the sheaths and bags?
Empty your drainage bag and wash it out before throwing away. Sheaths and
bags should be wrapped first in newspaper and then put in a plastic bag and
placed in the dustbin. Do not burn the sheaths or bags on an open fire.
How do I store the sheaths and bags?
It is important to store spare sheaths and bags in their original packaging
in a dry, safe place away from direct heat and sunlight.
Your sheaths and bags may be obtained on prescription from your family
doctor.
For further supplies of this leaflet and information on the wide range of
Bard* Integrity* Sheaths, Uriplan* Leg Bags and Uriplan Bed Bags, please
contact us at:
Bard Limited
Forest House
Brighton Road
Crawley
West Sussex
RH11 9BP
 01293 527888
For further information and advice, contact:
The Bard InfoLine Nurse Advisor
0800 591783
12:30 to 4:30 PM Monday to Friday
The Continence Foundation
The Basement
2 Doughty Street
London
WC1N 2PH
0191-213 0050
9:00 AM to 6:00 PM Monday to Friday
* Trademark P. No. 9604/012
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