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Daddy has congestive heart failure and was in the hospital this week for two days with fluid build-up. He's back in his AL now, but he told me this morning he thinks he needs to "wear a catheter." He cannot control the urine flow when they increase his diuretic after one of these bouts of extra fluid, and he gets his clothes wet sometimes when he pees. He needs help; and it he has to wait more than a few minutes, accidents happen.


I was very alarmed at the suggestion and wanted to ask if this is ever even a solution to what has to be a common problem in this situation. Use of catheters causes so many other issues, and he is not able to self-care anyway. There is no telling what the facility will charge if he decides he needs a catheter! And I can't believe any doctor would do that just for the convenience of keeping him from having little accidents when he pees, right?


Thoughts? Thanks!

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Ten years ago I had surgery for prostate cancer. Getting rid of the cancer was completely successful but I am incontinent. For many years I used the male pads called "Guards." I still use them at night. They work but as the years went by I was using more and more of them each day. At one visit I joked with my urologist, "It doesn't take much pressure to stop the flow, maybe I should just put a clamp on it." To my surprise, he said, "I'll prescribe a Cunningham Clamp" for you." It's a miracle. It is just what it sounds like, a small foam lined clamp that closes the urethra. Easy on, easy off, easy to clean and I once again have a bladder that fills without leaking. I'd recommend it to any man with incontinence. It's even nice to have the feeling of needing to "go" as in the pre surgery days. It's unobtrusive and you don't feel it at all when wearing it. You don't wear it during sleep but otherwise it's a great solution to an annoying problem
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RedVanAnnie Sep 2019
How helpful of you to be able to offer your experience. The clamp sounds like a good option.
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I don't think any doctor is going to allow a permanent catheter to be surgically placed without a good medical reason for doing so and even if a doctor wanted to start placing them at patient request no insurance company would cover it. I agree with the folks here who said adult briefs and bedside urinals are the best options.
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If he has some control I highly recommend Depends Fit-Flex for Men. They are what my dad wears. After enduring bladder cancer surgery several years ago followed by a severe illness two years ago that wrecked his kidneys, he has trouble controlling his urine. At first he was so embarrassed by the other kind of adult briefs that were bulky and white and looked very diaper-ish, but the Depends look and feel more like underwear (they're a 'manly' dark grey, too). And he says they're very comfortable since the side panels are elastic, and easy to get on and off around the kidney catheter. I buy them at Walmart or online at Amazon and we just refer to them as his underwear.

If this isn't an option then I agree, start with the condom catheter since it's non-invasive.
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There are condom catheters you could try. That would be better than inserting one.
The problem with inserting a catheter is it can lead to more infections.
If it just a matter of him having to wait until he can get assistance maybe a Urinal that he can keep by his chair or bed. When it is urgent that he get to the bathroom if no one is there the urinal would be close by.
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I considered a catheter for my husband as well. He also has CHF and is on Lasix. I (affectionately) call him “Mr. Niagara Falls”. I was told by a nurse that catheters, especially permanent ones, are a nightmare. Infections are very common and with CHF his heart is compromised so an infection is bad, bad news. Hubby wears adult incontinence briefs (don’t call them “diapers”). Proper hygiene is still important but the AIBs are much better than a catheter.
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My experience comes just from an elderly male friend. He passed away partly as a result of wearing a catheter for over a year! He ended up getting UTI and UTI. The urologist kept trying to get him to have it removed. He didn't want to wear a diaper or diaper brief. He ended up with lots of blood in the bag and many rounds of antibiotics. He died of sepsis and dehydration. So ... be really careful and talk about long-term side effects with his urologist.
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Llamalover47 Sep 2019
Maryjann: Wow. So sorry that happened to your friend. So do you think he would have survived had he had the cath removed?
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My dad has end stage CHF, goes into the hospital every few months and gets fluid drained with IV Lasix. His bladder has been termed “worn out” at his age, with no good fixes for it. So between routine Lasix and a failing bladder (add to it that long term use of Lasix often causes kidney issues) he’s a peeing mess. And catheters always, without fail, cause more trouble than they help. No matter which kind he always gets infections from them, without fail. Adult diapers, his words, not mine, are our best way of coping with it. Can certainly be messy but no infections
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There are condom catheters for men so that no tube invades the body - investigate this pathway as it has less problems than the other type - EMS use them here for transport to other hospitals
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Allencic's idea of a Cunningham Clamp also sounded like a good, non invasive alternative. Google it. Good luck to you.
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My mother wears a permanent internal catheter and I know for a fact it's easier on women than men. I don't know any men who have them (until the absolute EOL).

Incontinence briefs with a separate pad placed inside worked with dad. But he was pretty much bed bound, so there wasn't a lot of leakage.

Mother has constant UTI's due to the catheters not being cleaned properly. It's a daunting process. Luckily, she does not get 'crazy' with UTI's.

Keeping these things clean is a PT job, Mother can't keep hers clean enough and trying to help her is not allowed. She thinks she's doing fine, so I say nothing. Sometimes I go to her house and her 'secondary catheter' is lying on the bathroom floor, half full of 'sick' urine. She just swipes at the end she inserts and calls it good.

And a lot of men aren't even going to make THAT much effort.
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