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Bad skin breakdown from condom catheter

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    Bad skin breakdown from condom catheter

    I am at my wits end. My son has had a super pubic catheter for several years and it has been wonderful. He loved being dry and not worrying about getting himself wet. It started leaking so bad that I was changing him and the bed several times a day. His urologist was called and he discussed different options which some of which we tried and they failed. We finally took out the sp catheter and figured we would let it close because by now, it was not working at all. I put an ostomy bag on it and let it drain into that. Then, he starts peeing out of his penis too. The only option was a condom catheter as well. It worked okay and suddenly he was getting skin breakdown. I tried not to roll the catheter up too high but that allowed leaking too. I wrapped the penis with some wound meds and covered that with tegaderm before putting on the condom catheter. It worked great until he started leaking all over again. Lo and behold, the skin breakdown under the penis, where the end of the condom catheter would be, actually rubbed a hole in the skin that is what is leaking now. I need to get his urologist up to date because with covid so bad in the Baltimore area, he was only doing video chats with my son. I hate the idea of a foley because he used that right after his sci accident and always had a uti and sepsis that almost killed him twice. Please, any ideas what I can do for him for the time being. I am ready to break down in tears because my poor son has had so many struggles. Any input would be appreciated.
    DavesMom

    #2
    I came here when my son first had his accident and spinal cord injury. Everyone was so helpful and it helped me so much. I find it so hard to believe not one person could say anything about the issue he is having now. It hurts my feelings because things used to be so different. Thank you anyway even if you just read it.

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      #3
      I used condom cats for ~8 years. They were great until the skin behind the head of the penis would get irritated. Then there was no way one would adhere there!
      The only remedy I found was to only put the catheter on the head of the penis and put kleenex around the breakdown which prevented the catheter from adhering any farther. It was a delicate situation to navigate with such time-bomb in my groin, but that skin is well vascularized and rebounds/heals quickly.

      PS: I hunch the low response rate is a function of forum drop-off, unfortunately.
      69yo male T12 complete since 1995
      NW NJ

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      • ChesBay
        ChesBay commented
        Editing a comment
        Phil, you beat me by two minutes. I shouldn't have been goofing off in typing class! Glad you dodged the Covid from your other post. Be well.

      #4
      I do intermittent cathing. The only issue I can comment on is using an external male condom cath.
      I don't use an adhesive condom cath because I am taking external cath on and off throughout the day, to intermittent cath. I usually wash out condom cath with Ivory bar soap ( no soap with oil) and then pour a 10% bleach to water mix through cath and 32 oz. disposable bag. I hang that bag on a towel which is on a towel bar. I usually have about 3-4 bags rotating at a time, so I am always replacing them with a clean completely air-dried condom cath / 32 oz. condom cath leg bag.

      I use Rochester non-latex, non-adhesive external Condom cath:
      https://www.locostmedicalsupply.com/...-external.html

      Since I don't use adhesive I use Urocare ( my preference) or Rochester foam strap to hold the condom catheter on. Urocare strap: https://www.urocare.com/EN/Products/6400EN.php

      Finally, if I see any sign of skin irritation/breakdown I use a skin protector ( if your son's breakdown is pretty far along SCI nurse or wound nurse may want to comment on whether to use this type of product) ( Better prices on Amazon and eBay but the link gives you the idea.

      One thing I have noticed over the years if I happen to be on an antibiotic my skin is much more likely to become irritated. I immediately start using skin prep on those occasions.

      If your son is using an adhesive catheter none of this may be applicable to his situation, ( maybe skip prep?).

      In my decades of SCI, I realize everyone develops their own techniques to suit their circumstances hopefully others will weigh in with thoughts.

      Wishing you the best and let us know how it goes.

      https://www.allegromedical.com/ostom...B#130A-DDE6EE9




      Comment


        #5
        What brand/model of condom catheter is he using? Is it latex or silicone? Self adhesive or non-adhesive? Is he using some type of skin protective wipe/spray on his penis skin (I like 3M No Sting Barrier wipes: Cavilon)? Cavilon should ONLY be applied to intact skin though.

        If the skin breakdown is bad, the best solution is to insert an indwelling urethral catheter to keep the area clean and dry while the skin heals. Fortunately due to the highly vascular penis skin, it usually heals up pretty quickly...the indwelling catheter can then be removed, and a properly applied external condom catheter can be again used. It is also important to change the condom catheter and do good skin care and inspection of all the penis skin every 24 hours...leaving it on longer is just asking for problems.

        (KLD)
        The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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          #6
          If the skin breakdown is that significant that there is a hole in the urethra higher Up that is leaking, out the side of the penis, I would definitely go to the hospital, Never mind coronavirus restrictions, That is emergency room type of thing I would highly suggest, I would not be overly cautious about going to the emergency room if there is a severe problem, I have been in and out of the hospital many times during this whole coronavirus thing here in Boston, I spent most of the day in the emergency room yesterday
          Injured on July 8th 2017 at 28 years old.
          Fractured C4 - C7, Incomplete.

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            #7
            I would like to thank those who answered. It is so much appreciated. KLD, we are using a silicone condom catheter as David is allergic to latex. I purchased a Spirit hydrocolloid with adhesive style 3. This is the one they used in the hospital and as for keeping him dry, it did the trick. I purchased some of the bands that go on the outside as well to hold it on. When he went to wound care, they looked at the hole, which is very small and said that it happens very often with condom catheters. They gave me something to put on it. The hole is at the bottom of the penis at the very end of it. I have put in an indwelling catheter for the time being and the skin breakdown is healing nicely. I just cant put it up all the way and I will definitely a barrier wipe. Vindex, I have no qualms about getting him to the ER if necessary. It is healing and I do exactly as they said to do at wound care.

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              #8
              Used a condom catheter for 30 years and never had a skin breakdown. Usually voided spontaneously with such pressure it would form an airtight seal. Getting in bed would disconnect the leg bag and change it a drainage bag, than every morning would empty my bladder, take a shower and put on a new one when clean and dry.

              Keeping the penis dry is the key.

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