What I had = NOT Great
We long-term urinary catheter wearers need two types of drainage bags. One is for sleeping and/or wearing around the house when you don’t have anyone REALLY close coming by for a visit. That is the bedside drainage bag. It has a long, thick, heavy-duty plastic tube leading down to a quite-large bag with handles on it.
The other type of bag is the leg bag. That’s the one you wear when you need to go out into polite society, or you have guests coming to the house. It’s got a much more flexible as soft tube so it can move around easily beneath your pants. It also has a much smaller capacity.
[UPDATE 2017] Since writing this post, a new product has come out that solves all the downsides I point out below with the current crop of securement solutions. It’s called the Freedom Belt. More details on that at the bottom of the page HERE.
Here is what the Freedom Belt looks like (n the right) – which is sort of what it sounds like. It’s a belt you wear like a normal belt ( aren’t words helpful? :)). That belt then has super strong straps hanging down that you can attach any leg bag to. The support is incredibly secure.
One of the first things I had to do when I got home after having my suprapubic catheter installed was find good, comfortable and safe methods for dealing with my leg bag.
The problem was that I had this tube coming out of my belly with only a stitch to hold it in place, since it was a pig-tail type of catheter and not the Foley type that has a balloon to hold it in place. This actually presented me with two problems.
The first was that the only things holding my cath in place were the curved shape of the part of the catheter that was inside my body (which can easily be pulled out without a whole lot of pulling), and the aforementioned stitch through my skin. So I was paranoid of getting it caught in something or otherwise pulled out.
I was sent home with a sticker stuck to my leg that had two velcro straps on top of it that were supposed to hold the catheter up. this worked OK with my bedside drainage bag because the top of the tube had a large round plastic knob that looked like it was designed to stick a needle into for whatever nefarious purposes one might have for doing that. But with the velcro fastened under that knob, if wasn’t going to pull down my leg at all. My problem was with the leg bag.
Now most catheter securement devices, like the sticker on my leg – The Grip-Lok Foley Catheter Securement Device – assume (as the name even implies for this particular brand) that you will have a Foley catheter, which has two outlets at the end. If you wrap the velcro strap around just one of them, it stays up really well because it acts like a hook around the strap. But the pigtail catheter like I had only has one outlet. So if I stood up, the hose stretched out and pulled the end of the catheter down through the velcro strap. Trying to take a walk outside was pretty scary.
So what I did was wrap a bunch of narrow tape around the leg bag tubing, just below the outlet (see picture at the top left of the page). This worked to help the tube from pulling down when I walked. But it didn’t take long before it started working its way under the velcro and starting to pull down on my catheter. So eventually I just grabbed my roll of thick fiber tape and started wrapping until I had a huge wad of tape that was NOT going to pull through the velcro strap. Then I wrapped some softer medical tape around that, since the fiber tape was a bit uncomfortable on my skin, being as it is, designed for taping boxes shut:). But that really worked well and was the first big improvement I made to improve my life post-catheter.
See the picture at the top of the page for a diagram of this. The bow-tie shaped thing is the Grip-Lok Foley Catheter Securement Device.
Good Ideas and Bad Ideas
 This works well |
 This worked OK after adding tape |
 This does NOT work well by itself to hold a bag up |
Take a look at the drawings above. The first two will work well to prevent your leg bag from pulling down on the catheter, either causing pain at the insertion site, or possibly pulling it out! The first picture uses the “V” shape of a Foley catheter to catch on the securement device. The second picture shows a wad of tape providing the catch. The third picture, however, is all kinds of wrong (again, if you are able to walk). The first problem is that the velcro on the securement device is above the “V” where the two outlets of the Foley split. You could pull the catheter up and down pretty easily through the velcro strap. Not good. The second problem is the securement device itself. It is made of stretchy material that you wrap tightly around your leg and close with the velcro strip on the end.
As I mentioned in my article, Tips For Holding Your Catheter In Place, these will slide down your leg after taking two or three steps. You can try wrapping it tighter around your leg, but you can only do that so much before it starts to cut off your circulation. So all-in-all, if you are ambulatory, avoid using this type of securement device (unless you simply cannot have any adhesive on your skin for some reason, which would prevent you wearing something like the GRIP-Lok or Venetec StatLock, which is another kind of sticky-on-y type of device.
Tension – not too much, but also not too little
Here is a little lesson I learned the other night. You need SOME tension pulling away from your insertion site if you are wearing a suprapubic catheter. So you need a balance. Pull down/away too much and you risk pain and/or pulling your cath out. But leave too much slack between the insertion site and the securement device, and the part of the catheter inside your bladder can fall away from the bladder wall and sink down toward the opening of the urethra. Not only can this cause pain “down there” where the tip makes contact, but it can cause the balloon (if using a Foley cath), which is helping to seal the point-of-entry, to move away from the insertion site, which could cause urine to leak out of the site. I haven’t had the urine-leaking-out problem, but I HAVE had the other one.
I decided to use my old technique of using the wad of tape (see picture in the middle above) method with my leg bag the other night, because my GRIP-Lok was starting to unstick a bit. It was only about 15 minutes before I was feeling pain in my wee-wee because there wasn’t enough tension to hold the balloon against my bladder wall. As soon as I could, I reset to using the method in the picture on the left above, allowing less slack above the GRIP-Lok. Also – and here I must specify that although my urologist recommended this for me, it is not recommended by many specialists, so call your doctor first – I gently pulled the catheter out and away from my insertion site until it stopped coming. This allowed me to pull the balloon back up into place.
So if you are wearing a leg bag and have a suprapubic catheter, make sure you have enough tension to hold the balloon in place (assuming it’s a Foley), but not enough to tug at the insertion site.
IMPORTANT UPDATE – Added Apr 25th, 2017
There is a new product that solved ALL of the problems I mentioned above, AND is cheaper that any of the solutions mentioned above. I wish I’d had one of these in 2013. It’s called the Freedom Belt. I wrote a post about it here: Get Active Again With The Freedom Belt
The Freedom Belt
The Freedom Belt holds up a bag so you don’t have to rely on the flimsy velcro straps to hold it up. It also prevents dangerous pulls on the catheter tube. If you plan to get out into the world while wearing a leg bag, you absolutely owe it to yourself to check this out.
Do you have a good tip for managing the drips that occur with most catheters?
Hi Cindy,
Which drips are you referring to? I ask because with a leg bag they can come from a few different places. Ones coming from where the catheter attaches to the bag tubing (if you use tubing for the bag), from where the tubing connects to the bag (again, if you use tubing), and finally, the valve where you empty the bag.
Added to that is if you aren’t wearing a bag at all, which is what I’m doing during the day right now. In that case drips can come from where the valve attaches to the catheter, and from the tip of the valve itself.
In all cases, leaks can be prevented by ensuring you have a tight connection at each point. Theoretically, there should never be any “leaks” in this closed system until or unless you’re changing something, emptying your bag, or in case of accident (something comes unconnected).
Does that help at all?
Thanks for the question!
Ken
Hi can have help. I have been told I have to have a s.p.c fited. Is this the best way to go. Rather than using manually cathered.
Hi Phil. So much depends on your situation. Like how long you will need to have a catheter, and if you will need to have an indwelling one, or if you’ll be able to get by with intermittent catheterization.
If you need to have an indwelling catheter (it stays in) for a period of a month or more, my personal recommendation (not being a medical pro – just being a guy who went through it) is to have the SPC. I had one for about 6 months and compared to having the “normal” transurethral catheter, I found the SPC much more comfortable and easy to deal with. I felt pretty normal and very mobile once I had put my leg-bag on for the day. I could wear draw-string pants and pretty much do my thing.
Hope that helps.
Ken
Hi Ken Thanks for the advice I think I will be going down the S.P.C. Route.
Thanks phil
My husband has a SPC and he has been having problems with it “popping off” from where it connects to either the bed bag or the leg bag thus having a wet bed or pants. He is disabled and I homecare him so he cannot deal with these things himself. I change his catheter monthly (or more if needed) and I attach his bed bag or leg bag. When he tosses/turns during the night, I know he is pulling on it. I tried changing the attachment on his leg from one of those velcro things to the stat-loc (sticky) and that didn’t work unfortunately. He is using silcone catheters and I’m wondering if they are too slippery not to detach from the bags. Any suggestions? Also what kind of tape did you use in the 2nd illustration?
Hi Claire,
The tape was the little bit wound above the Grip-Lok catheter holder, and I used plain medical tape. It was just to create a wide section that would be more secure because THAT catheter was a pigtail and didn’t have the extra hose-end that is there for the saline to fill the baloon for a Foley. With a Foley, that extra end gives you a “V” shape at the end that helps with securing the tube. One end goes under the securement tape and the other end stays outside. See illustration here: https://livingwithacatheter.com/tips-to-avoid-urethral-catheter-spillages/ But to keep bottom part – the bag hose going into the catheter – is a harder thing. With the bedside bag, it was not much of an issue for me, at least at night. The tips of those things are sturdy and fit tightly right up into the catheter outlet. In fact, there is (usually) a little round plastic piece that holds the bag-end-connector in place, which is in there SUPER tight. You can try pulling that above the securement device (like a Stat-Lok or Grip-Lok), that should provide more security to prevent the bag end from pulling out. Daytime leg bags don’t have those, however. So for those (which typically have more stretchy hoses) you need to be really careful that there is enough slack and that the pants are loose-fitting. Those bags are typically only there for people who want to hide the bag under their clothes (if they are going out or interacting with friends and family, etc.). But they are less secure than the bedside bags. I got into the habit of only using the bedside bag on the weekends or when I was just going to be hanging around the house, simply because they were more secure. I had my share of accidents like you mention, though. Unfortunately, it’s sort of the price you pay. But to minimize it, I hope these tips will help. I hated the velcro leg straps because I was moving around and they slipped down my leg easily and pulled against the tube where it came out of my belly. I found that too risky and painful. So I used the sticky stuff to tightly secure things to my leg. Hope that helps at least a little.
Cheers,
Ken
I wear a alloy Foley suprapubic catheter 20ch and constant stinging sharp needle pain feels like tip of penis is there other suprapubic ones that give more comfort and also if I wear flip flow valve only small loss of urine and get kidney back pain
Not sure where to post my question. I have worn a SPC for the pasat 18 months. my only complaint is the severe pain I have in my penis. Several times a day and several times while in bed. I assume what I am feeling in the penis is actually a pain coming from the bladder. Pain caused by the ballon iritating the bladder. The pain is reduced by only putting 7 cc into the balloon but then there are leaks around the cath. The leaking will stop with 9 cc but then the pain is a real problem. Any ideas on how to lesson the pain. I don’t get much help for this problem from my Urologist.
Wow, Doug. I’m sorry but I don’t have any insights on this one. When I had the SPC, I didn’t have any pain in the penis. that does seem odd. Since you’re not getting any help from your urologist, I believe you should try to find another doctor. You should not be told to just bear the pain. Do not be afraid to be demanding. I hope 2017 brings more comfort for you.
Ken
I had severe pain and bleeding with the typical latex Foley SPC. The tip of the catheter was digging into the wall of my bladder. Most likely the pain you are experiencing is not from the balloon. I switched to a Poiesis dual balloon “Duette” foley catheter and my pain went away within a week and the bleeding went away within 4 weeks. Google Poiesis, Watch the videos. Show the info to your urologist and see if you can get them to agree to install one: you’ll be glad you did. Should be changed every 4 weeks. For easier removal of the catheter, have your Urologist squirt some lubricant down the hole before removal. Oh, one thing about lubricant: it must be water based as petroeum based lubricants will attack the silicon. 2-3X a day I apply an aqueous gel to the insertion point where the tube comes out of my body: I use a product (needs a perscription) called SilvrSTAT.
Thanks for posting that, Jim. For everyone else, check out my post (one of several) about the Poiesis “Duette” catheter. It was too new when I was going through my catheterization, so I never got to try one. But I always wanted to. Here is the post – https://livingwithacatheter.com/the-duette-a-better-catheter-than-the-foley/.
Have any of you tried CUBU the Comfy urine bag underwear. This underwear is by far the easiest and most comfortable why to wear a leg bag. It’s new and available on Amazon or on the cubu web site. You will love this underwear nothing like it
Thanks David! I had not heard of these. If anyone is interested in checking them out – see them on Amazon here – Urine Bag Underwear. I should point out that this product is designed primarily for people with urethral catheters. It can still be helpful for folks with suprapubic catheters, but some adjustments in the routing of the tube would have to be made.
It is good to know that there are different ways of handling catheter bags while out in public. Even if you are in a wheelchair it doesn’t necessarily mean you want everyone to see your catheter bag holder. Maybe using a freedom belt can help anyone that has a catheter bag be more secure about going out to public places and not having to worry about the cord being pulled out.
Yes, the bag is very secure with a Freedom Belt. And they have just reported that they are getting them in stock in September (the next week or two)!
Hi Oliver – just wanted to update you that Freedom Belts are in stock and they are AWESOME. I tried one a couple of weeks ago and soooo with I had had one when I was dealing with my catheter issues. You can get one (in 3-5 days) here: https://freedombelt.com/