www.incontinentsupport.org

I think it is awesome you are always looking to improve your products! however, draining an indwelling catheter into a diaper is just a recipe for infections. For many people that use a foley, leakage from around the catheter is common especially after a bladder spasm, so trying to control that leakage is a good idea, however, the issue comes back to keeping the area sterile.

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I’m a chronic Foley catheter user for nearly 4 years now. I don’t do this and don’t recommend the practice. The Foley catheter is a sterile procedure. The catheter and bag are a closed system, I prep the ends with alcohol prior to switching between leg bag and night bag and vice versa. I also sanitize the bag with vinegar and water and use bleach and water alternately several times a week. In almost 4 years I’ve had 3 UTI’s. I still wear a diaper over the foley just to catch the minor leaks that I usually have around the catheter.
Just a bit of insight from a guy who uses catheters & diapers.

I'm sorry for the necropost, but this seems somewhat important. I actually created an account specifically to reply to this.

First things first, Adam, you have some of the best products available already. I have used a number of them, and they are all top-notch. If anyone were going to do a catheter open in a diaper like you inquire in your first post, I would suggest that the Supremes might be an excellent choice because their wicking action is so good already that with a slow drip it would never leak until the entire thing was soaked. But that's not what I thought was so important.

I know others elsewhere have said they've heard from their urologist that an open catheter in a diaper is not a problem, and I also happen to know that with babies and small children this is common, presumably to keep them from playing with things they shouldn't and causing a big mess, an injury to themselves, or both. I have done some experimentation with this on my own; many will think me foolhardy for this, but I have non-speculative information to offer as a result. I have never gotten an infection by doing so. I haven't worn open catheters a great deal, but I think that the main reason I didn't have a problem is that the hearsay urologist Adam referenced is correct......to a point.

There is a crucial detail in this which has not been mentioned, which I discovered in my experimentation. Size not only matters, but is critical here! A large catheter has enough room in its tubing that air most definitely can get into the bladder if you leave it open, and it did mine. I noticed this quickly, and before it became a problem, thankfully. With a larger catheter, there's enough room that the urine can run out and exchange with air. This is a bad situation, as many have observed. Not only does air potentially introduce pathogens, but it makes the environment more attractive to many of them. Use of a small catheter makes it so that surface tension keeps the tube completely full of urine at all times, and somewhat mitigates the hazard. I don't see the bladder expanding on its own and inhaling through the tube. I don't think this is even anatomically possible, but of course there is some urine in the tube which can accommodate some movement without introducing air. Staying hydrated to ensure good flow helps, too.

Yes, the indwelling catheter is designed to be a closed system for good reasons, and technically using one without a bag makes it an open system, but practically, if you use a small catheter, the urine will keep it functionally closed even though it is technically open. Management of incontinence typically uses small catheters because they're quite adequate and more comfortable; the larger ones are usually used only for situations where there is debris in the urine which will clog a small one, and if that's the case, you're probably in the hospital already.

The Japanese Pediatric Society did an experiment with open catheters in diapers using pig bladders and anesthetized rabbits as test subjects, looking at effectiveness of drainage and bacterial growth. As I said, this is SOP with small children. They hypothesized that using a check valve to prevent backflow would reduce bacterial growth. They found it did nothing at all other than make the body retain more urine than it otherwise would have. Read more about it here: https://onlinelibrary.wiley.com/doi/abs ... /ped.13806 I would note that small children and rabbits are both going to be using comparatively small catheters, which helps with keeping air out of the system.

The conventional wisdom is, and always has been, don't use an open catheter in a diaper unless you're dealing with a small child who might injure himself otherwise. There are some good reasons for that, but that doesn't mean that there is never a situation where it may make sense to do so. I would note that the study I cited above is from 2019, so it is likely that this research is little known, and knowing that a handful of people have posted online that their urologist was ok with them wearing an open catheter in a diaper, it is entirely plausible to my mind that there is a developing new thought within urology on this topic that has not become mainstream yet. For myself, I have no worry about using a small catheter open in a diaper for a short time period. Of course, I'm not a licensed urologist, so my thoughts do not constitute medical advice. You should do whatever you and your urologist conclude is best for you.

Thx very much for the detailed reply. Take care,
Adam

I have grown in my experience and knowledge about a lot of thing dealing with incontinence and I think I have a really good idea where this line of thought is coming from and what the motivation is. From what I have seen, this practice comes from people that want to experience incontinence and the real feeling of wetting uncontrollably. It is a fetish thing, no more. I can not think of one practical reason why any doctor would recommend or endorse a practice like this.

If there are people out there trying to research this to actually try......don't. Bad idea on many levels.

Certainly you are correct that the most common reason for this thought process appears to be fetishism or curiosity, but you don't have to look very hard on the internet to discover that there are other reasons, too. This person thought it might be more concealable https://www.adisc.org/forum/threads/com ... per.50122/ and this person thought it might help his unusual psychological hangups https://www.adisc.org/forum/threads/cat ... es.149506/ This person had some concern about logistics for a few days https://www.justanswer.com/urology/9ubz ... iaper.html The poster didn't say what the issue was, but the scenario that comes to mind for me is active involvement in a sporting event. Not everyone dealing with incontinence is elderly or otherwise physically limited.

In all of these interactions, the OP was given the same advice you gave; some variation of don't. Still I have seen other places where people have indicated that their urologist was OK with doing so, and notably I have seen where people other than myself have indicated having done so with no ill effects. It's all anecdotal evidence, and the cautious approach is still don't. Just don't paint all those who wonder about it with the broad brush of fetishists; it's simply not correct.

The usual technique if you need to use an open catheter is to use two diapers; the inner one takes care of poo and the outer one pee, so that the catheter isn't exposed to poo. An open catheter draining into a single diaper is a well-known infection risk; even in a closed catheter system the risk is still present.

Thank you for mentioning that. I neglected to do so. You're correct, but there's more to that than you mentioned. The double diapering system does two things; in the case of a person who is double incontinent, it does in fact deal with the reality that you do NOT want #2 getting in your catheter. However, even for those who are only urinary incontinent it may be the better plan if someone were going to drain their catheter into a diaper, because it keeps the skin drier. Someone mentioned pooling of the urine around the urinary meatus as a bad thing that can lead to unpleasantness, and the double diapering system is also meant to reduce this. If you have no leakage, it can eliminate it. In either case the inner diaper need not be anything heavy, as it is not going to be doing much by way of absorption. I will note that for people who are only urinary incontinent, you may be able to accomplish enough of the same thing by using a single premium diaper which wicks moisture away from the inner surface. They have gotten very good.