What is a Urinary Sheath & How Does it Work?

National infection prevention guidelines recommend sheath as a preferred alternative to indwelling catheters for patients without urinary retention ​to reduce the risk of catheter-associated urinary tract infection (UTI)

Who Would Use a Sheath System?

Sheath systems are aimed to cater for men who have the ability to drain urine but don’t have the ability to control when it is released. Some conditions that can cause this are urinary incontinence, overactive bladder (OAB), Dementia, or conditions that can cause mobility issues. The Sheath can not be used for people with conditions that cause urinary retention.

If you’re considering a Sheath, it’s important to have an ​assessment​ with a healthcare professional.

Nurse Assessments

Before using an external catheter, it is important to be assessed properly to ensure the correct size. Sizing is important as if the Sheath is too tight, it may cause irritation to the skin, and if it is too loose, it’s likely to fall off³.  Various brands offer different sizes of Sheath so, when possible, try and use the measuring guide from the same company.

An assessment with a specialist nurse will be able to offer advice when it comes to using the external catheter itself, as well as help address any concerns you may have. At Nightingale, we are able to offer remote assessments, making our specialist nurses accessible to everyone wherever they may be.  To get more of an idea on the fitting and removal of the Sheath, take a look at this video explaining the process. https://youtu.be/oBPsiWzXD74

Key Benefits

Many people find that Sheath are a lot more comfortable than indwelling catheters, as they are non-invasive. An external catheter is also less prone to catheter-associated urinary-tract infections (UTIs) which can be common when using indwelling catheters.

A Sheath provides an alternative to incontinence pads for many individuals. Sheath, where used successfully, can offer an improved quality of life and greater dignity over pads. Male incontinence is a neglected area and pads are commonly used where a Sheath would be a more comfortable option⁴.

The easiness of applying and removing the Sheath can be the main motivation for many people. Once you’ve had an assessment and indicated the correct sizing, most people are able to apply and remove the sheath independently.

Challenges

If the sizing is incorrect, the Sheath can cause leakage which can result in skin irritation and discomfort. This is why an assessment with a specialist nurse is essential prior to the application of an external catheter.

Whilst ease of removal is generally seen as a benefit, it can be a challenge too. For people with conditions such as dementia, they are able to remove the external catheter easily which can cause accidents.

Removing a Sheath can be painful due to the stickiness of the adhesive. An easy solution to this is to use ​adhesive remover​ on removal. For some, allergies may be a cause of concern if you have allergic reactions to latex or adhesives. If you have any questions about this, please contact your healthcare professional or speak to one of our specialist nurses​.

Top Sheath Tips

• If the external catheter leaks at any stage, book an assessment with a specialist nurse. It’s likely to be a sizing issue.
• Always keep the urine bag or valve lower than the level of the Sheath to avoid back flow.
• Hygiene is essential. Always thoroughly wash your hands before applying and removing the Sheath, ensuring it does not touch any surfaces once opened.
• Always check the specific manufacturer’s directions for use and relevant fitting instructions. Different Sheath System can vary in shape and sizes depending on the manufacturer.