Using a Urinary Leg Bag

Patients experiencing difficulty with urination or who have undergone urological or gynecological surgery may be advised by their doctor to use a Foley or indwelling catheter. The catheter travels from the bladder through the urethra to help effectively drain urine. While a balloon helps the indwelling catheter remain in place, the urine gathers in a bag at the other end. A drainage or smaller urinary leg bag is recommended, based on time of day and output.

If you’re new to using a Foley catheter and its accessories, the following information can help you understand what a urinary leg bag does, how to attach and clean it and how often you should be emptying it. 

What Is a Urinary Leg Bag?

Foley catheters either drain freely into a bag or are controlled via a valve, which allows the bladder to fill and maintain its sensation and lessens atrophy. The urine may flow into a larger drainage or night bag or a urinary leg bag. Made of vinyl, silicone, PVC or latex, this system is recommended to patients using a wheelchair, managing incontinence, recovering from a related surgical procedure or confined to bed for part of the day. 

Along with the bag itself, a set of straps using hook-and-loop fasteners or elastic or a sleeve helps keep the bag in place during wear. 

For everyday and discreet wear, urinary leg bags:

•Are strapped directly to the patient’s leg, allowing for more natural movement.
•Fit under the wearer’s clothing.
•Help patients adapt to regular, day-to-day use of a Foley catheter.
•Are designed to gather and hold onto all the urine a patient produces during the day.

However, because leg bags are limited in size, they start to feel heavier as the day progresses. Patients or their caregivers are advised to empty the bag before it’s completely full, as this increases the risk of pulling out the catheter and subsequent urethral and bladder damage. 

Wearing a Urinary Leg Bag

Patients or their caregivers attach the urinary leg bag to the thigh or calf with the straps or a sleeve. With straps, one band secures the top half of the bag, and the other is designed for the bottom. A sleeve or holder, meanwhile, fully fits over the bag while offering an opening for safe, efficient emptying. Both systems help reduce skin damage and distribute the leg bag’s weight over a larger area to prevent slippage and damage to the urethra and bladder.

To maintain a steady flow of urine, the bag should ideally be placed below the bladder. To attach a urinary leg bag, patients are recommended to:

•Thoroughly wash their hands with soap and water.
•Empty any attached drainage or night bag.
•Place a towel below the catheter and the bag before detaching the catheter tube. During this process, pinching the catheter tube prevents urine from flowing out. Patients are advised to watch their motions to avoid accidentally pulling on the catheter.
•Place the drainage bag on the towel.
•Remove the coating from the leg bag’s tip.
•Clean the leg bag’s tip with an alcohol pad to avoid contaminating the catheter tube. After, attach the tip to the catheter tube.
•Secure the leg bag with the set of straps or sleeve, and hold the catheter in place on the leg with tape or adhesive. Check how tight the straps are.

In the evening, you’ll reverse this process to connect the night or drainage bag. 

Using a Urinary Leg Bag

To ensure more comfortable wear and efficient drainage with your urinary leg bag:

•Avoid any position that could pull on or twist the catheter.
•Make sure the urinary leg bag remains consistently below your bladder. Avoid supporting it at the waist, but also refrain from placing it on the floor.
Watch how much you drink to ensure consistent output. Your doctor will likely recommend how much liquid you should be drinking per day.
•You have the option of wearing your leg bag in the shower.
•Continue checking the catheter tube during use to monitor urine flow.
•Notify your doctor if the catheter detaches, you notice a change in urine color or smell, you feel pain or burning in your urethra or bladder, you start to run a fever, you spot abnormal drainage or redness around your urethra, or if urine stops flowing through the catheter.

How Often Should You Change a Urinary Leg Bag?

Patients or their caregivers are recommended to empty a urinary leg bag before it’s full — ideally, at the half to two-thirds mark. Going past this point increases the risk for reflux and urethral damage. On average, patients find themselves emptying their urinary leg bag at least twice per day. However, too-frequent changes increase a patient’s risk for infection. Disconnecting the leg bag can result in bacteria entering the catheter. 

Should the bag detach before the two-thirds point, patients are advised to attach a new, clean bag. From here, the leg bag can either be disposed of or washed with soap and water to reuse, based on your doctor’s recommendations. You may also be advised to replace the leg bag once per week to once a month. 

To empty a urinary leg bag:

•The bag’s contents can be emptied into a metal container or directly into the toilet.
•Avoid touching the bag’s tip during emptying to prevent contaminating the catheter.
•Close the leg bag’s tip once all contents have been emptied.
•Wipe away any urine.
•Thoroughly wash your hands with soap and water after re-attaching the catheter.
•Consider switching the bag to the other leg periodically.

For reusable options, soak the leg bag in a solution of water and vinegar before rinsing it out with warm water. Let the leg bag hang overnight to dry. In the morning, attach it to your catheter after removing your night bag. 

Recommendations for Urinary Leg Bags

Patients considering a leg bag may want to try out:

Hollister Urinary Leg Bag Combination Pack

This Hollister leg bag includes an easy-to-open drain valve that closes securely and can be used by patients with limited dexterity. With included fabric straps and extension tubing, this system allows fluid to flow without interruption and reduces potential skin irritation. 

Bard Dispoz-A-Bag

Made with lightweight yet heavy-duty material, this Bard leg bag helps reduce backflow and potential infection and lessen odors and leaks. These reusable systems include a Flip-Flo drainage valve or rubber cap and connect to various urinary appliances. 

Conveen Active Leg Bag

Ideal for those with a more active lifestyle, this Coloplast leg bag includes an integrated fabric elastic band with interior silicone straps that wrap around the thigh for more natural mobility. Free of PVC, this system uses a plug outlet tap to empty the full bladder without detaching the bag and anti-kink tubing to lessen backflow and leakage risks. 

Sources:

https://healthtalk.org/living-urinary-catheter/drainage-bags

https://my.clevelandclinic.org/health/articles/14832-urine-drainage-bag-and-leg-bag-care

https://www.vitalitymedical.com/leg-bag.html