“Catheters are used in urological surgery and when other methods of managing urinary incontinence fail. Ten percent of hospital patients receive an indwelling urinary catheter at some time during their admission,’ and the use of such catheters results in significant morbidity and mortality.”1
“A leg bag is a smaller size urine collection bag for your urinary (Foley) catheter. The leg bag can be worn on your leg during times when you are out of bed to collect urine.”2
As people handle daily issues with urine bags, they learn tricks and tips to master basic sanitation and proper use of these devices.
Urine and leg bag basics
Once the catheter is in place and ready to drain, connect it to a urine collection bag. There are two types of bags: leg bags, and regular urine bags, which are typically larger.
Using a leg bag is convenient when the patient is active and moving, as it attaches to the thigh, while a regular urine bag is advisable during sleep.
“There are two types of bags that can be attached to your catheter. The larger one has a longer tube and goes to a larger volume bag. This is the preferred drainage bag to use except when leaving the house and going into public. Because of its size, it drains the bladder better and may prevent your bladder from getting over-full, which can delay the return of normal bladder function. The other bag has a shorter tube and a smaller collection bag and can be strapped to your leg (leg bag, left photo). This allows it to be kept out of sight under loose-fitting pants or a long dress.
The larger bag must be used for overnight drainage since it holds more urine. Whenever the leg bag is used, it is necessary to pay close attention to its volume and not allow it to overflow. If it gets too full, it will not drain the bladder well and urine will back up into the bladder delaying the return of normal bladder function. Poor bladder drainage also increases your risk of bladder infection.”3
How to attach or remove urine and leg bags
Whether you are attaching or removing urine or leg bags, proper hygiene is important to prevent contamination. Otherwise, unhygienic practices can lead to urinary tract infections. Begin by washing your hands with water and soap for at least 15 seconds. Supplies include:
- A sanitized or fresh leg bag with straps or tape
- A large (regular) drainage bag
- Medical Gloves
- Alcohol swabs or pads
- White vinegar
- A clean towel.
“The leg bag is attached either to your thigh or lower leg with Velcro straps or a mesh sleeve. Where you wear the bag depends on what feels comfortable for you. An special strap on the thigh should be used to help to secure your catheter. Leg bags come in three different sizes, holding 350ml, 500ml, or 750ml.”5
When you are ready, drain the large (regular) urine bag. Regardless of the draining method, avoid any contact with the outlet tip. Place the catheter-urine bag connection on a clean towel and disconnect it as you pinch the open catheter end to prevent urine from leaking.
Next, put the removed urine bag on the towel. Remove the cover on the leg bag connection point and keep it for later use. Clean the tip with an alcohol swab and connect the catheter to the leg bag.
Fasten the leg bag to your thigh but beware not to over-tighten. You can strap the catheter to your thigh, but keep it barely loose to avoid tugging on your urethra and bladder.
How to empty urinary leg bags
Due to differences in size, a leg bag requires drainage more often than a regular urine bag. “This will need to be done many times a day as the bag fills up and becomes heavy. The frequency of this will depend on the size of the leg bag. Always wash your hands with soap and water first and dry hands well. Place the jug under the bag outlet tap and open to allow the urine to drain (avoid contact from the tap to the jug to reduce the risk of infection). When empty close bag outlet tap and wipe with a tissue. Make sure the leg bag is placed back in a comfortable position for the patient (The urine will need to drain downwards into the bag and be secured so that it does not pull). Dispose of contents of jug into the toilet Rinse out jug with warm soapy water and allow to dry. Wash hands with soap and water.”6
Following this, empty the leg bag into a container or toilet at least two times daily or when it is half full. Ensure you understand how to open the spigot to empty the urine since drain systems vary among different brands. Once drainage is complete, close the cap and wash your hands. In addition, you can alternate legs to wear the leg bag, preferably after a shower.
Regarding when to empty the leg bag, specialists suggest: “Don’t let the leg bag or night bag get full. Empty the drainage bag when it is ½ to ⅔ full (at least every 4 to 8 hours) or when switching from one type of drainage bag to another. If you’re using a leg bag, you may need to empty it more often (like every 3 to 4 hours) because it’s smaller than the night bag.”7
Remember to record the amount of urine drained if your healthcare professional recommended it.
How to clean the urinary leg bag
While health professionals recommend replacing the bag once a month, it still needs daily cleansing. To clean the bag after changing, you can use vinegar and water in the ratio of 1:3 to soak the bag for 20 minutes before rinsing it with warm water and hanging it to dry.“Collection bags should be washed with soap and water when they are exchanged. You may disinfect the bag and remove the urine smell by rinsing the bag with a distilled vinegar solution (1¼ cups white vinegar mixed with 2 quarts of water). Do not rinse the bag with water after using the vinegar solution. Your drainage bags should last 4-6 weeks under normal use with appropriate care. New bags can be purchased at medical supply stores.”8
A few more tips
- “Keep the collection bag lower than the level of your hips to prevent urine from flowing back into your bladder.
- Unless told otherwise, drink 8 to 10 cups of non-caffeinated fluid each day.
- Clean your leg bag and large collection bag at least every other day.
- Clean each bag with a solution of vinegar and water that is 1 part vinegar and 3 parts water, unless told otherwise by a member of your health care team.
- Change your old bags to new bags every 2 weeks or more often as needed.” 9
- Keep your body well hydrated to maintain healthy urine output as long as your healthcare professional gives approval.
- Avoid situations that might damage the catheter and urine bag.
- Prevent urine backflow by keeping the bag below your bladder at all times to reduce the risk of infection.
Warning signs when caring for urine and leg bags
See a doctor immediately if experiencing:
- Unusual urine smell or color.
- Burning sensation in the urethra.
- Urethral discharge.
- Bladder or low-back pain.
- Redness or inflammation of the urethra.
- Other warning signs such as nausea, lethargy, and urgency to pass urine. These symptoms may indicate the presence of a UTI (Urinary Tract Infection).
“If you call your doctor, have the following information ready:
- Your temperature
- The amount and appearance of your urine
- Try to describe your problem as detailed as you can. For example, if the problem is pain, be able to tell your doctor where the pain is, what the pain feels like (sharp, dull, burning) and when pain occurs.”10
“Essentially, the bladder is like a muscle and it will eventually waste away if not used regularly. It has been demonstrated that after only 6 months on free-flow drainage using a leg bag, the bladder shrinks and ceases to function properly.”11
(1) Everyday Aids and Appliances: Urinary catheters. Belfield, P. British Medical Journal. 1988. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2545116/pdf/bmj00277-0034.pdf
(2, 9, 10) Leg Bag for Your Urinary (Foley) Catheter. James, A., & Solove, R. The Ohio State University Comprehensive Cancer Center. 2018. https://patienteducation.osumc.edu/Documents/leg-bag.pdf
(3, 4, 8) Bladder Catheter Care. Cardosi, R. Comprehensive Care For Women With Gynecologic Cancer. 2019. https://www.watsonclinic.com/uploads/Bladder_Catheter_Care.pdf
(5) Managing a urinary catheter. NSH Borders. Patient / Carer information booklet. 2019. http://www.nhsborders.scot.nhs.uk/media/383900/managing-a-urinary-catheter-patient-information-booklet-may-2016.pdf
(6) Procedure for Catheter Aftercare. NHS Wirral. 2010. https://www.wirralct.nhs.uk/attachments/article/19/NPC03ProcedureforCatheterAftercare.pdf
(7) When You Have an Indwelling Catheter: Care Instructions. Home Care, Alberta Health Services. 2017. https://myhealth.alberta.ca/Alberta/AlbertaDocuments/when-you-have-an-indwelling-catheter-care-instructions-printable.pdf
(11) Urinary Retention: Catheter Drainage Bag or Catheter Valve?. Virdi, G., & Hendry, D. Current Urology. 2015. https://www.karger.com/Article/FullText/442847