The P Valve Struggle
by Jon Kieren:
Warning: Graphic language, reader discretion advised.
I somehow managed to make it through 5 years of technical diving without finding the need to install a P-valve in my dry suit. However, about halfway through my TDI Rebreather Full Cave Diver Course, I realized just how important this accessory would be if I was going to be making 4+ hour dives. Towards the end of a 3.5 hour training dive, we had just come out to the cavern zone and all I could think about was the excruciating pain in my bladder and rushing for the exit so I could drop my gear, get to the nearest tree, and relieve myself. At that moment, my instructor told me to tie off for a lost diver drill. All I could do was respond by raising the appropriate finger to him, shaking my head violently and signaling that we needed to abort. He responded with the shoulders shrugged and muttered through his loop “what’s wrong?” I pointed to my crotch, saluted “see you later” and made a dash for the exit. The whole way out I could hear him laughing hysterically, and I knew it was time to install a P Valve.
I left my suit with the manufacturer that weekend to install the accessory, and over the next week I started to research how this mysterious piece of equipment worked. It was overwhelming; pages and pages of forum threads on the subject, with only little bits of vaguely useful and often contradictory information scattered throughout. The process could have been made much simpler by just asking someone with experience, but how do you start that conversation? “Excuse me, can you please show me how to connect this tube to my penis?” Umm, no thanks. So I had no idea what to really expect, and when it came time to start trying things out, I was very grateful that my wife has a good sense of humor (and compassion).
What is a P Valve?
First things first, if you don’t know exactly what a P-valve is, it’s pretty basic. Essentially, it’s a tube that has a valve on one end that vents to the outside of your dry suit that allows liquids to pass from the inside of the suit to the outside. Simple enough. The other end is the interesting and intimidating bit. This is the end that connects to your “anatomy” and allows you to urinate without making a mess on yourself. The connection happens by using an interesting piece of medical equipment, the condom catheter.
Condom – I know what that is, and am familiar with using one. The condom is associated with pleasant and enjoyable experiences. I’m comfortable with this.
Catheter – I know what that is, but have never needed to use one. The catheter is associated with extremely unpleasant circumstances, and honestly, the thought of using one horrifies me.
So then what is a condom catheter, exactly?
Well, it’s a mix of the two. It’s essentially a condom (good, familiar), that you glue on to your manhood. Wait…. WHAT!? Yes, that’s right; the condom is produced with a strong medical adhesive on the inside. When you roll it on, pretty much just like you would a condom, you are securely gluing it in place (this is extremely important, as you do NOT want the condom catheter to come off prematurely!). The “tip” of the condom is left open so it can be mated with the “tube” of the P-valve. When you pee, everything (hopefully) travels straight into the tube, and out of your dry suit.
OK, it’s not as bad as the typical catheter that you think of. Just roll the condom on, hook up the tube, and pee freely. Awesome, let’s buy some of these catheter things and go diving! Go ahead and Google “Condom Catheter”. Actually, I’ve already done it for you, just click HERE. As you will quickly realize, there are A LOT of options out there. Many different manufacturers, varieties, and yes of course, SIZES. Where to start? A quick search on the common diving forums will result in a few of the varieties and manufacturers preferred by divers. The “wideband” varieties are equipped with adhesive from almost the tip, all the way down. The “freedom” styles have a much narrower band of adhesive. More adhesive means a better hold… it also means more difficult to remove (more on that in a bit). You may want to consider the material the catheter is made out of. Some are latex, and some are silicone. If you have latex allergies, the decision is pretty obvious, but I have found the silicone to be more comfortable anyway. So it really comes down to personal preference. Personally, I don’t want to worry about whether the glue is wearing off of my catheter when I have a couple hours of deco to do, so I prefer the wide bands.
What size condom catheter do i need?
I want the best hold, I know that. Now, what size? Many catheter manufacturers produce a “sizing guide”, which is essentially a chart you hold up to your unit and see how you measure up. Guys, this is not a time to be macho. Nobody cares what size catheter you order (however if you’re really embarrassed, you can always keep an “XL” in your gear bag in case anyone ever asks to borrow one). I do suggest ordering a small batch of the size you determined, as well as one size up and one size down, and try each to see which you prefer. You want it to be snug, but the goal is not to strangle your buddy. You also want to consider the temperature and whether shrinkage may be a factor (yes ladies, it shrinks).
Like any new piece of dive gear, the excitement builds when your first box of catheters shows up on your doorstep. As you open the packaging and get a good look at your new device, the reality sets in. “What did I get myself into here?” It is a good idea to go ahead and give things a try and get sorted out well before your first attempt to use your P valve on a real dive. These first dry runs are intimidating, uncomfortable, and can be downright terrifying and painful (but very entertaining for your spouse). There is a bit of trial and error here, but here are a few “tips” that I have found useful:
- Manscape – This is an extremely important step. You don’t need to go overboard, but cleaning up the area around the base will help you avoid trapping hairs in the catheter adhesive. This won’t affect the functionality of the catheter, but will make removal much less painful. Also, a trapped hair may get tugged during your dive, this is a painful surprise and usually happens at the worst possible moment (gas switches, shooting an SMB, tying in a jump reel, etc.).
- Don’t be afraid – When you first take a close look at the catheter, you’ll quickly notice how strong the glue is. Remember what job that adhesive has, it’s an important one and it’s got to be strong. Don’t be afraid of it, it’s there to help you. Being timid here will only result in a misplaced and incorrectly installed catheter, which does you no good and will need to be removed and replaced.
- Get right in there – Having too much “extra” space at the tip of catheter will increase the likely hood of it pinching or kinking and restricting the flow of urine. This is bad, painful, and often results in a “blow off” (which is exactly what it sounds like). Once you’re all the way in up top, grasp your tip nice and tight and roll the catheter down just like a condom. Once it’s rolled all the way down, give it a good squeeze (just one, you don’t want to get excited) to set the glue in place.
- Be smooth – Wrinkles, creases, and air bubbles can cause discomfort and problems, try to get the catheter on as smooth and straight as possible. This takes some practice, so don’t stress out too much. As long as you don’t glue the hole shut, you should be fine.
- LEAVE IT! – Once it’s on, you have to leave it for a while. Remember that super strong glue that’s in there? It bonds to your skin immediately, and that bond is strongest the moment it’s applied. If you try to remove the catheter right away, it will not be a pleasant experience, and you may take some skin with it. Yeah, it’s terrible. After a couple of hours, your skin’s natural oils will begin to break down the glue and it will be easier to remove. I’ll be honest; I screwed it up a little on my first try. Things didn’t go well, and I tried to take it off right away. I was so horrified; I decided to leave it half on for a day and half. My wife still has not let me forget that one.
- Show your wife or significant other – Not a requirement, but it’s pretty funny. Just be warned, they may never look at you the same way again.
- Just like a Band-Aid – When it comes time to remove the catheter, there’s no gentle way to do it. Grip it and rip it, quick like a Band-Aid. It’s intimidating, I know, but there’s only one way that thing is going to come off. There’s no magic solution, but you will find various techniques that may help make removal more comfortable. Some people find that a hot shower and soap helps loosen the glue up a bit. There are several medical adhesive removal products on the market, and I’ve heard of people using baby oil as well, but most of these work best to remove the excess glue from your skin once the catheter has been removed. I’ve personally found that they make more of a mess than they are worth.
Make sure its comfortable
Once you have the installation down, the rest is pretty easy. Make sure the tubing for the P-valve is routed so it will not kink or get pinched by any equipment. Up vs. down, right or left, doesn’t really matter as long as you’re comfortable. If you have the type of valve that is unbalanced, be sure to “prime” the valve before you begin your descent. Remember what happens to air spaces when you descend? Remember that little air space in the tip of your catheter? Yup, fill it with urine before you head down to avoid a “squeeze” (read – pair of pliers to the tip of your penis). If your P-valve is a balanced model, you do not need to worry about priming, as the balanced valve will equalize the pressure inside the tubing.
Cleaning the P Valve
It is extremely important to properly clean your P-valve after each day of diving. Failure to do so can result in serious urinary tract infections that can ruin your month. There are a lot of options out there for sterilizing the plumbing, isopropyl alcohol and Steremine (a product often used to disinfect rebreathers) are good options, but anything that will sterilize the tubing will work just fine.
While all of this may sound intimidating, you will sort it all out after just a couple of dives (the learning curve is steep here). Once you have it all dialed in, your P-valve will be your new favorite piece of gear, I promise.