How to Use a PureWick: Position, Clean & Fix Leaks

The PureWick is a soft, external catheter designed for female anatomy that wicks urine away from the body using gentle, continuous suction. Getting reliable results depends on three things: placing the device snugly against the right anatomical landmarks, keeping the equipment clean, and catching small problems like kinks or poor seal before they turn into full leaks. None of this is complicated, but the details matter more than you might expect, and small adjustments in positioning can make the difference between a dry night and a frustrating one.

How the Device Actually Works

The PureWick is a single-use, flexible wick made of absorbent material. It sits externally against the body and connects via tubing to a collection canister that applies low, continuous wall suction (in hospitals) or battery-powered suction (in home-use pump units). When urine contacts the wicking material, the suction draws it along the wick, through the tubing, and into the canister. No part of the device enters the urethra or bladder, which is the main reason it carries a lower infection risk than a traditional indwelling catheter.

The wicking material is designed to stay in contact with the skin surface near the urethral opening. It works best when the wick maintains continuous, gentle contact without bunching or gaps. If the wick shifts away from the body or the suction is interrupted, urine pools on the skin instead of being drawn into the tubing, and you get leakage.

Positioning the PureWick Step by Step

Correct placement is the single biggest factor in whether the device captures urine effectively. The wick is placed between the labia majora, with the absorbent (soft, fabric-like) side facing the body. The top of the device should be aligned roughly with the pubic bone, and the tail end is tucked gently into the gluteal cleft, running between the buttocks toward the back.¹ The tubing exits from the tail end and connects to the suction canister.

A few positioning details that trip people up:

Orientation: The wick has a smooth outer side and a soft, absorbent inner side. The absorbent side must face the skin. If it is reversed, the device will not wick properly and urine will pool.
Depth between the labia: The wick should rest gently between the outer labia, not pressed deep or forced between the inner labia. You want light, even contact along the length of the perineum.
Gluteal tuck: The back end of the wick needs to extend far enough to catch urine that runs posteriorly, especially when the person is lying on their back. If the tail is too short or not tucked far enough, urine escapes before it reaches the absorbent material.
Tubing path: Route the tubing along the inner thigh and off the side of the bed. Avoid running it under the leg where body weight can kink or compress it. A kink anywhere in the line kills suction instantly.

The tubing should have a gentle downward slope from the patient to the canister whenever possible. Loops or uphill runs in the tubing create spots where urine sits instead of flowing, which reduces capture and can cause backflow toward the patient.

Setting Up and Adjusting Suction

In a hospital, the PureWick typically connects to wall suction set to low continuous mode, usually around 40 to 60 mmHg. At home, the PureWick system comes with a battery-operated pump that provides the same gentle suction without needing a wall outlet. The suction should be strong enough to pull urine through the wick but not so aggressive that it causes discomfort or pulls the device out of position.

When you first connect the tubing, check that you can hear or feel a slight draw at the wick end. A simple test: hold the wick end near your palm and confirm you feel gentle suction. If you feel nothing, check that the pump is on, the canister lid is sealed properly, and there are no kinks or disconnections in the tubing. Home-use pumps have an indicator light that shows when suction is active.

If the canister is full, suction drops or stops entirely. Most home canisters hold around 2,000 mL, which is enough for an overnight session for most people, but you should check the level before the person settles in for the night. Emptying or replacing the canister at the same time you swap out the wick simplifies the routine.

How to Fix Common Leaks

Leakage is the most frequent complaint with the PureWick, and the good news is that most leaks trace back to a handful of fixable causes. Research on the device’s outpatient performance found that when healthcare providers placed the device, roughly three-quarters of uses had low or very low leakage. When users placed the device themselves, about half reported very little to no leakage, with results improving as people gained experience.² That gap between professional and self-placement narrows with practice, but it tells you that positioning technique is the main variable, not the device itself.

Here is a troubleshooting checklist when leaks occur:

Wick has shifted: Movement during sleep or repositioning in bed is the top cause. Check that the wick is still seated between the labia with the absorbent side against the skin. Re-tuck the tail into the gluteal cleft if it has pulled forward.
Tubing is kinked: Follow the tubing from the wick to the canister with your hand. Even a small bend under a blanket or at the bed rail can stop suction. Straighten any kinks and secure the tubing with tape or a clip along the bed frame.
Canister is full or lid is loose: A full canister has nowhere to pull urine into. An unsealed lid breaks the vacuum. Empty the canister and press the lid firmly until you hear or feel it click.
Wick is saturated: PureWick wicks are designed for single use and lose absorbency after several hours. If the wick feels heavy and waterlogged, replace it with a fresh one rather than trying to reposition the old one.
Patient position changed: If the person rolled from their back to their side, the wick may need to be adjusted. Side-lying can cause the wick to shift laterally. Gently reposition it so it still runs centrally along the perineum.

A randomized trial comparing the PureWick system to a competitor for overnight incontinence management found an average urine capture rate above 90%, with very low skin irritation scores.³ Capture rates were even higher at the median, suggesting that when positioning is good, the device works very well, but occasional poor-placement episodes drag the average down. The practical takeaway is that one bad placement session does not mean the device is failing. It usually means the wick needs a better seat.

Cleaning and Replacing Components

The wick itself is single-use and should be discarded after each session, typically every 8 to 12 hours or sooner if it becomes visibly soiled or saturated. Do not attempt to wash and reuse a wick. The absorbent fibers lose their wicking ability once they have been wet, and reusing them increases the chance of skin irritation and bacterial growth.

The tubing and canister, on the other hand, are reusable in most home pump systems. After each use, disconnect the tubing from the pump and the canister. Rinse both with warm water and a mild soap or a dilute vinegar solution. Some manufacturers recommend using a cleaning tablet designed for the canister. Rinse thoroughly, let everything air dry, and reassemble before the next use. Avoid using harsh chemicals or bleach on the tubing, as these can degrade the material and leave residues that irritate skin.

The pump unit itself just needs a wipe-down with a damp cloth. Keep the pump on a stable surface near the bed, preferably at or below mattress height to help gravity assist the urine flow through the tubing.

Protecting the Skin

Because the wick sits against the skin for hours at a time, moisture-related skin breakdown is a real concern, particularly for older adults or anyone with fragile skin. A barrier cream or moisture barrier wipe applied to the perineal area before placing the wick can help protect the skin without interfering with the device’s function. Use a thin, even layer; too much cream can clog the absorbent material and reduce wicking performance.

Each time you change the wick, take a moment to inspect the skin for redness, irritation, or early signs of breakdown. The randomized trial mentioned earlier found extremely low skin irritation scores with the PureWick, but that was under controlled study conditions where devices were changed regularly and skin was monitored.³ At home, without that level of monitoring, it is easy to let a wick stay on too long or skip the skin check. Build the inspection into your routine every time you swap out the wick.

If you notice persistent redness or any broken skin, give the area a rest from the device and consult a healthcare provider. Applying the PureWick over damaged skin invites infection and worsens the irritation.

Self-Placement vs. Caregiver Placement

Whether the person using the PureWick places it themselves or has a caregiver do it affects performance, at least initially. In the healthy volunteer study, median capture rates were above 95% regardless of who placed the device, but self-placement showed more variability, especially in early uses.² People who placed the device themselves reported “very little to no leakage” just over half the time, compared to about three-quarters of the time when a provider did it. The gap is not enormous, and practice helps close it.

For self-placement, a handheld mirror can be useful during the learning phase to confirm the wick is correctly oriented and positioned. Lying on one side with knees slightly bent, reaching between the legs from behind, is a common approach that gives good access to both the front and back of the perineum. Once you have placed a few successfully, the positioning becomes more intuitive and the mirror becomes unnecessary.

Caregivers, whether family members or home health aides, benefit from a brief demonstration during a medical visit. Surveys of patients and caregivers using the PureWick at home found that both groups reported convenience in managing incontinence and preferred the device over adult diapers.⁴ The learning curve exists, but it is short, and most caregivers feel confident after a few tries.

When the PureWick Is and Is Not the Right Choice

The PureWick works best for people who are relatively still for extended periods, particularly overnight. It is widely used in hospitals, skilled nursing facilities, and home care for women with urinary incontinence who want an alternative to diapers or pads. It is not designed for men, though a separate male external catheter exists for that purpose, and it is not a replacement for an indwelling catheter in situations where precise urine output measurement is medically necessary, since some urine inevitably escapes capture.

Mobility matters. If the person is very active, gets up frequently, or tosses and turns aggressively in bed, the device will shift and leak more often. It works well for someone who is sleeping, resting in a recliner, or has limited mobility. For people who are up and moving during the day, the PureWick is generally used only during rest periods, not as an all-day solution.

Body habitus also plays a role. In people with a higher body mass index, the tissue folds around the perineum can make it harder to seat the wick in consistent contact with the skin. Extra attention to positioning and possibly more frequent checks are needed. There is no hard cutoff where the device stops working, but thinner wicks or different placement angles may help.

Infection Prevention and Why Technique Matters

One of the main clinical reasons external wicking devices gained traction is their potential to reduce urinary tract infections linked to indwelling catheters. A systematic review and meta-analysis of studies on female external wicking devices found that catheter utilization rates dropped by about 14% after these devices were introduced, and in hospitals that implemented formal use protocols, catheter-associated urinary tract infections fell significantly.⁵ A separate quality-improvement project in critical care units found that PureWick implementation was one of several interventions that contributed to clear and measurable drops in infection rates.⁶

The evidence is not uniformly positive, though. One single-institution study found that the period after introducing external wicking devices actually showed a higher rate of UTI compared to the period before, with about 9.8 infections per 1,000 device days.⁷ The researchers noted that the external device was being used alongside, not instead of, indwelling catheters in many cases, and the institution’s protocols may not have optimized when each device type was appropriate. The meta-analysis found that the infection reduction was significant only when hospitals had clear implementation protocols in place, suggesting that the device alone is not enough. How you use it, when you use it, and having a consistent process for placement and replacement all matter.

For home users, the infection-prevention lesson is straightforward: change the wick on schedule, wash your hands before and after handling the device, clean the reusable components regularly, and do not leave a soiled wick in place hoping it will last a little longer. Bacteria thrive in warm, moist environments, and a saturated wick sitting against the skin is exactly that environment.

Overnight Use and Sleep Quality

Most home users rely on the PureWick primarily at night, and the payoff in sleep quality is often dramatic. Instead of waking multiple times to change pads or make it to the bathroom, the person can sleep through normal voiding episodes while the device quietly draws urine into the canister. Caregivers also benefit from fewer nighttime disruptions, which makes a meaningful difference in households where one person is providing round-the-clock care.

For overnight use, set up everything before bed: place a fresh wick, confirm suction is working, check the canister level, and route the tubing so it will not snag on blankets. Keep a spare wick on the nightstand in case a middle-of-the-night repositioning is needed. Some people find that wearing loose-fitting underwear or using a light adhesive strip helps keep the wick from shifting during sleep, though neither is strictly necessary if the initial placement is good. The goal is to reduce the number of times anyone has to wake up, so front-loading the setup pays off.

Survey data from patients and caregivers found that satisfaction with the PureWick was high and that most users planned to continue using the device, favoring it over adult diapers for comfort and convenience.⁴ For many families, the transition from pads to an external catheter system feels like a significant upgrade in dignity and quality of life for both the person managing incontinence and the people helping them.