Sometimes this situation necessitates adjuvant daily or twice daily catheterization, medications, or sphincterotomy. Medications to improve drainage, such as alpha blockers can improve emptying by reducing outlet resistance, and sometimes by reducing pressures. Application difficulties with condom catheterization are likely problematic in the event of impaired hand function. Slippage of the condom can result in leaks. Perkash et al. (1992) describe the use of penile implants, in part as a means to circumvent this issue with condom application.