Total sales in the US increased 9% to $4.9 million from $4.5 million in the fourth quarter of 2010 driven by 30% growth in our US direct sales, somewhat offset by a 10% decline in our US private label business. Total sales outside of the US mainly in Europe and the Middle East region or EME grew 46% led by 48% growth in direct sales. This growth came from a combination of strong organic growth and from our Laprolan acquisition. International private label sales also improved, up 30% over the fourth quarter of 2010.
Geographically 33% of our sales in the fourth quarter were in US with 67% of our sales outside the US compared to 41% and 59% last year respectively. This change is primarily driven by our April 1st acquisition of Laprolan based in the Netherlands. We are pleased with our performance, both domestically and abroad. Total sales for the fiscal year 2011 increased 28% on a reported basis to $52.9 million from $41.4 million in same period of last year. Foreign currency added 150 basis points with total sales growth in the period implying constant currency growth of 26.5%.
Total fiscal year 2011 sales growth excluding the effects of foreign currency and our acquisition of Laprolan was 9%. Turning to direct sales, total global direct sales increased 43% year-over-year in the fourth quarter. Our US direct sales for the fourth quarter totaled $2.9 million versus $2.2 million last year or a gain of 29%. Our intermittent catheter line, which represents 48% of US direct sales in the fourth quarter, was 48% year-over-year in the fourth quarter. This growth was complemented by a 13% increase in male external catheters and 21% increase in Foley catheter sales.