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New compact micro-hole zone catheter enables women to achieve effective bladder emptying without flow-stops

19 September 2024
Professional
02 September 2024
Volume 33 · Issue 17

Abstract

Background:

Clean intermittent self-catheterisation (CISC) with conventional eyelet catheters (CECs) is associated with urine flow-stops, which require the catheter to be repositioned so flow can resume. Flow-stops often occur because bladder mucosa is sucked into the eyelets.

Aims:

This investigation aimed to compare the bladder-emptying performance of the micro-hole zone catheter (MHZC) with the CEC.

Methods:

This was a multi-centre, randomised, open-label, controlled cross-over study with 82 women comparing the MHZC to the CEC. The endpoints relating to bladder-emptying performance included the residual volume at first flow-stop, the number of flow-stops and the proportion of successful treatment responses. The women's perception of the catheters was assessed as well as device discomfort.

Findings:

Catheterisations with MHZC significantly reduced the risk of flow-stops, with relative risk results showing a 2.74 times lower risk of flow-stops with a health professional-led catheterisation and a 2.52 times lower risk during self-catheterisation. There was no statistical difference in residual urine volume at first flow-stop between the two catheters. Catheterisations with the MHZC were significantly more likely to achieve zero flow-stops and a residual urine volume of <10 ml at first flow-stop. The women had a significantly more positive perception of the MHZC than the CEC in areas including handling, confidence, sensation and satisfaction.

Conclusion:

The MHZC enabled effective bladder emptying without catheters needing to be repositioned, supporting the women by simplifying the procedure and making them feel confident that their bladders were empty.

Clean self-intermittent catheterisation (CISC) has been established as the preferred bladder management method for people living with lower urinary tract dysfunction in terms of both safety and quality of life, compared to other types of urinary catheterisation (Chartier-Kastler and Denys, 2011; Romo et al, 2018; Gharbi et al, 2022; Sartori et al, 2024).

However, catheterisation using conventional eyelet catheters (CECs) involves a risk that the hydrodynamic pressure pulls the bladder mucosa towards and eventually into the eyelets, which can block the flow of urine; this is described as a urine flow-stop resulting from mucosal suction (Glahn, 1988). To resume flow and achieve a fully emptied bladder, the catheter has to be repositioned, as advised by nursing guidelines (Vahr Lauridsen et al, 2024).

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Clean intermittent self-catheterisation
Urinary tract infection
Lower urinary tract dysfunction
Urinary flow-stops
Micro-hole zone catheter