Continence (Sep 2024)
A Narrative Review of Micro-hole Zone Technology: An innovation in clean intermittent self-catheterisation
Abstract
Clean intermittent self-catheterisation (CISC) is a very common and largely well-tolerated intervention for people with neurological and urological voiding dysfunction; however, catheter-associated urinary tract infections (CAUTIs) are a troublesome and potentially major complication. The main risk factors predisposing to CAUTI associated with CISC are poor patient compliance, failure to achieve complete bladder emptying resulting in residual urine, and microtrauma during catheterisation, potentially weakening the bladder’s defences against UTI. An innovative development in the design of CISC catheters is Micro-hole Zone Technology (MHZT) used in the novel Luja™ CISC catheter, which aims to overcome some of the problems associated with conventional CISC catheters. Through a narrative review of the literature undertaken by a multi-disciplinary panel of experts, specialists and patient advocate, who reviewed all major factors contributing to CAUTI and the potential benefits of MHZT catheters over conventional two-eyelet CISC catheters (CECs). MHZT catheters potentially confer the following advantages over CECs in male and female patients: (1) more effective bladder drainage in one continuous flow; (2) reduced risk of blockages by preventing the occlusion of the catheter end-eyelets by bladder mucosa; (3) reduced risk of bladder mucosal microtrauma; and (4) reduced intra-catheter pressure if any flow stop occurs, hence minimising the unpleasant dragging sensation. These benefits are likely to improve the patient’s comfort, quality of life and compliance. However, the panel acknowledged the lack of robust clinical data as to whether MHZT catheters reduced the incidence of CAUTI. Hence, comparative studies between MHZT and CECs are needed before definitive conclusions can be drawn.
