A Narrative Review of Micro-hole Zone Technology: An innovation in clean intermittent self-catheterisation
Thomas B.L. Lam,
Altaf Mangera,
Paul Abrams,
Mohammed Belal,
Carmel Curtis,
Jacqueline Emkes,
Jonathan Charles Goddard,
Sarah Hillery,
Karen Irwin,
Karen Logan,
Nikesh Thiruchelvam,
Polly Weston,
Ann Yates,
Christopher Chapple
Affiliations
Thomas B.L. Lam
Aberdeen Royal Infirmary, Aberdeen, UK; Academic Urology Unit, University of Aberdeen, Aberdeen, UK; Corresponding author at: Aberdeen Royal Infirmary, Aberdeen, UK.
Altaf Mangera
Spinal Injuries Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
Paul Abrams
University of Bristol, Bristol, UK; Bristol Urological Institute, Southmead Hospital, Bristol, UK; Bristol Health Research Charity, Bristol, UK
Mohammed Belal
University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; The British Association of Urological Surgeons, London, UK
Carmel Curtis
King’s College Hospital NHS Foundation Trust, London, UK
Jacqueline Emkes
National Bladder and Bowel Health Project NHS England and Excellence in Continence Care Board – Chair Patient and Carer forum, Manchester, UK; Bladder Health UK, Birmingham, UK
Jonathan Charles Goddard
Leicester General Hospital, Leicester, UK
Sarah Hillery
York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK; The British Association of Urological Nurses, Bathgate, UK
Karen Irwin
Bladder & Bowel UK, Manchester, UK
Karen Logan
Aneurin Bevan University Health Board, Newport, UK
Nikesh Thiruchelvam
Addenbrooke’s Hospital, Cambridge, UK
Polly Weston
University Hospitals of Morecambe Bay NHS Foundation Trust, Kendal, UK; Association for Continence Professionals, Bathgate, UK
Ann Yates
Cardiff & Vale University Health Board, Cardiff, UK
Christopher Chapple
Department of Urology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK; University of Sheffield, Sheffield, UK; Sheffield Hallam University, Sheffield, UK
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.
