Catheter-associated bladder mucosal trauma during intermittent voiding: An experimental study in pigs

Area of Science:

• Urology
• Biomedical Engineering
• Medical Device Design

Background:

• Intermittent catheterization is common but can cause bladder mucosal trauma.
• Conventional eyelet catheters (CECs) are associated with adverse effects.
• Understanding catheter-induced trauma is crucial for improving patient outcomes.

Purpose of the Study:

• To characterize bladder mucosal trauma from CECs.
• To evaluate if a microhole zone catheter (MHZC) design reduces this trauma.
• To assess the efficacy of novel catheter designs in preventing adverse effects.

Main Methods:

• A porcine model was used to simulate human catheterization and bladder drainage.
• Pigs were randomized to receive either CECs or MHZCs for repeated catheterizations.
• Cystoscopy, histopathology, and pressure measurements were performed to assess bladder trauma and catheter performance.

Main Results:

• CECs generated significantly higher pressure gradients, leading to suction events and bladder trauma (epithelial loss, edema, hemorrhage).
• MHZCs demonstrated no significant bladder trauma.
• Pigs proved to be a suitable model for investigating urinary catheter performance.

Conclusions:

• Conventional eyelet catheters cause considerable bladder mucosal trauma, a potential risk factor for urinary tract infections.
• MHZC design minimizes mucosal suction and associated trauma, offering a solution for reducing infections and enhancing user comfort.
• This study highlights the potential of improved catheter design and validates the use of pigs as an animal model for catheter research.