A Narrative Review of Micro-hole Zone Technology: An innovation in clean intermittent self-catheterisation

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.

Thomas B.L. Lam^a,b, Altaf Mangera^c, Paul Abrams^d,e,f, Mohammed Belal^g,h, Carmel Curtisⁱ, Jacqueline Emkes^j,k, Jonathan Charles Goddard,^l, Sarah Hillery^m,n, Karen Irwin^o, Karen Logan^p, Nikesh Thiruchelvam^q, Polly Weston^r,s, Ann Yates^t, Christopher Chapple^u,v,w

Aberdeen Royal Infirmary, Aberdeen, UK
Academic Urology Unit, University of Aberdeen, Aberdeen, UK
Spinal Injuries Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
University of Bristol, Bristol, UK
Bristol Urological Institute, Southmead Hospital, Bristol, UK
Bristol Health Research Charity, Bristol, UK
University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
The British Association of Urological Surgeons, London, UK
King’s College Hospital NHS Foundation Trust, London, UK
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
Leicester General Hospital, Leicester, UK
York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK
The British Association of Urological Nurses, Bathgate, UK
Bladder & Bowel UK, Manchester, UK
Aneurin Bevan University Health Board, Newport, UK
Addenbrooke’s Hospital, Cambridge, UK
University Hospitals of Morecambe Bay NHS Foundation Trust, Kendal, UK
Association for Continence Professionals, Bathgate, UK
Cardiff & Vale University Health Board, Cardiff, UK
Department of Urology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
University of Sheffield, Sheffield, UK
Sheffield Hallam University, Sheffield, UK

Source: 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, A Narrative Review of Micro-hole Zone Technology: An innovation in clean intermittent self-catheterisation, Continence, Volume 11, 2024, 101332, ISSN 2772-9737, https://doi.org/10.1016/j.cont.2024.101332.

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