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

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  • Kristian Stærk
  • Brit Schrøder
  • Jensen, Louise Kruse
  • Troels Petersen
  • Thomas Emil Andersen
  • Lene Feldskov Nielsen

Objective: The objective of this study is to characterize bladder mucosal trauma associated with intermittent catheterization with conventional eyelet catheters (CECs) and to assess if a microhole zone catheter (MHZC) design concept reduces this adverse effect. Materials and Methods: A porcine model was developed to reflect human catheterization and bladder drainage. Nine pigs were randomized for catheterization with CEC (n = 6) or MHZC (n = 3). The bladder was drained repeatedly 20 times through the catheter. Cystoscopy was performed before and after the procedure, and bladders were analysed by histopathology. Two additional pigs were used for cystoscopy visualization of suction events in vivo. Cystoscopy, gross pathology, histopathological score, leucocyte infiltration, and intracatheter pressure at flow stops during voiding were compared for each group. Results: A significant higher pressure gradient was measured inside the CECs compared with MHZCs during flow stop. Consequently, CECs resulted in suction events inflicting bladder trauma characterized by loss of epithelium, oedema, haemorrhage, and neutrophil tissue infiltration. No significant trauma was identified when using MHZC. Conclusions: Considerable mucosal bladder trauma is inflicted by CECs which may be an overlooked risk factor for urinary tract infection. Catheters can be designed to minimize mucosal suction and reduce associated trauma. This may be a solution to reduce infection frequency and increase user comfort. Furthermore, the study demonstrates the potential of pigs as an attractive animal model for investigating urinary catheter performances.

OriginalsprogEngelsk
TidsskriftBJUI Compass
Vol/bind5
Udgave nummer2
Sider (fra-til)217-223
Antal sider7
ISSN2688-4526
DOI
StatusUdgivet - 2024

Bibliografisk note

Funding Information:
The authors would like to thank Julie May Jensen for assisting with the experimental work. A special thanks to veterinarian Louise Langhorn and the animal technicians at the Biomedical Laboratory, University of Southern Denmark.

Publisher Copyright:
© 2023 The Authors. BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company.

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