Impact of micro-hole zone catheters vs. conventional eyelet catheters on bladder emptying, flow stops, and microtrauma in adults with neurogenic or non-neurogenic lower urinary tract dysfunction requiring clean intermittent catheterization: a systematic review and meta-analysis

Intermittent catheterization is the gold standard method for bladder emptying in neurogenic and non-neurogenic lower urinary tract dysfunction patients. Despite their usage, eyelet catheters are associated with frequent flow stops, incomplete bladder emptying, and mucosal trauma that leads to patients’ discomfort and contributes to chronic urinary tract infections. This systematic review and meta-analysis aim to assess the safety and impact of the micro-hole zone catheter in this population. Several databases were widely searched for studies through 2025. The primary outcome was bladder emptying, and secondary outcomes were flow stops and microtrauma. The Cochrane risk of bias tool 2.0 was used to assess the risk of bias. We identified four publications with a total of 253 patients. There was a significant difference in the residual urine volume between the two groups [mean difference: -21.40 mL; 95% confidence interval (CI): -40.03 to -2.80, p=0.0005]. The mean difference in flow stop rate was 0.20 (95% CI: 0.12 to 0.34, p=0.3173), and the mean difference in microtrauma was 0.15 (95% CI: 0.09 to 0.26, p=0.628). All favor the micro-hole zone catheter. The micro-hole zone catheter demonstrated a safety option compared to the eyelet catheter with regard to microtrauma, residual urine volume, and fewer flow stops that lead to better emptying of the bladder.