To completely empty the bladder when using a conventional 2-eyelet catheter, repositioning of the catheter is needed. However, there is a risk of bladder microtrauma when repositioning the catheter.¹ Both residual urine due to incomplete bladder emptying and microtrauma constitute risks for UTI development.²

Of the 90% of IC users that reposition their catheter, 78% experience that their urine starts to run again. This means that the bladder is not completely empty at first flow stop.³

Flow stops make complete bladder emptying uncertain and complex:

• Uncertain as flow stops give a false indication of an emptied bladder
• Complex because the user needs to reposition the catheter¹

The importance of repositioning is also underlined in the EAUN clinical guidance.⁴

"When urine flow stops, withdraw the catheter very slowly, in centimetre steps. If the urine flow starts again during withdrawal, discontinue withdrawal and wait for the flow to stop before resuming catheter withdrawal"

- EAUN Guideline

Draining of urine during catheterisation creates negative pressure inside the catheter. This causes the bladder mucosa to get sucked into the eyelets of the catheter, blocking them, leading to a urine flow stop.¹

Repositioning of the catheter helps to release the mucosa and continue the draining of urine. Mucosal suction can cause microtrauma to the bladder wall and compromise the protective layer of the epithelial cells.¹ A compromised bladder wall would give easier access for bacteria thus increasing the risk of UTIs.^5,6

View from the inside of a Conventional Two-Eyelet Catheter