An ex vivo porcine urethral model for investigating intermittent catheter-associated urethral microtrauma

• An ex vivo urethral model addresses a critical gap in current methods for assessing catheter-induced urethral microtrauma. • Most PVP-coated catheters generated more uroepithelial damage than an integrated amphiphilic surfactant (IAS) catheter. • The use of IAS catheters over hydrophilic PVP-coated catheters may reduce urethral trauma and associated complications. • Physiologically relevant models are necessary in guiding future catheter design and improving patient quality of life. Catheter-associated urethral microtrauma is a significant complication of intermittent catheterisation, compromising patient quality of life (QOL) and increasing urinary tract infection risk. Current research is hindered by the lack of robust physiological models to evaluate the mechanical interactions between catheter materials and urethral tissue during intermittent catheterisation. This study introduces the first ex vivo porcine urethral model to investigate tribological performance and material-tissue interactions during intermittent catheter (IC) use, enabling more informed catheter design. We examined four commercial hydrophilic polyvinylpyrrolidone (PVP)-coated ICs and a coating-free integrated amphiphilic surfactant (IAS) IC. ICs were inserted into porcine urethras using a texture analyser, held for two minutes, and withdrawn while measuring force and work done. Post-catheterisation, urethras were examined for microtrauma. Three of four PVP-coated catheters required significantly greater withdrawal force compared to the IAS catheter, correlating with increased urethral transitional membrane damage post-catheterisation. Ex vivo findings suggest that IAS catheters may lower the risk of complications compared with PVP-coated catheters in intermittent catheterisation. This study provides a new platform for comprehensive evaluation of IC-tissue interactions. It underscores the importance of tribological design in medical devices, aiding future innovation in device design and ultimately improve the QOL of patients undergoing intermittent catheterisation.