Development and Validation of an Automated Intermittent Bladder Irrigation System for the Prevention of Catheter-Associated Urinary Tract Infections: A Preclinical Study Using a Porcine Model.

Objective: To develop and validate a novel automated intermittent bladder irrigation system designed to prevent catheter-associated urinary tract infections (CAUTI) and manage catheter-related complications by addressing operator dependency, inconsistent outcomes, and potential complications associated with traditional techniques in patients requiring long-term catheterization, using a porcine model.

Methods: A quantitative evaluation method using standardized agar specimens was used to assess the clearance rate. Bladder irrigation procedures were performed on four female pigs to compare the automated system with conventional manual irrigation. Each method was tested with 13 repeated procedures per animal. The primary outcome was particle clearance rate, and the secondary outcomes were procedure time, pressure stability, and safety parameters.

Results: The automated irrigation system demonstrated superior efficacy for agar specimen removal compared with manual irrigation (94.4% vs 89.4%, p = 0.041). The automated system significantly improved procedural consistency (standard deviation: ±4.94% vs ±11.47%) and shortened irrigation time (8.2 ± 0.5 vs 12.4 ± 3.2 minutes, p < 0.001) compared with manual irrigation, despite the latter being performed by an experienced urologist. The automated system maintained stable irrigation pressures within physiological limits for all procedures, and no complications such as mucosal injury or severe hematuria were observed in either group.

Conclusions: This preclinical study demonstrated that our automated intermittent bladder irrigation system provided superior clearance rates and significantly reduced procedural variability compared to manual techniques, highlighting the importance of automation in ensuring consistent and safe clinical outcomes independent of operator variables.