1. Why Do People with Spinal Cord Injury Need Intermittent Catheterization?

1. The communication pathway between the brain and bladder is disrupted

The normal urinary control system

Under normal conditions, the brain communicates with the bladder and urinary sphincter through the spinal cord, coordinating two important functions:

• Urine storage
• Urine emptying

Like a commander giving instructions to soldiers, the nervous system allows the bladder to store urine safely and release it at the appropriate time.

How spinal cord injury affects bladder function

A spinal cord injury can interrupt the communication pathway between the brain and the bladder.

After injury:

• The brain may no longer receive accurate signals from the bladder.
• The bladder and urinary sphincter may lose coordination.
• The bladder may not empty effectively.

This condition is known as neurogenic bladder dysfunction.

2. Incomplete bladder emptying increases risks to the urinary system

When urine remains in the bladder for a long time, it may lead to several complications:

① Increased risk of urinary tract infections (UTIs)

Residual urine provides an environment where bacteria can grow, increasing the risk of urinary tract infections.

② Bladder deterioration

Long-term high residual urine volume and increased bladder pressure may affect bladder muscle function, making emptying more difficult and reducing bladder function over time.

③ Kidney damage

High pressure inside the bladder can transmit backward to the ureters and kidneys, affecting urine drainage and potentially causing:

• Hydronephrosis
• Progressive kidney damage
• In severe cases, renal failure

2. Intermittent Catheterization: The “Gold Standard” for Bladder Management

Intermittent catheterization is recognized as a key method for assisting bladder emptying and is considered the gold standard for bladder management in patients with urinary retention.

By regularly emptying the bladder, intermittent catheterization:

• Helps mimic natural urination patterns
• Reduces residual urine volume
• Lowers the risk of urinary tract complications
• Helps protect kidney function
• Improves quality of life

It is widely recommended for patients with:

• Neurogenic bladder dysfunction
• Non-neurogenic urinary retention

Treatment plans should always be individualized, and hydrophilic-coated catheters are recommended as an advanced catheter option.

Intermittent catheterization is recognized by international and national urological guidelines, including recommendations from organizations such as the European Association of Urology (EAU) and the Chinese Urological Association.

3. Why Are Hydrophilic-Coated Catheters the Preferred Choice?

1. Long-lasting lubrication reduces friction and urethral trauma

Hydrophilic coatings absorb and retain water, creating a smooth, low-friction surface during catheterization.

Studies have shown that hydrophilic coatings can significantly improve catheter lubricity:

• The contact angle decreases from 116.46° before hydration to 20.60° after hydration, indicating improved hydrophilicity.
• Friction force decreases from approximately 1.1 N to 0.1 N.
• After repeated testing (200 cycles), the catheter maintains consistently low friction performance.

This helps reduce discomfort during catheter insertion and withdrawal.

2. Reduced urethral injury and lower risk of urinary tract infection

A meta-analysis involving 735 spinal cord injury patients demonstrated that hydrophilic-coated catheters may provide significant clinical benefits:

• 23% reduction in urinary tract infection risk
  (RR = 0.77)
• 25% reduction in microscopic hematuria risk
  (RR = 0.75)

Hydrophilic-coated catheters help minimize urethral irritation and improve patient safety during long-term intermittent catheterization.

3. Improved patient acceptance and adherence

Clinical research involving 232 patients from West China Hospital of Sichuan University showed that compared with conventional catheters, hydrophilic-coated catheters improved:

• Patient acceptance of clean intermittent catheterization (CIC)
• Comfort during daily catheter use

Better comfort may encourage long-term adherence and improve patients’ confidence in managing their bladder health.

DAXANmed Hydrophilic-Coated Intermittent Catheter

DAXANmed hydrophilic-coated intermittent catheters are available in two designs:

• Water sachet type
• Ready-to-use pre-lubricated type

Designed with medical-grade hydrophilic coating technology and patented technology (Patent No. ZL201810063901.3), DAXANmed catheters provide:

✓ Reduced friction during catheterization
✓ Improved comfort and ease of insertion
✓ Lower risk of urethral trauma
✓ A more comfortable daily catheterization experience

Choose DAXANmed — supporting safer, smoother, and more confident bladder management.

Conclusion

After spinal cord injury, the bladder may no longer function normally on its own. However, through regular intermittent catheterization, patients can achieve effective bladder emptying and better protection of urinary tract health.

Hydrophilic-coated intermittent catheters provide a safer, more comfortable, and sustainable solution by reducing friction, minimizing urethral irritation, and improving patient experience.

Choosing the right catheterization method and the right catheter can help reduce daily concerns and restore confidence in everyday life.

Whether during daytime activities or nighttime rest, proper bladder management allows people living with spinal cord injury to face life with greater freedom and confidence.

References

[1] Urodynamics and Continence Group, Chinese Urological Association. Chinese Expert Consensus on Clinical Application of Intermittent Catheterization. Chinese Journal of Urology, 2024, 45(9):654-657.

[2] Gao S, Liu Z, Zeng W, et al. Preparation and Performance Characterization of Sterile Hydrophilic Lubricating Silicone Catheters. China Medical Equipment, 2023, 38(2):7-11.

[3] Huang H, Song R, Guo S, et al. Effect of Hydrophilic-Coated Catheters on Urinary Tract Infection in Patients with Spinal Cord Injury: A Meta-analysis. Chinese Journal of Nursing, 2016, 51(11):1302-1307.

[4] Long Y, Zhang J, Zhu L, et al. Effect of Hydrophilic-Coated Catheters on Compliance and Acceptance in Patients Performing Clean Intermittent Catheterization. China Medical Herald, 2023, 20(1):48-51.