Why Are “Hydrophilic-Coated Catheters” the Preferred Choice in Pediatric Clean Intermittent Catheterization?

The "Chinese Expert Consensus on Pediatric Clean Intermittent Catheterization" (hereinafter referred to as the "Consensus") was led by the Pediatric Surgery Branch of the Chinese Medical Association and aims to standardize the clinical application of Clean Intermittent Catheterization (CIC) in children. The document explicitly states that CIC is a core treatment method for children with neurogenic bladder and other voiding dysfunctions, and the choice of catheter directly impacts operational safety, complication rates, and patient compliance. Among the options, hydrophilic-coated catheters are repeatedly emphasized as the preferred choice. This article delves into the importance of hydrophilic-coated catheters based on the content of the "Consensus."

Ⅰ. Unique Advantages of Hydrophilic-Coated Catheters  

01 Excellent Lubrication, Reducing Urethral Trauma  

Ordinary non-coated catheters require additional lubricant, which complicates the procedure and results in unstable lubrication. In contrast, hydrophilic-coated catheters form a smooth water film upon contact with water, providing lasting and even lubrication. This characteristic significantly reduces friction during catheter insertion, thereby lowering the risk of urethral mucosal injury. The "Consensus" notes that hydrophilic-coated catheters can "reduce pain and improve patients' quality of life and satisfaction."

02 Reduced Incidence of Urinary Tract Infections (UTI)  

UTI is the most common complication of CIC and is closely related to catheter contamination and improper operation. Hydrophilic-coated catheters are mostly single-use, avoiding bacterial residue and biofilm formation associated with repeated catheter use. The literature cites multiple studies confirming that the use of hydrophilic-coated catheters can "significantly reduce the rate of urinary tract infections."

03 Improved Compliance in Children and Their Families  

Children have delicate urethras and are sensitive to pain. The smoothness of hydrophilic-coated catheters makes the catheterization process more comfortable, especially for children requiring long-term CIC. Additionally, the "Consensus" mentions that hydrophilic catheters are easy to use, reducing operational anxiety for parents or children and thereby improving treatment compliance.

Ⅱ. Explicit Recommendations in the Literature  

The "Consensus" explicitly states in the "Operational Standards" section:  

"It is recommended to use hydrophilic catheters for CIC when conditions permit."  

For children requiring long-term catheterization, hydrophilic-coated catheters can "reduce urethral complications (such as strictures and false passages)."  

If a child has a history of urethral spasms or recurrent infections, hydrophilic catheters are the preferred choice.

Ⅲ. Hydrophilic-Coated Catheters vs. Other Types of Catheters  

Non-coated catheters: Require frequent application of lubricant, provide poor lubrication, and easily cause urethral injury and pain; repeated use carries an infection risk.  

Closed catheter systems: Complex operation, high cost, and limited scope of application.  

Hydrophilic-coated catheters: Combine lubrication, safety, and convenience, making them particularly suitable for pediatric populations.

Ⅳ. Clinical Data Support  

Multiple studies cited in the "Consensus" confirm:  

Stenshalle et al. (2005) found that hydrophilic-coated catheters significantly reduce urethral microtrauma.  

Newman et al. (2020) compared and found that children using hydrophilic catheters had a 30% reduction in UTI incidence.  

A domestic study (Zhang Guoxian et al., 2018) indicated that hydrophilic catheters can reduce the risk of recurrent UTIs in children with neurogenic bladder.

Ⅴ. Practical Application Recommendations  

Prioritize single-use hydrophilic-coated catheters to avoid repeated use.  

Select the appropriate model based on the child's age and urethral anatomy (starting from 6–8 Fr for boys and 8 Fr for girls).  

Train family members in standardized procedures: Emphasize hand hygiene, lubrication steps, and insertion techniques to avoid forced operation.  

Long-term follow-up monitoring: Regularly review urinalysis and urinary tract ultrasounds to promptly assess urethral risks.