Sterile water or saline solution for inflating the balloon of pediatric catheters

Urethral catheterization is a standard clinical procedure, but pediatric data on balloon-related complications remain scarce. Balloon failure during removal may be associated with the type of inflation media and the size of the catheter lumen. Adult findings may not apply to pediatric catheters due to structural differences.

To compare the performance of sterile water and 0.9 % saline solution as inflation media in pediatric Foley catheters and evaluate balloon deflation and crystalline deposits under controlled in vitro conditions.

Foley catheters (8Fr, 10Fr, 14Fr, 16Fr) were used. Balloon inflation channels were assessed by cross-sectional area and perimeter. A total of 236 catheters were filled with either sterile water or saline, immersed in artificial urine at 37 °C for 15 days, and later inspected for deflation performance and crystal deposits. Select samples were stained with eosin, toluidine blue, and aniline blue for microscopic analysis.

Pediatric catheters showed significantly smaller inflation lumens than adult catheters. Balloon integrity was preserved in 99.6 % of cases, with no significant volume loss differences between inflation solutions. However, eosin staining revealed crystalline deposits in two saline-inflated pediatric catheters. No deposits were observed with sterile water or under unstained conditions.

While both inflation media performed similarly in short-term use, crystal formation in saline-filled catheters suggests sterile water may be preferable in prolonged pediatric catheterization.