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Thread: Chronic UTI's, culprit? Catherization, HELP!

  1. #1
    Junior Member Bluegirljazz's Avatar
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    Smile Chronic UTI's, culprit? Catherization, HELP!

    I don't have a spinal cord injury per se but was born with Spina Bifida which damaged my spine from L-5 and below. Therefore I have non-working bladder, neurogenic as they call it. When I was 15 and then again at 18 my bladder was augmented with unused bowel. that was over 20 years ago.

    About 8 years ago I started doing neomycin irrigations but stop doing them when I moved overseas to a country that does not have this form of treatment, they do the oral prophylactic antibiotic which I'm sure many of you have been on before or are on perhaps, well I'm getting to the point where many oral antibiotics are starting to not work.

    About 2 years ago then I started have severe bladder kidney infections with over 12 hospitilazations and two of them systemic, they are now coming every month and my energy is depleted physically, mentally, and emotionally. Then I did a google search and found this forum! My husband and I will be moving to the UK in July but until then I have to get some help.

    Also I read some of the post on here and found that people have done treatments, newer ones, that are keeping them either UTI free or minimizing the amount of occurrence for them. That would be a dream for me! So I would like to know what is the latest in medical technology or treatment for the prevention of UTI's in people with neurogenic bladders that have to do intermittent catheterizations?

    Thanks for any help you can offer!

    P.S. I recently heard about silver coating on catheters, like they have been putting on band-aids to aide in prevention of infections? Does anyone know anything about this?
    Last edited by Bluegirljazz; 02-21-2010 at 10:41 PM.

  2. #2
    Quote Originally Posted by Bluegirljazz View Post
    I don't have a spinal cord injury per se but was born with Spina Bifida which damaged my spine from L-5 and below. Therefore I have non-working bladder, neurogenic as they call it. When I was 15 and then again at 18 my bladder was augmented with unused bowel. that was over 20 years ago.

    About 8 years ago I started doing neomycin irrigations but stop doing them when I moved overseas to a country that does not have this form of treatment, they do the oral prophylactic antibiotic which I'm sure many of you have been on before or are on perhaps, well I'm getting to the point where many oral antibiotics are starting to not work.

    About 2 years ago then I started have severe bladder kidney infections with over 12 hospitilazations and two of them systemic, they are now coming every month and my energy is depleted physically, mentally, and emotionally. Then I did a google search and found this forum! My husband and I will be moving to the UK in July but until then I have to get some help.

    Also I read some of the post on here and found that people have done treatments, newer ones, that are keeping them either UTI free or minimizing the amount of occurrence for them. That would be a dream for me! So I would like to know what is the latest in medical technology or treatment for the prevention of UTI's in people with neurogenic bladders that have to do intermittent catheterizations?

    Thanks for any help you can offer!

    P.S. I recently heard about silver coating on catheters, like they have been putting on band-aids to aide in prevention of infections? Does anyone know anything about this?
    Hi, I am moving your post to the Care Forum where all these issues are discussed in great detail. Wisel

  3. #3
    Are you seeing a good urologist who is experienced in neurogenic bladder management? When did you last have tests to rule out stones or other problems in your urinary tract? When did you last have urodynamics tests done?

    Do you do intermittent catheterization, and if so, how often and for what amounts? Or are you using an indwelling catheter now? Are you taking any anticholenergic medications?

    Routine Neomycin instillations done with intermittent catheterization are an old procedure not done any more. I haven't seen them since the 1970s in the USA. I know of no evidence that they actually reduce the incidence of UTIs.

    When you say UTIs, I assume you mean fever, chills, flank pain, etc. and not just a positive culture (colonization).

    (KLD)

  4. #4
    Senior Member WPDaggy's Avatar
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    Hi Bluegirljazz, welcome.

    I'm sorry to hear of your woes, but you've come to the right place. The people here are great, and offer some fantastic advice.

    I struggled with pretty bad UTIs last year and was hospitalized 4 times as a result. I had been intermittently catheterizing for 14 years with no problems, until last year. I got an infectious disease doctor on my case during the final hospitalizing and he started me using a silver-coated Foley, which I have changed monthly. He wanted to try something different in an effort to break the cycle. So far so good. It's been nearly a year since I was last in the hospital. I do drink over a gallon of water a day and take supplements to boost my immune system, so that probably has something to do with it.

    Anyway, good luck in getting the infections under control.

  5. #5
    Junior Member Bluegirljazz's Avatar
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    Quote Originally Posted by SCI-Nurse View Post
    Are you seeing a good urologist who is experienced in neurogenic bladder management? When did you last have tests to rule out stones or other problems in your urinary tract? When did you last have urodynamics tests done?

    Do you do intermittent catheterization, and if so, how often and for what amounts? Or are you using an indwelling catheter now? Are you taking any anticholenergic medications?

    Routine Neomycin instillations done with intermittent catheterization are an old procedure not done any more. I haven't seen them since the 1970s in the USA. I know of no evidence that they actually reduce the incidence of UTIs.

    When you say UTIs, I assume you mean fever, chills, flank pain, etc. and not just a positive culture (colonization).

    (KLD)
    Hi KLD- Okay I'll try to answer questions in bullet from below:


    • "Are you seeing a good urologist who is experienced in neurogenic bladder management?" Yes and no, he was trained in Australia at a very reputable university but we are in "developing country" (semi-third world) in Asia, if that makes any sense.


    • When did you last have tests to rule out stones or other problems in your urinary tract? When did you last have urodynamics tests done? Twice last year, he even went in with a scope into my kidneys in May- clean, no obstruction, no change in kidney shape since last type of test was done in the States, nada, all good. He also does ultrasounds on my kidneys almost every three months with the increase of the infections over the past 2 years.


    • Do you do intermittent catheterization, and if so, how often and for what amounts? Yes, I do this every three to four hours except at night. I try to keep the pressure or amount down to 300 cc's, I have a huge bladder to the augemention, can get 500 cc capcity.


    • Or are you using an indwelling catheter now? No.


    • Are you taking any anticholenergic medications? Not sure what this is but I am on a daily dose of Nitrofurtonin- 100 mg prophylactic.


    • Routine Neomycin instillations done with intermittent catheterization are an old procedure not done any more. What about gentamycin or other antibiotics, I was told by a Urology Department in Kansas they use this, just curious?


    • When you say UTIs, I assume you mean fever, chills, flank pain, etc. and not just a positive culture (colonization). Throwing up, flank pain, fever, chills, lethargy, systemic (twice) meaning the infection was in the blood (got very, very sick then), headaches due to the fever, cloudy mucous ridden urine, and smells. And they come on a matter of our hours- no warning.

    It is almost like my body is in a bad cycle and can't get out of the "infection mode." I've been so desperate I'm even trying accupunture and Chinese herbal medicine. I want to be UTI free or down to one or two a year....I'm to the point where I told my family that this is no way to live and I have pretty much given up wanting to live if I have to continue with this UTI/Kidney infections. So there you have it!

    So irrigation with some type of antibiotic is not done anymore? They are still doing this in Kansas City I can tell you that much, interesting!

  6. #6
    You need to have urodynamics (CMG with sphincter EMG) done. There is no way to determine your bladder pressures without this, and I suspect this may be what is the culprit.

    Did your ultrasounds also include your ureters and bladder, not just your kidneys?

    No, instillations of either antibiotics or antiseptics is no longer considered appropriate or effective as a method to prevent UTIs, esp. as if you have high pressures this will only make the situation worse. The same applies to routine so-called prophylactic use of medications such as Nitrofurtonin or Septra.

    (KLD)

  7. #7
    Junior Member Bluegirljazz's Avatar
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    Quote Originally Posted by SCI-Nurse View Post
    You need to have urodynamics (CMG with sphincter EMG) done. There is no way to determine your bladder pressures without this, and I suspect this may be what is the culprit.

    Did your ultrasounds also include your ureters and bladder, not just your kidneys?

    No, instillations of either antibiotics or antiseptics is no longer considered appropriate or effective as a method to prevent UTIs, esp. as if you have high pressures this will only make the situation worse. The same applies to routine so-called prophylactic use of medications such as Nitrofurtonin or Septra.

    (KLD)
    Hello I went back through my medical records and I had urodynamics done (CMG with sphincter EMG) last year as well, I misunderstood you sorry about that, so we've been able to rule a pressure issue as well as reflux into the kidneys.

  8. #8
    What was your PdetMax on your urodynamics??

    (KLD)

  9. #9
    Junior Member Bluegirljazz's Avatar
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    Quote Originally Posted by Bluegirljazz View Post
    Hello I went back through my medical records and I had urodynamics done (CMG with sphincter EMG) last year as well, I misunderstood you sorry about that, so we've been able to rule a pressure issue as well as reflux into the kidneys.
    I meant to write "we have been able to rule out..."

    I will have to get back to you on the results, I am at work and live on the other side of the world. Thanks!

  10. #10
    Moderator jody's Avatar
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    I have been using a yellow antibacterial coated catheter from rochester medical. they sent me samples. I think it actually helps. Kld would a person be resistant eventually? I was sceptical, but the things seem to work.

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