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Thread: Anyone else having UTI's after a Mitrofanoff surgery?

  1. #1

    Anyone else having UTI's after a Mitrofanoff surgery?

    I have had a C5/6 injury since 1998. I read about the Mitrofanoff procedure here on Spinewire and I thought it would help my Mom and I (because she is my main caregiver that helps me with my intermittent catheterization) so I found a pediatric urologist and an urologist who would do the surgery in Minnesota. I had the surgery up in Minneapolis using only my appendix (I didn't need an augmentation and my bladder tested well in the urodynamics) and everything seemed ok except some lingering pain.

    The first time we tried to catheterize through the Mitrofanoff was on November 23. A few days later I started having UTI symptoms. On November 28 I was diagnosed with the first of 5 infections all with the bacteria Enterococcus faecalis (which I had never had before my surgery.)

    My UTI symptoms include having a fever, severe AD, increased spasticity, increased pain, urgency, pain and burning in both my natural urethra and my Mitrofanoff stoma, etc. After the infections started we decided to only use my natural urethra and not the Mitrofanoff, but every few weeks we ended up trying to use the Mitrofanoff to keep it from closing.

    Except for using the Mitrofanoff those few times we have been doing everything the same as we had been for the last couple years. (natural urethra, new catheter each time, gloves, benzalkonium chloride wipes, etc.)

    I took a specimen in this past week so I'm not sure which bug I have yet (we always do a culture and a sensitivity test to make sure I get the correct antibiotic and I take 10 - 14 days worth of the correct one) but I have a feeling it is the same bug. The Enterococcus faecalis only responds to Ampicillin instead of my usual Cipro sensitive bugs. I also had an ultrasound to check for a stone, but none were present and my bladder checked out as functioning normally. I am also still taking the Detrol I’ve been on since my accident.

    The surgeon and nurse mentioned after the surgery that the appendix could get some bacteria in the bladder (they never mentioned it before the surgery) so I am worried that the Mitrofanoff is causing the problem.


    Is it even possible for a Mitrofanoff to cause a UTI? If it is not, I'm totally lost as to what could be the problem as nothing else has changed.


    I would appreciate any ideas on what I should ask about or try to do. I am at my wits end and I am really regretting the surgery because things were going well with my bladder before I had it. I don’t want to scare anyone away from this surgery as a bunch of the girls here really seem to like their Mitrofanoff surgeries, but I would really like to know if anyone else had this problem after their surgery.

    Thanks for your help. Melissa

    P.S. I think I’m going to have to try using Microcyn/Vetericyn, so if anyone has used it with their Mitrofanoff I would appreciate knowing if they tried cleaning their stoma and/or flushing the length of their Mitrofanoff/appendix with it. (I feel like the appendix must be full of bacteria so I keep thinking I should basically rinse the length of it with Microcyn/Vetericyn.)
    Life is a lesson you learn when you're through.

  2. #2
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    i really am not understanding... the mitrofanoff procedure does not prevent you from getting UTIs, so yes, this is something you still will have to contend with. it may be from the appendix, it may not. i havent really seen an increase of infection since getting the mitro.

    i've used vetericyn on my mitro and it seems to work better than when i injected it into my bladder.
    "Smells like death in a bucket of chicken!"
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  3. #3
    the appendix is not sterile and will show organisms but only symptomatic utis should be treated. When is the doctor going to recommend you use it?
    CWO

  4. #4
    Quote Originally Posted by crypticgimp View Post
    i really am not understanding... the mitrofanoff procedure does not prevent you from getting UTIs, so yes, this is something you still will have to contend with. it may be from the appendix, it may not. i havent really seen an increase of infection since getting the mitro.

    i've used vetericyn on my mitro and it seems to work better than when i injected it into my bladder.
    Thanks for your input, crypticgimp. I appreciate your help and experience and if it is ok I'll PM you about the way you've found Vetericyn works with your Mitrofanoff.

    I realized that I forgot to mention something important in my original post. Before I had the Mitrofanoff surgery, I only had a couple/few UTI's a year, but since the surgery they have been pretty constant.

    I didn't have a bad UTI problem before the surgery. I thought I could become more independent in my care, (I have a C5/6 injury) but I never expected to have a lot more UTI's after the surgery. I'm glad to know that you didn't have an increase in them. I hate UTI's.
    Last edited by melliska; 02-06-2012 at 03:11 AM. Reason: Typo...lol
    Life is a lesson you learn when you're through.

  5. #5
    Quote Originally Posted by SCI-Nurse View Post
    the appendix is not sterile and will show organisms but only symptomatic utis should be treated. When is the doctor going to recommend you use it?
    CWO
    They told me about the appendix containing bacteria only after the surgery. I make sure to only take a specimen in if I have multiple UTI symptoms (fever, AD, fatigue, spasticity, urgency, pain, etc.) and I always have a C&S and take the appropriate antibiotic for the full 10-14 days as prescribed.

    Do you mean, when am I going to use the Mitrofanoff? Or something else? So far I'm nervous to use it because the infections started after the first time I tried it, plus it still hurts, and I'm not sure yet if it is sufficiently draining my bladder. (I'm not sure how much urine you can retain after cathing before it isn't healthy.) I've had several issues with it and from what I've read, I might be a candidate for a revision.

    Thanks for your help. Melissa
    Life is a lesson you learn when you're through.

  6. #6
    Did you have alot of infections before? Are the utis more, less or the same with the Mitranoff?
    My understanding is the appendix is used to make the stoma more accessible so you will be able to cath your self and increases the capcity not much at all like a bladder augmentation does where part of the bowel is added to the bladder and slowly stretched to hold more.
    I would ask the surgeon who did the procedure and see what he recommends. You need to cath through the stoma if the surgeon says to or it will close. The bladder should drain, you might have to reposition yourself, turn on your side or press on the abdomen to totally empty but you need to make sure it empties.
    CWO

  7. #7
    Senior Member rdf's Avatar
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    She posted this already two posts up: Before I had the Mitrofanoff surgery, I only had a couple/few UTI's a year, but since the surgery they have been pretty constant.

    Quote Originally Posted by SCI-Nurse View Post
    Did you have alot of infections before? Are the utis more, less or the same with the Mitranoff?
    My understanding is the appendix is used to make the stoma more accessible so you will be able to cath your self and increases the capcity not much at all like a bladder augmentation does where part of the bowel is added to the bladder and slowly stretched to hold more.
    I would ask the surgeon who did the procedure and see what he recommends. You need to cath through the stoma if the surgeon says to or it will close. The bladder should drain, you might have to reposition yourself, turn on your side or press on the abdomen to totally empty but you need to make sure it empties.
    CWO
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  8. #8
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    my issue is in not being able to get to the one room accessible toilets on campus so i can just wash my hands, then urinate. in a regular restroom, i wash my hands but still need to touch the wheel or door to get to a stall and i've used hand sanitizer to no effect, so i'm getting infections.

    i found that when i wiped the stoma area before and after cathing with the vetericyn it was more effective than instilling the bladder with it.
    "Smells like death in a bucket of chicken!"
    http://www.elportavoz.com/

  9. #9
    Quote Originally Posted by SCI-Nurse View Post
    Did you have alot of infections before? Are the utis more, less or the same with the Mitranoff?
    My understanding is the appendix is used to make the stoma more accessible so you will be able to cath your self and increases the capcity not much at all like a bladder augmentation does where part of the bowel is added to the bladder and slowly stretched to hold more.
    I would ask the surgeon who did the procedure and see what he recommends. You need to cath through the stoma if the surgeon says to or it will close. The bladder should drain, you might have to reposition yourself, turn on your side or press on the abdomen to totally empty but you need to make sure it empties.
    CWO
    No, I was not having a lot of infections before the Mitrofanoff surgery. I had a couple/few per year before the surgery, but since the surgery they have been continuous even with proper cathing procedures, UTI symptoms, C&S, and treatment.

    That is correct. The appendix is just basically used as a second urethra to cath through. I did not have an augmentation as my bladder was large enough. I am currently keeping the stoma open and functioning using an L stent without actually having to cath through it for the time being.

    How much urine can be retained in the bladder safely after cathing? Once I start using the stoma, I will be using it independently while sitting, so I will not be able to roll on my side or really reposition myself and I'm not sure if I'll even have enough hands to press anything. Is there a certain amount that is unacceptable after a successful cath?

    I really want to figure out what could be causing these infections. Then I am going to really try to use the Mitrofanoff. I've still had some pain when I've tried it, plus it sets off bad bladder spasms when I try to use it during a UTI so I'm trying to fix the infections first.

    I am still taking the Detrol I have since rehab. I had a foley for two weeks after surgery, but I was told my bladder wouldn't shrink in that time. I am starting to wonder if some part of the surgery changed my bladder for the worse.

    I would appreciate any more information involving the Mitrofanoff surgery and increased UTI's if any such information exists. I would also appreciate any ideas as the urologist I had an appointment with just said I was pretty much doing everything correctly and didn't really have any ideas.

    Thank you, Melissa
    Life is a lesson you learn when you're through.

  10. #10
    Quote Originally Posted by crypticgimp View Post
    my issue is in not being able to get to the one room accessible toilets on campus so i can just wash my hands, then urinate. in a regular restroom, i wash my hands but still need to touch the wheel or door to get to a stall and i've used hand sanitizer to no effect, so i'm getting infections.

    i found that when i wiped the stoma area before and after cathing with the vetericyn it was more effective than instilling the bladder with it.

    Crypticgimp, I'm so sorry to hear that you can't wash your hands properly in the restroom on campus. That is a horrible reason to get sick with a UTI!

    Thank you for the tip on washing the stoma with the Vetericyn. I keep going back and forth on how to use it. I could wash the stoma/urethra on the outside of my body, I could use the gel version on the catheters, I could try to "rinse" my urethra and "appendix urethra" with the liquid version, I could instill it in the bladder, or I could do a combination of things, or all four ideas! I know doing all four could be overkill, but I am so tired of being constantly sick!

    Thanks so much for your help! Melissa
    Last edited by melliska; 02-08-2012 at 04:38 AM. Reason: Typos..lol
    Life is a lesson you learn when you're through.

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