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Thread: UTI / Major Leakage and Urgency

  1. #1

    UTI / Major Leakage and Urgency

    Good afternoon everyone !

    I have a big problem I wanted to share with everyone in hopes that I can get some valuable feedback that might assist me. For about 4+ months now (estimate) I've been having lots of leakage problems. I wear depends for men every day and have noticed that I've been wetting them a lot during the day and also at night. I had an appointment with one of my urologists on Friday and she told me that she thinks it would be a good idea if I do another round of bladder botox (300 units this time). She said that she's going to want me to do 7 days of an antibiotic before the procedure to help with an infection that I believe I have due to color, clarity and smell. She also mentioned that InterStim was an option before I look into getting an augmentation done. She referred me to one of her colleagues that does that sort of thing that she works with.

    I have a few questions relating to my leaking and possible uti.

    1. I'm not supposed to go in to do the botox until April 10th which means I wouldn't start the antibiotic until the 3rd or around then. Being that I feel like I do have an uti currently, is that waiting too long to start an antibiotic ? I just don't want it to get any worse off then it is already. Is 300 units common for those who are paralyzed ? I got 200 the last time and I'm hoping 300 gives me some relief.

    2. I've had Cdiff in the past and had a horrible time dealing with it. The last time I took an antibiotic (Bactrim) was about a week ago. After taking the drug for about 3 days, I started getting no stool but a LOT of white/pinkish mucus. Should I be concerned about taking more antibiotics ? When I do take them they definitely help the clarity of my urine, but make me extremely constipated for days until I finally get off of the drug. It's a real battle to have to pick whether I want normal bowel programs or clear pee. It doesn't seem like I can have both.

    3. Does anyone have any information about InterStim ? I do know that going that route would be much less invasive than an augmentation of my bladder. If I have no other choice left I'll obviously take the augmentation route, but I'd prefer to stick with something less invasive. It is something that wouldn't require local anesthesia, correct ? I think I had read somewhere that they do some sort of trial first with a test machine that's connected to your lumbar area to control spasms. Is that true.

    4. I feel like I have to urinate every hour when I should be doing it every 4-6 hours. Is there anything I can be doing to slow down my bladder spasms or to reduce the amount of leakage I'm experiencing ? Having to go to the restroom all the time and interrupt my daily activities is starting to get extremely old.

    5. I also want to know if there is any way it could be my kidneys. Could it be something that the doctors could check with some sort of test they could perform ? I had read somewhere they can inject some sort of dye into me to light up the kidneys and see if something's wrong. Is this true and if so what would the test be called ? Could it have anything to do with my sphincter not closing off and keeping urine out from leaking ? My urologist told me that she doesn't believe this was the case because apparently it usually happens in older patients and also the person doing the Botox would have seen my sphincter upon doing the scope for the procedure.

    Thanks ahead of time for any responses. I don't know what to do and don't know what to think. I'm tired of having to rush to the bathroom every hour because I get the urge to urinate (pressure in my lower abdomen area). Also, I'm getting pretty decent volumes of urine every time I do an ic. 400-500 usually every hour or so. I desperately need answers and for something to go my way with this. Some relief.

    Thanks !

  2. #2
    Possible UTI (Urinary Tract Infection)
    Don't wait to find out if you have a urinary tract infection. Infections can go septic quickly if left untreated. But, don't start taking just any antibiotic for a possible uti. Get a order from your doctor for a Urinalysis (UA) and a Culture & Sensitivity (C&S). The C&S will tell your doctor if you have a uti, exactly what the bacteria is that is causing the infection, and the antibiotic that is most likely to cure the infection. UTIs in spinal cord injured are considered complex and should be treated with 12 to 14 days of the recommended antibiotic. After the course of antibiotics is finished, get another UA and C&S to see if the infection is gone and the urine is sterile.

    Urine Color and Clarity
    Urine Color and Clarity are not necessarily signs or indicators of infection.

    Probitoics

    While taking antibiotics take a probiotic supplement and eats foods like yogurt, kefir etc.

    Anticholinergics
    Are you taking an anticholinergic like oxybutynin? These drugs will help calm the bladder spasms.

    Male Incontinence Pouches
    To help prevent the inconvenience of being wet try using a male incontinence pouch. They hold about 200cc unrine. There are several brands available. Two pictured below. Search internet for Male Incontinence Pouches. Many companies will send you free samples.

    Botox
    Been a long time since I had Botox. But, my urologist used 200 units. I got 4 rounds of Botox and on the fourth, I found it was ineffective.

    Kidney Testing - IVP (intravenous pyelogram)
    IVP uses traditional x-rays to produce pictures of the kidneys, ureters, and bladder. A substance called "contrast dye" is injected into a vein, circulates through the bloodstream, and is processed and excreted by the kidneys. Kidney and bladder stones can be a cause of frequent urinary tract infections.

    Intermittent Catheterization Volumes and Frequency
    You wrote: "I'm getting pretty decent volumes of urine every time I do an ic. 400-500 usually every hour or so." If you are doing intermittent catheterization every hour or so (and didn't misspeak), that is way to many catheterizations per day. Another test you may need to have or talk to your doctor about is Urodynamics. This is a study that assesses how the bladder and urethra are performing their job of storing and releasing urine. Urodynamic tests can help explain symptoms such as: incontinence. frequent urination. sudden, strong urges to urinate but nothing comes out.

    InterStim
    Before plunging into InterStim, do an internet search and read as much about the procedure as you can. There is quite a bit of information from forums where people share their experiences to scholarly papers written by doctors and other reliable sources.
    Attached Images Attached Images  

  3. #3
    I was in the same boat for a while. Leaking and painful bouts when my bladder wanted to void. I went back to the urologist last week and they said my urine looked clear but if felt as though I had a UTI. He gave me a sample pack of Myrbetriq. I don't want to jinx anything but it has made a huge difference thus far - no pain and bladder can handle more fluid. I go back in a month to get results of the urinalysis. I swear there had to be some bacteria in there because there were similarities in the pain I experienced and leakage frequency.

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