Page 1 of 3 123 LastLast
Results 1 to 10 of 26

Thread: Desperately Need Help to Get Rid of Chronic UTIs

  1. #1

    Desperately Need Help to Get Rid of Chronic UTIs

    Bare with me while I describe my situation and then have some questions for everyone here.

    I have a C4-5 SCI post 32 years. I managed my bladder situation for the first 6-8 months of my quad career by intermittent catheterization about 6 times a day while using a condom catheter in between.

    Got hooked up with a urologist in NYC who performed a partial sphincterotomy. That worked flawlessly for about 18 years or so. 50-75 CC residuals in my bladder with very good pressures as per urodynamics studies.

    I then started getting more and more UTIs. Gradually my residuals from the urodynamics studies increased to 200+ cc's. Also a bladder ultrasound showed static amounts of urine in my bladder of anywhere from 300-600 CC's at any given time. Still managing my bladder with just a condom catheter.

    I tried doing some intermittent catheterization throughout the day. I found it is really not easy and/or practical for me as I have a pretty active life and getting the help to do the catheterizations 4-6 times a day just did not work out for me. Also, I still had to wear the condom catheter in between catheterizations and that meant using 4-6 catheters a day. Not cost-effective at all.

    My urologist had suggested numerous times of putting in a suprapubic catheter. I finally relented and gave this a shot this past January.

    Because of the sphincterotomy that I had in the past I quickly found out that I still had to wear a condom catheter along with the suprapubic catheter. This meant using 2 leg bags during the day and 2 bed bags at night.

    This did reduce my residuals and the amount of urine static in my bladder to a very minimal 100 CC's or less at any given time. This still however did not reduce the amount of UTIs I was getting. Also this did not change the bug that 95% of the time was causing the infection's. E. coli.

    Dealing with 2 leg bags and 2 bedside drainage bags quickly got old and cumbersome. I decided to try keeping the suprapubic catheter in but clamping it off thus only having to wear one bag at a time. I have been emptying the suprapubic catheter every 2-4 hours acting pretty much like an intermittent catheterization. Again, still not reducing the UTIs.

    My bathroom is about 8 x 10. One side of the bathroom is my toilet. Along the same wall about a foot and 1/2 away is my sink. On the other side of the bathroom next to my sink is my roll in shower basically an open platform throughout the whole bathroom.

    I try very hard to keep everything clean.

    Here are some questions I have:

    From an infectious disease standpoint, what would be the best way to keep a bathroom like this as clean as possible? Is there any kind of filter machine that I could use to help get rid of the E. coli that gets spread throughout the bathroom?

    I clean my bags with vinegar and water and then drain them and keep all the clamps open so they dry throughout the day and/or night. Is there a better way to manage the cleaning of my bags?

    I would assume I need to be extremely anal with my help using gloves while cleaning my catheter and perineal area. Is there any types of washes specifically for the perineal area and/or the suprapubic catheter to help clean the area better?

    Is there anything else I am missing?

    I'm really sick of all these UTIs I'm getting. I thank you for any and all of your suggestions and help.

    Andy

  2. #2
    You might be able to use a Y tubing fitting to allow the use of a single leg bag. Did you ever have the sphincterotomy redone? My understanding is that they can gradually heal and then bladder pressures and residuals increase. Other than that, my battles with UTI's have typically come down to pushing more fluid and keeping residuals down. Are you sure the infections are getting cleared up? eColi responds pretty well to a lot of different antibiotics. Perhaps try a different type next time. Good luck, I know that UTI's are a miserable experience.

  3. #3
    As many know here, I would point you to super originated water that is found in Microcyn Technology that can be used as a bladder instillation to help prevent urinary tract infections. Here are some threads at which to take a look:

    http://sci.rutgers.edu/forum/showthr...light=Microcyn

    http://sci.rutgers.edu/forum/showthr...light=Microcyn

    There is some evidence that e. coli bacteria related urinary tract infections can be ameliorated by using d-mannose. You can do an internet search for more information or use the Care Cure Community search box at the upper right corner of the screen to find more thread and posts on this site.

  4. #4
    Senior Member lynnifer's Avatar
    Join Date
    Aug 2002
    Location
    Windsor ON Canada
    Posts
    18,356
    D Mannose. Can get it from Amazon.

    I don’t like vinegar ... I use bleach diluted with water.
    Make America Sane Again. lol

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

  5. #5
    First of all, are you talking about constant UTIs (fever, chills, flank pain, AD, severe malaise) or just colonization of urine (high bacterial counts with no symptoms)? The first require treatment, while in general practice is to NOT treat the second.

    Has your urologist discussed a sphincter bulking procedure with you? This could possibly reverse the sphincterotomy and decrease leakage through the urethra.

    Many people who used reflex voiding for years find that eventually their bladder decompensates and is no longer able to empty effectively, even with a sphincterotomy. This is why this method of urinary management is rarely recommended any more.

    E. coli is nearly always spread by touch...it is not airborne, so air filtering would do nothing to prevent it being spread in your bathroom. Good hand hygiene with soap and water or 60% or more alcohol based hand cleaners, and cleaning of surfaces possibly contaminated with stool with bleach or other disinfectant wipes is the best way to manage your bathroom.

    You could also explore use of CHG wipes to such as the ones produced by Sage or Bard specifically for cleaning the perineal area, the catheter, and the skin around the catheter on a routine basis. We started using these in the hospital several years ago: http://www.bardmedical.com/products/...y-care-system/

    Vinegar is not a very good disinfectant for bags. 10% bleach solution has the best research base, and is what is currently recommended, although it is even better to maintain a closed system and leave your leg bag on your SP catheter 24/7, attaching a night bag to the drain port on the leg bag at night, and cleaning only the night bag.

    Anytime we see someone who has the same bacteria over and over in spite of an appropriate course of antibiotics, we start looking for urinary stones. Have you had tests for these (which should be done annually)?? Also, for men, chronic prostatitis can manifest itself this way. Speak to your urologist about being evaluated for this.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  6. #6
    I found eating half a Ruby Grapefruit every other day or so made my urine a bit clearer, maybe it was doing something!
    Not as harsh as your normal Grapefruit either.
    I think the fruit can effect some medications, so best to check if you're on someething like that.

    Good luck!

  7. #7
    Senior Member
    Join Date
    May 2002
    Location
    Saskatchewan
    Posts
    133
    Quote Originally Posted by SCI-Nurse View Post
    Many people who used reflex voiding for years find that eventually their bladder decompensates and is no longer able to empty effectively, even with a sphincterotomy. This is why this method of urinary management is rarely recommended any more.

    Also, for men, chronic prostatitis can manifest itself this way. Speak to your urologist about being evaluated for this.
    (KLD)
    Are cholinergic drugs ever prescribed to increase bladder contractions and help empty more effectively in cases where the bladder is decompensated?

    Can any ongoing infection be a sign of chronic prostatitis or is it e. coli in particular?

  8. #8
    Quote Originally Posted by beckman View Post
    Are cholinergic drugs ever prescribed to increase bladder contractions and help empty more effectively in cases where the bladder is decompensated?
    No, the use of these drugs (like Urecholine) is not recommended, as they are very likely to cause dangerously high bladder pressures, and come with many side effects.

    Quote Originally Posted by beckman View Post
    Can any ongoing infection be a sign of chronic prostatitis or is it e. coli in particular?
    Any repeated infection, esp. if the infection was properly treated with a sensitive antibiotic, but then comes back later with the same strain of bacteria.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  9. #9
    Quote Originally Posted by brython2 View Post
    I found eating half a Ruby Grapefruit every other day or so made my urine a bit clearer, maybe it was doing something!
    Not as harsh as your normal Grapefruit either.
    I think the fruit can effect some medications, so best to check if you're on someething like that.

    Good luck!
    Take a look at the medications you are taking. Many medications have prohibitions on consuming grapefruit or grapefruit juice.

  10. #10
    "weels58,"
    If after going through "KLD's" check list of possible causes of your frequent and recurring urinary tract infections and still are having problems, get a consultation with an infectious disease physician. They are often more adept at prescribing antibiotics than your urologist or primary care physician.

Similar Threads

  1. which is better for chronic UTIs?
    By jbridges9 in forum Care
    Replies: 6
    Last Post: 05-02-2013, 06:34 PM
  2. Desperately seeking:
    By kelton in forum Life
    Replies: 4
    Last Post: 12-22-2010, 08:21 PM
  3. I desperately need a new chair!!
    By Westley in forum Equipment
    Replies: 5
    Last Post: 11-19-2009, 01:59 PM
  4. Chronic Utis-Levaquin and Bactrum-Detrol??
    By canchess in forum Care
    Replies: 2
    Last Post: 07-30-2008, 12:25 PM
  5. I need your votes desperately!!
    By parapete in forum Announcements & Feedback
    Replies: 30
    Last Post: 01-07-2007, 11:06 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •