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Thread: How to tell if you have a UTI...no symptoms?

  1. #21
    So I got my urodynamics appt made and they also scheduled a procedure where they look at the inside of my bladder with a camera to check for anything that may be wrong. I didn't ask for this specifically, I guess it was suggested by my urologist. Is this necessary or typical to have done in addition to the urodynamics? My 20% of both procedures is over $400 so I'm trying to figure out how critical the second procedure is.

  2. #22
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    Quote Originally Posted by Brad09 View Post
    So I got my urodynamics appt made and they also scheduled a procedure where they look at the inside of my bladder with a camera to check for anything that may be wrong. I didn't ask for this specifically, I guess it was suggested by my urologist. Is this necessary or typical to have done in addition to the urodynamics? My 20% of both procedures is over $400 so I'm trying to figure out how critical the second procedure is.
    According to your profile, you were injured in 2012. I believe a cystoscopy, the second procedure you described above is recommended every 5 years to evaluate the anatomy of the bladder. So, it sounds like it is a reasonable procedure for you to have at this time.

  3. #23
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    Sorry to hijack the thread. I'm having leaking around my sp and very strong smelling urine.Dr ordered a UA and C&S. The results of the C&S are >100,000 cfu/ml Klebsiella pneumoniae ssp, 50,000 to 100,000 cfu/ml Morganella morganii ssp morganii. NP said that was ok no antibiotics ordered.

  4. #24
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    Quote Originally Posted by HACKNSACK44 View Post
    Sorry to hijack the thread. I'm having leaking around my sp and very strong smelling urine.Dr ordered a UA and C&S. The results of the C&S are >100,000 cfu/ml Klebsiella pneumoniae ssp, 50,000 to 100,000 cfu/ml Morganella morganii ssp morganii. NP said that was ok no antibiotics ordered.
    The nurse practitioner does not understand urinary tract infections in spinal cord injury, especially with a supra pubic catheter in place. Typically you should have physical symptoms potentially fever (although I've never had a fever with a urinary tract infection-I typically have severe autonomia, chilling, sweating, shaking, but temperature usually around 96-97 degrees), flank pain, generally feeling bad. If you are leaking either around the stoma and/or from the urethra, something is going on in your bladder to cause severe spasms. >100,000 cfu of Klebsiella is enough to treat for a urinary tract infection. Some physicians will treat at 50,000-100,000 cfu of a bacteria present because they understand complex urinary tract infections in spinal cord injury.

    Have stones been ruled out?

    I would request that the ordering physician review your symptoms and the urinalysis (UA) and culture & sensitivity (C&S) and evaluate the symptoms you are experiencing. You should not have to put up with a leaking supra pubic catheter. If that doesn't happen, consider seeing an infectious disease ID) physician. Over the years, I have had much better luck with ID physicians managing bladder infections than my urologists.

  5. #25
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    Quote Originally Posted by gjnl View Post
    The nurse practitioner does not understand urinary tract infections in spinal cord injury, especially with a supra pubic catheter in place. Typically you should have physical symptoms potentially fever (although I've never had a fever with a urinary tract infection-I typically have severe autonomia, chilling, sweating, shaking, but temperature usually around 96-97 degrees), flank pain, generally feeling bad. If you are leaking either around the stoma and/or from the urethra, something is going on in your bladder to cause severe spasms. >100,000 cfu of Klebsiella is enough to treat for a urinary tract infection. Some physicians will treat at 50,000-100,000 cfu of a bacteria present because they understand complex urinary tract infections in spinal cord injury.

    Have stones been ruled out?

    I would request that the ordering physician review your symptoms and the urinalysis (UA) and culture & sensitivity (C&S) and evaluate the symptoms you are experiencing. You should not have to put up with a leaking supra pubic catheter. If that doesn't happen, consider seeing an infectious disease ID) physician. Over the years, I have had much better luck with ID physicians managing bladder infections than my urologists.
    I never get a fever either. I'm leaking around the stoma but I'm still filing my bag up. In the morning I have atleast 1000ml in my bag but a chux pad soaking wet underneath my butt. The smell is really really bad. The NP works with the ID Dr. When I finished my last round of antibiotics a few months ago I asked the NP to run another UA and C&S and she said we don't recommend that. The leaking never stopped all the way after the last round of antibiotics. It was small amounts it has gotten worse over the past couple weeks. I'm calling the ID Dr. in the morning.

  6. #26
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    Quote Originally Posted by HACKNSACK44 View Post
    I never get a fever either. I'm leaking around the stoma but I'm still filing my bag up. In the morning I have atleast 1000ml in my bag but a chux pad soaking wet underneath my butt. The smell is really really bad. The NP works with the ID Dr. When I finished my last round of antibiotics a few months ago I asked the NP to run another UA and C&S and she said we don't recommend that. The leaking never stopped all the way after the last round of antibiotics. It was small amounts it has gotten worse over the past couple weeks. I'm calling the ID Dr. in the morning.
    Getting a urinalysis and a culture & sensitivity several days after you finish a course of antibiotics should be standard practice. Even after a 12 to 14 day course of antibiotics, some bacteria may remain and antibiotic treatment may need to be repeated, likely with a different antibiotic.

    That said, you may want to be evaluated for bladder stones. Stones harbor bacteria and it is hard to get rid of an infection when you have stones.
    Last edited by gjnl; 10-04-2018 at 02:26 PM.

  7. #27
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    Quote Originally Posted by gjnl View Post
    That said, you may want to be evaluated for bladder stones. Stone harbor bacteria and it is hard to get rid of an infection when you have stones.
    Got tested for stones in March.

    IMPRESSION: NO DEFINABLE CALCIFICATIONS ARE PRESENT IN THE RENAL
    PELVIS OR ALONG THE COURSE OF THE URETERS.
    THE BOWEL GAS PATTERN IS NORMAL

  8. #28
    One last thing to throw in this thread that started last month - If you are getting frequent infections or are highly colonized then you would do well to consult with an infectious disease physician/provider. When you see infectious disease you could talk to them about why you have a high colony count of bacteria. Most infectious disease providers will not want to treat unless you have symptoms.

    I have also heard that some people go to great lengths at cleaning their environment -bathroom-body- everything. I had a patient who got frequent infections and then when he got his bathroom cleaned on a regular basis his infection rate went down.

    pbr
    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. #29
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    Are there any articles that discuss complex urinary tract infections in spinal cord injuries? How to handle it.
    Last edited by HACKNSACK44; 10-09-2018 at 11:53 AM.

  10. #30
    It is discussed in the clinical practice guideline on bladder management in SCI:

    https://www.pva.org/CMSPages/GetFile...b-9c557bc21b34

    Have you been evaluated for prostatitis by your urologist?

    (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.

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