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

  1. #11
    The general consensus in SCIers and other folks who are likely colonized is not to treat a UTI unless you are having symptoms.

    If you don't have a fever, or increased spasticity or really nasty, smelling, dirty looking urine or decreased bladder volumes when you cath then you probably shouldn't treat it. Why wipe out a colonization of bacteria that isn't really causing you problems and risk the newly vacant real estate being occupied by bugs that are resistant to whichever drug you pick and might possibly cause a symptomatic infection?

  2. #12
    Quote Originally Posted by funklab View Post
    The general consensus in SCIers and other folks who are likely colonized is not to treat a UTI unless you are having symptoms.

    If you don't have a fever, or increased spasticity or really nasty, smelling, dirty looking urine or decreased bladder volumes when you cath then you probably shouldn't treat it. Why wipe out a colonization of bacteria that isn't really causing you problems and risk the newly vacant real estate being occupied by bugs that are resistant to whichever drug you pick and might possibly cause a symptomatic infection?
    Generally, I agree with you, but ">=100,000 CFU/ml, Heavy growth Escherichia coli" falls well above what is considered colonization parameters. I know my neurobiologist has treated me a time or two at this level of bacteria load when I have had fewer or milder symptoms with which I normally present. My urologist has had a few experiences with a urinary tract infection going directly to the kidneys, without causing much problem/symptoms in the bladder. But, he has always done a culture & sensitivity (C&S) before prescribing an antibiotic.

  3. #13

  4. #14
    I don't intend to play a game of match the studies. My comments are related to discussions I have had with my neurourologist and his experience. He has suggested antibiotic treatment for me when I have presented with a heavy bacterial load and very mild, few to no symptoms of a typical bladder infection. I have questioned his rationale of treating with antibiotics in these cases, and in his practice, he has had enough urinalyses (UA) return heavy bacterial load that when not treated went directly to kidney infections, especially in the population he serves, spinal cord injured, multiple sclerosis, spinal bifida etc.

  5. #15
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    So what is the general consensus on re-using condom catheters? Is it ok to take them off a few times a day to intermittent cath and then put back on? Do they need to be replaced daily? What if you have a different leg bag you use at night so you only take the condom catheter on and off once a day, how many days can you use it?

    Also, are any of the answers to these questions backed up by urologists, studies, etc. or is it just whatever an individuals experience has been?

  6. #16
    This is an older study, but for what it is worth:

    https://www.ncbi.nlm.nih.gov/pubmed/8900706
    Attached Images Attached Images  

  7. #17
    Note that study was done in 1996...

    (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.

  8. #18
    From: Evidence Based Guidelines for Best Practice in Urological Health Care, Male external catheters in adults. This is a publications of the European Association of Urology Nurses (EAUN). The publication is date March 2016. https://nurses.uroweb.org/wp-content...omplete_LR.pdf
    7.3.4 Changing interval
    Daily changes of sheaths are recommended for all users when daily hygiene is performed. When the MEC falls off or leakage occurs it should be changed more often and if this recurs the patient should be reassessed.
    It is recommended that the urine bag should be changed at least once a week. In hospitals, the bag is changed every time the MEC is changed due to the risk of cross contamination. Changing the urinary bag should follow local or national policies or standards.


    From: Ostomy Wound Management, journal of the Association for the Advancement of Wound Care
    Issue Number:
    Volume 54 - Issue 12 - December, 2008
    Index:
    Ostomy Wound Manage. 2008;54(12):18-35.
    Diane K. Newman, RNC, MSN, CRNP, FAAN

    https://www.o-wm.com/content/internal-and-external-urinary-catheters-a-primer-clinical-practice
    External Catheters

    (EC) External Catheters (IUC) Intermittent Urinary Cathete
    External catheters are condom-type sheaths applied (usually rolled) over the penis and connected to a drainage bag. They are used primarily for urine collection in men who experience urinary incontinence. The most popular ECs are disposable and must be changed every 24 to 48 hours. Reusable ECs are removed, washed, and reapplied. Although ECs can be an appropriate urine containment option for men, scant research has rendered the role of ECs in hospitalized patients or LTC residents unclear. Most available research53 has involved men in VA medical centers (VAMC) who report that an EC is more comfortable, less painful, and less restrictive on their activities than other devices such as an IUC. This research also indicated that nurses preferred ECs to IUCs. Saint et al53 compared IUCs with ECs in male inpatients in a VAMC. Seventy-five subjects were randomized to receive either an IUC (n = 41) or a condom catheter (n = 34). The incidence of adverse outcomes was 131 per 1,000 patient-days with an IUC and 70 per 1,000 patient-days with a condom catheter. The median time to an adverse event was 7 days in the indwelling and 11 days in the condom group. Adverse outcomes including bacteriuria, symptomatic UTI, or death were lower in men using ECs, particularly in men who did not have dementia. When patient satisfaction with the urinary device was assessed, the patients with an EC were more likely than patients with an IUC to report their device to be comfortable and not painful.

    From:
    Spinal Cord Medicine, Bladder Management for Adults with Spinal Cord Injury, A Clinical Practice Guideline for Health-Care Providers, Consortium for Spinal Cord Medicine, Administrative and financial support provided by Paralyzed Veterans of America, Page 27
    http://www.pva.org/media/pdf/CPGBlad...eme_1AC7B4.pdf,

    Proper use and care of external condom catheter.
    The condom catheter is applied securely to avoid leakage and constriction for 24 hours. To avoid skin maceration and breakdown, the glans is washed daily when the condom is changed, the skin is aired for 20–30 minutes, and the condom is reapplied. To prevent pressure ulcers, alternate legs are used to anchor the tubing.

    Holister makes an external catheter that they call an "extended wear external catheter." Their recommendation is to change it every 24 hours. Then again, I would expect manufacturers of external catheters to recommend changing them every 24 hours, since that sells more catheters.

    In the end, best to ask your urologist.
    Last edited by gjnl; 09-21-2018 at 05:25 PM.

  9. #19
    Quote Originally Posted by Brad09 View Post
    So what is the general consensus on re-using condom catheters? Is it ok to take them off a few times a day to intermittent cath and then put back on? Do they need to be replaced daily? What if you have a different leg bag you use at night so you only take the condom catheter on and off once a day, how many days can you use it?

    Also, are any of the answers to these questions backed up by urologists, studies, etc. or is it just whatever an individuals experience has been?
    I'm curious how you get a condom catheter off and back on at all? When I use them they are super sticky and they come off in a stickified tangle. I couldn't picture trying to put one back on, but maybe you're using a different product than I am used to.

  10. #20
    Quote Originally Posted by SCI-Nurse View Post
    Note that study was done in 1996...

    (KLD)
    Yes, I mentioned it was an older study.

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