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Thread: UTI with no symptoms

  1. #1
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    UTI with no symptoms

    Currently have a UTI, cultures showed four different bacteria. Going to start antibiotics today. I'm T6 complete, with severe nerve pain 24/7 so I can't rely on pain to know if I have a UTI. I use a leg bag and cath every 12 hours because side effects of meds are too severe and botox stopped helping. So I can't go by my bladder leaking, or having to cath more frequently, to know if I have a UTI. I never get a fever with a UTI and the last few times I've had one there hasn't been a difference in smell. Discoloration comes and goes with how much water I drink, so that's not a good indication either. I could have had a UTI for the last 3 weeks and had no idea. I'm not sure how I'm supposed to know in the future. Are the home tests you can buy at the pharmacy accurate enough for me to at least know I need to go to the urologist to get it checked? Or any other suggestions?

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    The current wisdom is not to treat a colonized bladder that is asymptomatic, but that doesn't help if you cannot get a symptom under any circumstances. Is your urologist accustomed and educated about treating SCIs?

    There are UTI test strips in US pharmacies (over the counter). I use them if my nerve pain gets above a 7/10 just as a quick check.
    T3 complete since Sept 2015.

  3. #3
    we only recommend treatment for symptomatic UTI. not urine discoloration or smell if you had no symptoms then why was urine tested? we call asymptomatic urine with organisms in it-colonization. if you continue to treat these organisms you may become resistant to the antibiotics. unless you are going for surgery, have recurrent kidney or bladder stones or have to be hospitalized in ICU because the symptoms occur as sepsis and are life- threatening or have a reason we don/t recommend testing or treating. sometimes annually we will test and treat but not more often. the research is being done on the biofilm of the bladder.CWO
    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.

  4. #4
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    One other question just for my education. You said you wear a leg bag and cath every 12 hours. I assume you just dump the bag every 12 hours or something? Always assumed that a leg bag meant Foley or condom cath.
    T3 complete since Sept 2015.

  5. #5
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    Quote Originally Posted by Mize View Post
    The current wisdom is not to treat a colonized bladder that is asymptomatic, but that doesn't help if you cannot get a symptom under any circumstances. Is your urologist accustomed and educated about treating SCIs?

    There are UTI test strips in US pharmacies (over the counter). I use them if my nerve pain gets above a 7/10 just as a quick check.
    Thanks, yes my urologist is knowledgeable about SCIs. I'll see if I can find some test strips.

    Quote Originally Posted by SCI-Nurse View Post
    we only recommend treatment for symptomatic UTI. not urine discoloration or smell if you had no symptoms then why was urine tested? we call asymptomatic urine with organisms in it-colonization. if you continue to treat these organisms you may become resistant to the antibiotics. unless you are going for surgery, have recurrent kidney or bladder stones or have to be hospitalized in ICU because the symptoms occur as sepsis and are life- threatening or have a reason we don/t recommend testing or treating. sometimes annually we will test and treat but not more often. the research is being done on the biofilm of the bladder.CWO
    I usually have it checked when my nerve pain gets really bad, or the color is darker than usual. However, I've had it checked in the past with those issues and there was no UTI. But it's the only "symptom" I have and apparently its just a role of the dice as to whether or not there is a UTI because of it. So I had it checked just to be sure. You say you only recommend treatment for symptomatic UTI, but the point of my post was I have all the "symptoms" all the time (probably should have reworded the title). How do I know if the bacteria that grew in the cultures is enough to need to take the antibiotics for, or if its a "normal" amount and I should avoid the antibiotics?

    Quote Originally Posted by Mize View Post
    One other question just for my education. You said you wear a leg bag and cath every 12 hours. I assume you just dump the bag every 12 hours or something? Always assumed that a leg bag meant Foley or condom cath.
    Yes, I use a condom catheter and leg bag 24/7. I cath twice a day just to keep any residual urine from sitting in my bladder all the time. Can't take bladder meds because of cognitive side effects (which affects my job) and botox only lasts 1-2 months. The last urodynamic test I had showed my bladder will only hold about 70cc's before voiding on its own. So the leg bag is my only option at this point.

  6. #6
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    Bummer.
    But you do get a symptom from UTIs then - increased nerve pain. I get the same, but the problem is that I also get increased nerve pain from inadequate sleep or other forms of stress so isolating the UTI cause is difficult. I know I treated one UTI with no change so likely a round of antibiotics I could have avoided.

    I just came off my first botox round. Lasted about 8 months. I'm on oxybutinin until I get my next round of shots and man it's a hit to my brain and wakefulness. I'm actually offsetting it somewhat with modinifil - at least it beats back the sleepiness!

    Someone (Oddity) said they can change the Botox strain so that you don't form a resistance to it.

    SCI-Nurse, is that the case?

    So Brad, with a condom catheter you wind up with retained urine? I know little about condom catheters, but I always assumed you'd need to have a relaxed urinary sphincter for them to work without building up pressure...? Just trying to see the path ahead as it appears I'm following you!
    T3 complete since Sept 2015.

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    Quote Originally Posted by Mize View Post
    Bummer.
    But you do get a symptom from UTIs then - increased nerve pain. I get the same, but the problem is that I also get increased nerve pain from inadequate sleep or other forms of stress so isolating the UTI cause is difficult. I know I treated one UTI with no change so likely a round of antibiotics I could have avoided.

    I just came off my first botox round. Lasted about 8 months. I'm on oxybutinin until I get my next round of shots and man it's a hit to my brain and wakefulness. I'm actually offsetting it somewhat with modinifil - at least it beats back the sleepiness!

    Someone (Oddity) said they can change the Botox strain so that you don't form a resistance to it.

    SCI-Nurse, is that the case?

    So Brad, with a condom catheter you wind up with retained urine? I know little about condom catheters, but I always assumed you'd need to have a relaxed urinary sphincter for them to work without building up pressure...? Just trying to see the path ahead as it appears I'm following you!
    Yea, my nerve pain goes up and down all the time so, like you, I have no idea if a UTI were causing it. And for me it doesn't jump from like a 3 to an 8, I average around 7-8 all the time. The oxybutinin side effects were the worst for me, but I also had side effects from vesicare, myrbetriq, etc. I haven't heard about changing the botox strain, I may look into that. I did botox injections for about 5 years before they stopped being as effective. I was always on the oral meds at the same time.

    As far as using the condom catheter, I'm not sure about how relaxed the urinary sphincter has to be but since my bladder only holds 70cc on its own my urologist said it was fine to us the leg bag full time and cath every 12 hours. When I do cath its only for around 70cc, so most of it is getting out on its own throughout the day. The leg bag is a pain to clean everyday, but knowing that after 10am I don't have to cath again until I go to bed is nice. Saves a lot of time everyday too.

  8. #8
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    SCI-Nurse, please chime in on these items.

    Regarding the condom catheter thing, the part I don't understand is this: what matters isn't the amount of urine in your bladder, but rather, the pressures it achieves during spasms as increased pressure means increased likelihood that urine - and thereby bacteria - will be forced back into the kidneys and from there it can jump to one's blood; then the life-threatening sepsis battle starts. So I've always been under the impression, as a physics person, that one doesn't leak until some threshold of pressure is reached. If that pressure is less than the pressure needed to hit the kidneys then one is safe. If the pressure is higher (so no leak) then up to the kidneys it goes. I guess I'm mistaken about this.

    Back to just chatting (i.e. SCI-Nurse is optional )
    Yeah, my normal nerve pain is 3-4 with excursions to 7-8. Nothing really touches the pain directly, but I do find a low-THC, high-CBD vape pen helps considerably. I refer to the effect I get from this combination as a "distractant." Allow me to explain.
    If you were to ask me, prior to using any THC/CBD what my pain level was, I would immediately respond with a number, "7! Argh!"
    If I then take a treatment and you ask me again thirty minutes later, there would be an appreciable pause as I stop whatever I was doing to observe my pain level again and then I would say "about a 7" and go back to what I was doing.

    My assessed pain value doesn't change, but my ability to ignore it does. I find this extremely valuable to my mental state.
    T3 complete since Sept 2015.

  9. #9
    Holding it in for 12 hours even if it's a small amount may be the cause of a UTI. Recommended cathing period is 4 hours.

  10. #10
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    Quote Originally Posted by August West View Post
    Holding it in for 12 hours even if it's a small amount may be the cause of a UTI. Recommended cathing period is 4 hours.
    Back to the part I don't understand. I know a guy whose used a condom cath since he was injured in his teens and he's now approaching fifty. I guess I'll ask him if he also caths on top of the condom cath, but I had the impression he did not.
    T3 complete since Sept 2015.

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