Bladder problems/UTI?s

[KyleP2112]

I’ve had bladder problems on and off that involves pain from bladder spasms and voiding. Having your pants get soaked while you are trying to live your life or when you’re out in public is not fun.

I do have Botox bladder injections done every 5 to 6 months, which I?ll be having again in about a month from now. My urologist has said The voiding problem is likely due to bladder spasm in and the need to have Botox injections done again.
Most days I try to drink around 80 ounces of water. Also, the catheter is changed with a sterile changing kit about every week and a half to two weeks.
For bladder meds I take - mybetriq er 50 mg, toltordine er 50 mg and pyridium if needed for pain. Also, urologist prescribed sterile saline for bladder flushing 2 to 3 times per week

With all this said, whenever a culture of my urine is tested it still comes back with the presence of one, sometimes two, bacteria strains will cause an infection. I understand there?s a difference between colonization, which is going to happen with the presence of a SP catheter, and a true infection in the bladder wall. After taking antibiotics my bladder does spasm much less and I have significant pain relief.

Any suggestions on how I can cut down on the presence of bacteria or what I can use to flush the bladder to help improve some of the symptoms, like the pain and bladder emptying or avoiding.?

Thanks

[SCI-Nurse]

Being colonized goes along with having a chronic indwelling catheter. You can minimize UTIs with maintaining a closed system, securing the catheter to prevent pistoning in/out of your urethra (or stoma if an SP), cleaning the catheter outside your body and the meatus/stoma area daily, being sure that there are never dependent loops in your drainage bag tubing, and avoiding raising the bag above your bladder. If you have a SP, also keep any pubic hairs trimmed or shaved 1-2" around the stoma.

Detrol LA (tolterodine) and Myrbetriq ER (mirabegron) both should help to reduce bladder spasm, but not necessarily with a high bacterial count; UTI or colonization. Wondering if the Botox is still working for you at all. Many find that the effectiveness becomes less and less with repeated injections.

Why do you need to change the indwelling catheter so often? In the absence of serious clogging, monthly is sufficient, and while it seems counterintuitive, more frequent changes actually increase your risks of UTI.

What type of catheter are you using? If latex, you may have a latex allergy, which can worsen any bladder spasm due to bacterial count.

Lastly, have you discussed the possibility of interstitial cystitis with your urologist? It is not common in people with SCI, but can occur. Biopsy of the lining of the bladder is required to make this diagnosis definitively.

(KLD)

[KyleP2112]

The last time I had Botox injections will be about six months ago when I get it done again. Last time this was done my bladder was very calm, much more comfortable, and relaxed. Prior to this I had actually gone about or year and a half since having bladder injections done. Hopefully repeating bladder directions with Botox doesn’t lose its effectiveness for me.

Basically the catheter is changed So often because I find my bladder spasms and discomfort increasing the longer the catheter is in. It does make a lot of sense that changing the catheter more often actually increases the risk of infection.
I’ve been using the silicone coated elastomer catheter. I did try the duet catheter with two balloons which felt really good. Unfortunately this type of catheter is more expensive and I don’t believe it is covered by my insurance (Medicaid,, Medicare)

No I haven’t discussed interstitial cytisis with my urologist… Can you tell me more about it? Just looked up this issue on the Internet. I have had urinalysis and a cystoscopy done in March (6 months ago). The urologist reported that my bladder looked healthy though he wasn’t looking for this issue exactly.
Thanks so much for getting back to me

[HACKNSACK44]

Also, urologist prescribed sterile saline for bladder flushing 2 to 3 times per week

Why did your urologist prescribe flushing your bladder 2 to 3 times a week? As KLD mentioned I have been using a closed bag system for around 6 months and my recurring UTIs that I was having has decreased. It's not perfect but it's much better.

[SCI-Nurse]

I agree. Routine irrigation in the absence of clogging is not recommended, as it usually requires breaking the closed system, and increases your risks for UTI.

(KLD)

[KyleP2112]

Seems like some of the habits I’ve gotten into over the years, when it comes to the urology/bladder/catheter department, really are not so good. It’s never too late to learn…

So today I have less bladder spasming and pain but as I speak I am still getting wet pants as my bladder is voiding some. Not good

[HACKNSACK44]

Seems like some of the habits I’ve gotten into over the years, when it comes to the urology/bladder/catheter department, really are not so good. It’s never too late to learn…

So today I have less bladder spasming and pain but as I speak I am still getting wet pants as my bladder is voiding some. Not good

What kind of catheter are you using?

[KyleP2112]

I have been using bard silicone coated elastomer supra pubic catheter, 22FR, 10 mL balloon.

[HACKNSACK44]

I have been using bard silicone coated elastomer supra pubic catheter, 22FR, 10 mL balloon.

Take a look at the Duette Catheter. http://www.poiesismedical.com/produc...tte-tutorials/

[KyleP2112]

I tried the Duette catheter when the company that sells it shipped a ?sample? to me. Having the second balloon seem to agree with my bladder but the issue is the cost of these catheters.
Has anyone had experience with getting their insurance, whether it?s private insurance or Medicaid or Medicare, to pay for the cost of these catheters?