Urinary Tract Infection (PN, April 2002)

[SCI-Nurse]

This is from the April 2002 Paraplegia News:

Urinary Tract Infection
The most common problem of the genitourinary (GU) system is urinary tract infection (UTI). Changes in urinary function are often subtle, but you are your own best advocate to prevent UTIs.

The neurologically normal adult population seldom has UTIs. SCI/D, however, causes an interruption in the nerves sending information to and receiving information from the brain. In some people the external sphincter muscle may be spastic; in others, the bladder may be flaccid (lifeless).

In either case, you need help eliminating urine. Otherwise it can back up through the ureters, damage the kidneys, and lead to infection.

Signs and symptoms of a UTI are not usually the same for SCI/D patients as for others. Urinary urgency, pain, and burning during urination are common complaints with non-SCI/D clients. SCI/D patients may experience chills; fever; flank pain; hematuria (blood in urine); urinary frequency; cloudy, thick urine; smelly urine; sediment in the urine; increased spasticity; and autonomic dysreflexia.

If you have a UTI, you may experience all or some of these symptoms. Contact your physician or get to your hospital's emergency room. Treatment usually consists of increasing fluids (an IV may be started), antibiotics, and possibly insertion of a Foley catheter.

If you have an infection, take all antibiotics as they are prescribed, for the entire recommended time. Maintain an adequate diet, increase fluids, and routinely empty the bladder. Notify your physician if your condition worsens. Be sure to have a follow-up examination.

You are the first line of defense against UTIs. Maintain good fluid intake to "wash out" bacteria, and routinely empty the bladder. These are primary ways of keeping your bladder clear of infection.

Be alert to any change in bladder function or urine appearance and report it to your physician. Learn and practice correct procedures of intermittent catheterization. If an indwelling catheter is necessary, make sure you and your family understand how to maintain perineal hygiene and correctly care for your catheter.

Regular medical examination is important. Discuss your concerns with your healthcare provider. Review all prescribed and nonprescribed medications. Have periodic microscopic examinations every three to six months or if you see pus or blood in the urine. Have a blood sample taken about every six to nine months to see if your kidneys are working correctly. And finally, annual evaluations usually include an x-ray of the kidneys, ureters, and bladder (KUB) and urodynamic evaluation.

©2002 PVA. May not be reproduced without permission. The above is taken from an article appearing in the April 2002 PN/Paraplegia News.