17 replies to this topic

[A trophy guy]

Hi again. This is something that has been at the back of my mind for some time; is it possible to have a UTI and never even know it? I mean, can you get one, have it run it's course and then return to normal health?

I ask because as far as I know, I have never had a UTI. However, I also do not cath. I never have, I have always used either a valsalva or crede (which I adopted as I got older) method for voiding. I do have sensation and I can feel when I need to go. I also have control so I never wet myself or wet my bed.

I've never really had any sort of issue with peeing basically. What I have had issues with are urologists. I have actually had to leave out of a urologists' office mid-app't due to this doc's attitude towards me and my method of voiding. While he found only about 130 ccs of residual urine in my bladder after I voided and had my bladder scanned, AND the fact that I had never had any problems in the (at that time) ten years I had been in a chair; this dr. insisted that I was doing the wrong thing by not using a catheter.

He waved off my concerns, saying that sooner or later I would start having problems.

Well that just seemed so messed up to me. I have read so many shitty stories about the problems created by the necessity of catheters. As well as the sexual problems catheters create. Why would I voluntarily go down that path when I have been so effin lucky to be totally problem free for the entire time I have been paralysed? On top of the fact that I would be able to feel it?

I didn't expect to blab like this when I started with this question. I was hesitant to bring this up because I know that so many of you guys deal with so much when it comes to this crap; I didn't want anyone to be offput in anyway. I don't want anyone to misunderstand me.

Anyway, all this talk of UTIs has put the thought in my head; could I ever be dealing with a UTI and not know it? Or mistake it for something else? I also get my urine/blood tested on a routine basis every 6 months and no infections/bacteria have ever shown up there.

One thing that has always confused me, on the topic of residual urine, is the matter of sterility. Now if there is some urine left in the bladder after one voids, regardless of the method used, it is urine that has never left the bladder. Urine is sterile until it leaves the body. So that [i]sterile, residual urine gets combined with the urine that gets voided out in the next void, and so on and so on. At no point does any non-sterile urine re-enter the body; the urethura or the bladder. So how is it considered a risk for infection?




I have no idea why that big chunk of my post is in italics. I didn't do that and I can even seem to fix it. Weird.

Edited by A trophy guy, 06 November 2011 - 07:40 AM.

[ajl338]

Surely that is rubbish
Lots of able bodied people get UTI's some people are just more prone that others (to do with the length of your tract apparently) If it works for you then its ok.

If you got an infection and your body delt with it, is this necessarly a problem? I was thinking the same thing but if i am strong enought to fight it off then i think that is ok. The problem for utis is if you are unable to fight it and from what i can work out if your bladder is filling to much and putting pressure on your kidneys.

I have had a lot of crap with doctors and now just do what I think best. Catheters bring another set of problems such as potential damage and the nurse who taught me to cath said I had to be very clean when i did it and it brought increased risk of uti's. Since then I have done two 10 day wild camping expeditions, with no running water (except the river) and peed in various other wild places without a problem. I think they are programmed to tell you the worst case sceniro.

[Vanessamaee]

Im not really sure what "shitty" stories you have heard about having to use a catheter. I have to cath every four hours, I can't tell when I have to pee and I can't control me pee at all expect for when I am cathing, I can then push harder to increase my flow.

I've had 3 UTI's in the past 6 months (since my injury) 2 were when I was in the hospital and wasn't even cathing myself, then the third one was when I was home and I didnt realize I had a UTI until it got so bad I couldnt cath due to a mucus plug. I ended up having to go to the emergency room which at 10pm at night, was not a fun trip.

How ever as far has HAVING to be sterile, I find it a bunch of BS. I think they stress it so if you get a uti you cant blame them. but no matter how sterile you are, your still inserting a foreign object up your pisser, risk of infection is always there. But cath or not, anyone is able to get a uti. I have a friend who is totally able bodied and I swear it seems like every other month she has a uti or kidney stone or something.

If your shiity story is refering to how sterile you "have" to be. I wouldnt agree. I too went on a camping trip, only for a weekend though, and had no running water. I peed in empty beer bottles when out on the lake, empty water bottles during the long car ride and off my chair right into the grass if there wasnt a bathroom around. I am semi cautious about touching the tip im inserting, but as far as sterile wipes, gloves, lube etc. I havent dont that since the hospital and they were making me do it there, ad havent had any issues.

But peeing without a catheter would be awesome. So if it works for you. keep it up. Im so sick of Doctors.

[Califanna]

In answer to your question, yes you can have a UTI and not know it, especially for men. As for working it out of your system, I have heard that some people can do it by drinking vinegar and boat loads of Vitamin C. I myself always need some antibiotics to get rid of one, but I am a woman.

The biggest issue is the bladder and kidney stones that can develop over time when you are having UTI's over and over again. I have experienced both and did not know it until I saw blood in my urine.

If you review the symptoms to look for on this site, you can diagnose yourself. As for curing a UTI yourself, it is possible and you may be one of them who has the ability to do it yourself. Holistic remedies are available.

[edlee]

TG,, your urologist is a dick. If you don't NEED to cath,, why in hell would he tell you that you should,,, unless he was some kind of sadistic bastard?

Yes,, your body CAN fight off some UTIs. Not all,, of course,, but your chances,, as a male,, are pretty low with regard to getting one in the first place, if you aren't shoving stuff up your Johnson.

I'm certainly not a doctor,, nor a scientist of any sort,,, but having gone through seven years of cathing and UTIs,, I think I have seen some flaws in the general reasoning given BY doctors, about UTIs and cathing. My thought is that it isn't bacteria on the catheter being inserted that causes most infections,, but bacteria already in the eurethra being pushed into the bladder BY the clean catheter. To be very blunt,, most UTIs are caused by ecoli,, which are prevelant in our feces. Bacteria can move from one place to another within a very thin layer of water. Most who use a wheelchair find that their asses sweat a lot. So, it follows,,, in my mind, at least,,, that their is the possibility that the ecoli in your eurethra get there by moving through that layer of sweat from your anus to your eurethra,, where they are pushed up the line to the bladder.

Most males ,, who can urinate normally,, don't have UTIs,, because the bacteria is flushed out regularly. Women,, have a much shorter eurethra than do men,, so their incidence of infection is higher.

Now,, I may be full of it,,,, but a lot of this makes sense to me. Another question occurs to me,,,, what amount of residual urine do ABs retain after they void??? I wonder if anyone ever bothered to check. Surely there must be SOME left in there.

Questions,,,, I got a million of em. Not so many answers, tho.
ed

[ajl338]

apparently when i went for urodynamics tests anything under 300ml is ok, I thought they were worried about back pressure into the kidneys.

i am also confused becuase when originally i asked about a foley cath and was told no because it carried too many risks of infection. I am away at the moment with one in and this time i asked was told it is ok,the manufactures say it can stay in 3 months but I have just been doing the week or so. Also I get a bit of blood in the urine everytime i use a foley cath but i figured that was just part of it. Since i am not under the care of anyone it is hard to ask questions.

I did get sent to london to talk about electrical stimulation implanted in my spine, but since i wasnt going to allow anyone need my spine I didnt do the follow up appointment.

[A trophy guy]

edlee, on 06 November 2011 - 07:04 PM, said:

TG,, your urologist is a dick. If you don't NEED to cath,, why in hell would he tell you that you should,,, unless he was some kind of sadistic bastard?

Yes,, your body CAN fight off some UTIs. Not all,, of course,, but your chances,, as a male,, are pretty low with regard to getting one in the first place, if you aren't shoving stuff up your Johnson.

I'm certainly not a doctor,, nor a scientist of any sort,,, but having gone through seven years of cathing and UTIs,, I think I have seen some flaws in the general reasoning given BY doctors, about UTIs and cathing. My thought is that it isn't bacteria on the catheter being inserted that causes most infections,, but bacteria already in the eurethra being pushed into the bladder BY the clean catheter. To be very blunt,, most UTIs are caused by ecoli,, which are prevelant in our feces. Bacteria can move from one place to another within a very thin layer of water. Most who use a wheelchair find that their asses sweat a lot. So, it follows,,, in my mind, at least,,, that their is the possibility that the ecoli in your eurethra get there by moving through that layer of sweat from your anus to your eurethra,, where they are pushed up the line to the bladder.

Most males ,, who can urinate normally,, don't have UTIs,, because the bacteria is flushed out regularly. Women,, have a much shorter eurethra than do men,, so their incidence of infection is higher.

Now,, I may be full of it,,,, but a lot of this makes sense to me. Another question occurs to me,,,, what amount of residual urine do ABs retain after they void??? I wonder if anyone ever bothered to check. Surely there must be SOME left in there.

Questions,,,, I got a million of em. Not so many answers, tho.
ed

This makes a lot of sense to me, too.

[Trinity]

300mls sounds like an awful lot, I was told it should be under 100mls
As Ed said any bacteria is normally flushed out with the urine but if there is a high residual and therefore incomplete emptying then bacteria can take hold
If you are concerned ask them to dip your urine and see if there is any sign of infection.
As long as you're clear and your bladder pressures aren't high enough to cause reflux into the kidneys then obviously whatever you are doing works for you. If your bladder pressure are high then you may need to rethink

[MTB John]

I was told 50ml..

I have full (I think) sensation and I cath. You get used to, it certainly hurts a lot less then when someone else does it. But as said above if you don't have to, why would you.

As for Urologists, I found the nurses to be a much better source of information.

Now back to the original question - I've been wondering this myself a lot lately.
Sometimes I get the urge to go again straight after cathing (uti symptom), but the next time I cath things are back to normal. I never get any other symptoms. You can buy the dipsticks in the UK and I plan to buy a pack. Doctors here insist on running the full lab test and I don't want to wait for that.

Do you drink a lot of water? I do and am told this helps reduce the risk.

This is a rather rambling response..

[lavenderthistle]

I've had UTI's with blood present and never known....then again I am a rather odd bird. I had them pre-injury, I had them in the myelopathy phase pre-surgery..I've had a few post injury. I've (Knock on wood) been clean the last few months, but i pee on a timer or when I finish a glass of water I give the bathroom a go. No one ever told me that holding it for an epically long time was a bad thing.....now that Lav has shared way too much!! I take cystex if I notice the least bit of difference in bathroom habits.

Maybe one day life will be exciting and we can have urine tests at home like pregnancy tests...and now a totally irreverent, irresponsible and uncalled for comment.....as far as sex goes, one would hope the catheter would be removed before sex, but to each his own!! (it's a joke I warned you) ok I obviously need sleep!!!

[Tetracyclone]

ATG,

First, I love your forum name. it is so you.

As others have said, a good urologist will tell you "if it ain't broke, don't fix it." The man you went to is a danger to patients.

130 ml retention after peeing is a bit high by clinical standards used in my area, but again, if you are not getting sick and your biannual tests show no problem, it works for you. I remember a woman posting here 2 years ago with a story that she had been cavalier about cleanliness (she had to cath) for 20 years and never had a problem. Suddenly her health seemed to decline, evidenced by the fact that her immune system quit handling all the dirt she threw at it with random unwashed caths in public bathrooms, and she began getting regular UTIs that she could not shake.

The belief that urine is sterile is illogical. If it were completely sterile, then you could put it in a sterile bottle, stick it on a shelf, and it would still be without odor 5 days later. That is not the case, is it?! There must be a few random bacteria getting into urine inside the body.

My own body: I can usually expel all but 80-100 ml, which might be enough to avoid cathing, but my own bladder gets very uncomfortable and contentious after anywhere from 4 to 8 hours without cathing, depending on the day and how stressed my body is. How do I know I needed to cath? Because it is such a huge relief when I finish. Duhh.

People who never cath can get UTIs just from not drinking enough. My husband (AB) had one two years ago and his only symptom was being a bit tired.

I know another AB who, as a young woman, developed chronic UTIs because she only emptied her bladder 2/day. She ended up having to cath for 2 years to get her health back.

Our immune systems handle random bacteria... until they don't. We have to be aware that our bodies change over time.

MTB, I sometimes get "an urge to go" after cathing, yet do not have UTIs. For now I have banished them successfully with use of Microcyn. I think of the urge as this irritable urethra. It seems to correlate with post bowel program, there being backed up stool, or simply irritable urethra because I just irritated the poor thing by sticking a tube up it. It goes away in 15 or 20 minutes.

Lastly, research suggests that much contamination does come from the urethra itself. It will retain a few drops of urine that become breeding ground for bacteria. Also, urethras can become "colonized", which means the bacteria embed themselves in the wall of the urethra. The study from which this comes was not terribly large, as there never is much research money for such things. Patients who flushed urethras with saline did about as well avoiding UTIs as those who flushed with Microcyn.

[A trophy guy]

Thanks so much. That was an extremely informative post.

[xxm]

Trophy,

I've been voiding by Crede and Valsalva for more than 36 years with very rare UTI - one in 3-5 years. Crete was effective in the first 5-10 years after injury and then I changed to valsalva. In the last 3 years I have some leaks when my bladder was not fully empty after voiding.I do have regular examinations of my urine/blood but I have never visited urologist because I don't want to cath - at least for now. May be in the future I will change to IC but I want to postpone this as long as I can. You can PM me if you want to discuss this matter.

Regards
Rudy

[Scorpio81]

Well, I reckon that as long as you're not leaking, suffering with UTIs, getting bladder spasms and back pressure to the kidneys, then it's all good You're clearly happy with the way you manage your bladder, and your scans and tests show you're healthy, so there's no reason to rock the boat.

I did crede for many years, before I even knew there was a name for pushing down on your tummy to empty your bladder, only with me it wasn't entirely successful as I still suffered with spasms, leaking and bed-wetting. It was only when I finally plucked up the courage to see a urologist and had urodynamics and a renal scan done did I discover how much I was retaining (about 300ml) and just how much pressure was going on inside my bladder, and that it had caused dilatation of the collecting systems in my kidneys! I was advised to start self-cathing and to take medication to calm the spasms, so I did and I can honestly say it changed my life - I was in control of my bladder for the first time instead of the other way around Unfortunately everything started declining a few months back, but i'm planning on having botox at some point so hopefully i'll get back on track.

That's just my experience though - we're all different and have different ways of managing. The aim of the game is to keep yourself as healthy as possible and find ways of managing your bladder that suits you and your lifestyle - sounds like that's exactly what you're doing, so sod what the doc says!

In answer to your question 'can you have a UTI and not know it', in my experience, yes you can. My urine sometimes shows nitrites - i've had a nurse mention it when i've had to have a sample checked for other reasons a couple of times, and she said I really should have some antibiotics for it, but i'm really not keen on taking them unless I really have to. Sometimes I start getting mild symptoms, but manage to flush it out by drinking lots. However, that approach doesn't always work - it can seem like it's gone, then all of a sudden it gets bad really quickly, so i'm generally quite vigilant. I've heard that asymptomatic infections shouldn't necessarily be treated - people who use any type of catheter will always show some level of bacteria in their urine. As for the sterility of urine, i'm not so sure, but I do know that urine that's retained in the bladder longer than it should 'stagnates', and somehow that's when bugs multiply. I'd not heard of bugs living in the urethra, but that makes sense actually. I think people with 'normal' bladder function are able to completely empty each time they pee, or at least retain very little. I was told that residuals higher than 100ml isn't good and can cause back pressure to the kidneys.

[Denna]

I have heard so many different stories from urologist its gotten scary to think if they know what they are talking about. I have heard that if there is left over urine then you can get and infection. Also I have heard to not let anyone do a dip stick test cause it will always show up as positive for uti for us sci. That they have to do a culture on the urine. Then I heard the opposite. Then I heard your suppose to get your bladder tested every 6 months for the amount of urine it will hold as it will reflux into the kidneys. And that over time your bladder will hold less and less. And dont even get me started on the different ways I have been told to clean a catheter. Its great you have never had a uti. trust me you will know if youve had one. I have had them before and after my injury.

[Kwag_Myers]

My GP was going over my lab tests with me earlier this year and mentioned that bacteria always shows up in my urinalysis. He also said that anyone not familiar with my situation would diagnose a UTI, even though I don't have any symptoms. Occasionally, I'll have cloudy urine, but not for an extended period. Usually, a glass or two of water clears it right up.

So, to answer the question, yes you can have a UTI and not be aware of it.

[wheels1974]

Your much better off being your own Doctor. You done the right thing, trust me. 130cc as a residual is slightly high, I was always told under 100cc.
I have been a C4 Quad for 24 years and I have always been on condom caths. Unfortunately things have now changed over the past 5 months as I stopped passing urine, so I now have a indwelling Foley catheter which I get my father to change every 6 weeks.
Having a Catheter should only be used as a LAST alternative. Although I must say so far it's been fantastic, apart from today where I had a dilemma that shocked my father and myself, because he blew up the balloon while it was still in my urethra which caused quite allot of bleeding, I called my Urologist straight away and as long as the blood doesn't clot in the urine and doesn't come out my urethra to much then it should heal. God willing it will reduce over the next few days as I am still worried.

Re: Your question: "Is it possible to have a UTI and never even know it?" 100% YES, while I was on Condom Caths, every time I took a urine sample I ALWAYS had some sort of UTI and 80% of the time I NEVER knew I had a UTI to begin with, in most cases the urine samples were done due to standard testings. The only time I would treat a UTI is when I became symptomatic to it or if the UTI was the type that produced stones, otherwise don't bother treating them.

All the best.

[dom]

 A trophy guy, on 07 November 2011 - 06:49 AM, said:

Thanks so much. That was an extremely informative post.

Hi ATG good answers here, i always was under the assumption that women were more prone to utis than men? also with the urethra bit surely those who cath must have a 'dry' one all the time which to my mind can't be good? unless they have the odd urge incontinence which may be a good thing as it does clean the tubes a bit?
Yes i should imagine it is possible to have a uti without really knowing it, maybe feeling off sorts for a while