[jdub]

My experience with UTIs and my recommendation

This post is directed more towards people who cannot cath (with intermittent catheters) themselves. People who have frequent UTIs and use a foley, indwelling, or internal catheter should read this.
As a C5-C6 quadriplegic, I was discharged from the rehabilitation hospital with an indwelling urethral catheter, specifically a French 14 latex Bard catheter. FYI- “French 14 refers to diameter of catheter” After a few months, I began to develop encrustaceans inside the catheter tip when I changed the catheters and noticed increased debris inside the catheter tube. Urine samples revealed an UTI of varying bacterium most notably Proteus mirabilis. During this time, I was taking Hiprex (methenamine hippurate), and drinking excessive amounts of fluids as preventive measures which clearly were failing.. Basically, my body was battling an UTI and bladder infection constantly. I ended up taking antibiotics after every positive urine sample, which cleared my urine for only a matter of a week or two. A few times, I woke with autonomic dysreflexia, resulting from my catheter being clogged with debris and could not drain. These were painful, traumatic, and potentially life-threatening as most of you know. Bladder scans revealed bladder stones and I subsequently underwent a lithroscopy. For a year, we tried to prevent bladder stones which formed due to bladder infection and UTI’s increasing urine alkalinity by irrigating the catheter and bladder with Renaciden producing less than satisfactory results.

After I switched urologists (from my experience not every doctor is equal in ability), we began to explore a better bladder management program: researching techniques, data, and other people’s experiences. Our conclusions and possible recommendations are as follows:
1. Suprapubic Foley’s (catheter enters through an incision between the bellybutton and the penis) reduce the catheter’s exposure and cuts back bacteria as opposed to a urethral catheter. It also has other benefits such as providing an emergency entrance to the bladder through the urethra and no tube comes out of the penis for sex.
2. Silicon catheters are better than latex, since latex is organic which makes the catheter easier for bacteria to form and adhere to. Silver and antibacterial catheters are the best at preventing UTI’s but for insurance reasons they may not be readily available.
3. Changing the catheters every week or two weeks as opposed to 1 catheter per month prevents the bacteria from forming a biofilm which enable encrustaceans and debris build. The idea behind biofilm is somewhat revolutionary in the medical field in regards to bacteria and may be challenged by some doctors, but basically the premise is certain bacteria will grow together and behave more like a multi-cell organism rather than single cell organisms which temper effects of antibiotics and irrigation.
4. Still drink plenty of fluids although cranberry pills or juice is not necessary.

To conclude, a quadriplegic can live their life with an urinary tract infection without major health risks (Note: bladder cancer might be linked to constant bladder infection). However, after I changed my bladder program, the bacteria counts dropped significantly, leaving me infection free, and without an infection or taking antibiotics to battle infection I feel more energetic and generally healthier.

[Suzukicrash]

I used to straight cath 5-6 times a day and never once got an infection, but I was told that the suprapubic is better and a lot easier just to empty your bag once a day. As soon as I got my suprapubic surgery I have got nonstop infections every two weeks and now for the past six months I have been getting a different infection every single week and am constantly on antibiotics orally and sometimes IV (like I am right now).

I'm pretty sure I use rubber or latex catheter size 16 which I end up having to change every couple weeks regardless, to ensure a clean urine sample when I get tested for infection.the dysreflexia is driving me crazy so I am looking into a surgery to bypass the bladder. Do you use those silver catheters? I had heard that silver was good for killing infections.I don't want to do any more surgeries unless it's a last option. thanks for the advice

[jdub]

I use a Kendall Dover silver catheter French 18. However, the silver and other antibacterial compounds only last for a few days (a week or so) therefore it is good to change weekly, biweekly, or so depending on how the urine is.

Straight cathing is considerably more hygenic than any catheter constantly in your system. The problem for some quads is that they cannot cath themselves and end up switching to an indwelling catheter whether suprapubic or urethal.