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Hi, I have an incomplete spinal cord injury which negatively affects my bladder and bowel function. I have been advised to use intermittent catheters to ensure my bladder can be completely emptied as I have problems with retention and incomplete emptying. I also have detrusor dysfunction diagnosed at Kings College Hospital via video urodynamic analysis.

I find that catheters really help me to empty but I keep suffering with recurrent infections. However, when sent off for analysis there is not enough bacteria to warrant antibiotics so my gp won’t prescribed them, but I’m left coping with all the symptoms.

Is there anything I can do to:-

(a) reduce the risk of infection - I have been observed by the community bladder nurse specialist and she says I’m doing everything correctly and taking the right measures regarding cleanliness but I’m still getting infections .... I also use introducers to reduce external contamination but still get infections

(b) how to deal with infections without antibiotics?

I would be grateful for your advice as I’ve stopped catheterising because of difficulties with infections but am struggling with detrusor failure

Thank you for your help!

The use of daily low dose antibiotics will reduce the risk of UTI associated with self-catheterisation by about 50% - data from the ANTIC trial.

Non-antibiotic preventative strategies would include Methenamine Hippurate, D-mannose, Cranberry supplements and intravesical treatments - however these have not been specifically evaluated in an exclusive ISC population.

Hi,

I am 31 and currently only void bladder through ISC. We went with the lofric primo size 12 catheter when I first was put on these through hospital as I struggled with insertion due to pain. I am better at this now, but still get frequent UTIs despite nightly antibiotic which has recently been changed. I have had a UTI on and off now for the last 2 months but had antibiotics until about 2 weeks ago on top of the nightly ones. Pain and discomfort has settled a bit and rather than painful it is annoying. So I have 4 questions:

1) Is there an easier catheter I can use one that is not so big to carry around as I get very embarrassed and actually tend to not go to the toilet and wait until I get home esp. where there is not a bin within the toilets to dispose of catheter. The lofric primo are not easy to hide.

2) Why am I still getting pretty consistent UTIs again? I had loads then none for a good 7 months and now it is back with a vengeance.

3) Sometimes I get a lot of pain with the pelvic triangle particularly after a failed catheter insertion, this then goes on for a long time. The pain is very annoying and feels like I really need to go to the toilet but on trying cannot do anything and catheter rejected. I have had blood with this also previously.

4) I wake up a lot at night with the feeling of needing to go to the toilet but there is nothing there? The GP put me on Pamsvax XL but to no effect?

There are many different brands of ISC catheter that can be trialled and most people will be able to find one to suit. If you are struggling with insertion then this could be the cause of pain, bleeding and UTIs. I would advise a discussion with your urology specialist nurse who should be able to show you a range of products.