Doctor is telling me I will have constant bladder infections

[skyeg3]

I have been injured 4 years now, I am a 25 year old c6 complete quad. I never had a lot of bladder infections, maybe once a year, but recently I have had 3 back to back infections. The bacterium is klebsiella pneumonium and everytime the doctor prescribes cipro but he puts me on more and more each time. My last course was 10 days long. He tells me that as long as I am doing intermitant caths, I can expect a constant infection. I know this is not true because I have friends who cath that do not have infections. But I also have friends that do have a lot of problems.

Should my doctor be trying different antibiotics? Does anyone have advice?

[funklab]

I have been injured 4 years now, I am a 25 year old c6 complete quad. I never had a lot of bladder infections, maybe once a year, but recently I have had 3 back to back infections. The bacterium is klebsiella pneumonium and everytime the doctor prescribes cipro but he puts me on more and more each time. My last course was 10 days long. He tells me that as long as I am doing intermitant caths, I can expect a constant infection. I know this is not true because I have friends who cath that do not have infections. But I also have friends that do have a lot of problems.

Should my doctor be trying different antibiotics? Does anyone have advice?

Is the doctor you refer to a urologist? If not it sounds like you should probably see one.

Like you my first few years were okay, but my bladder has gone to shit recently. A urologist is much more qualified to suggest other bladder management issues (medications, botox, suprapubic, augmentation, etc, etc) that might help reduce UTIs.

Also, it would probably be useful to evaluate how clean the cath technique is and if that might be contributing.

You are right that just because you cath you will not necessarily have frequent infections, but if I was you I'd get the opinion of a good urologist and see if they have any suggestions.

[SCI-Nurse]

When you perform intermittent self catheterizations you are causing friction on the interior of your urethra each time. If you have had numerous infections of late I would re-look at the type of catheter you are using.

it would be advised to get an ultrasound of bladder and kidney annually to check for bladder and kidney stones and check your kidney for hydronephrosis (fluid around the kidney that is caused by pressure backing up from your bladder)

If you haven't seen an urologist, I would recommend doing so and getting a cystoscopy, especially with numerous UTIs of late. The cystoscopy will look at the lining of your urethra and bladder.

You may want to consider changing the type of catheter you use to an UltraSlick type one. The catheters have a coating on the exterior that when activated by water make them slick and can bypass scar tissue or tiny crevices or tears in your urethra (If they are there).

It is always best to treat acute urinary tract infections with antibiotics BUT in the long term it is prevention of UTIs without using antibiotics that will keep you healthy.

pbr

[hlh]

Do you always do a urine culture before starting antibiotics to make sure the bug is susceptible to CIPRO? That is essential. Also, my Dad's doctor would never keep using the same antibiotic, if it had already failed.

Totally agree with other posters. See a urologist who has experience with neurogenic bladder. You probably need urodynamics, cystoscopty and a renal ultrasound to see if there have been changes in your body contributing to increased risk of infection, like increased bladder pressures or bladder stones. Those can be treated.

it is also worth reviewing your cath technique. Maybe your bladder was healthy enough in the past that you could get away with being sloppy. Maybe now it has changed a little and you can't get away with your current technique anymore.

Also - we have had good luck once in breaking a cycle of 3 UTIs in row of the same bug with a prolonged course of antibiotic. Like 4-6 weeks. Regardless, we also use 2 weeks on antibiotics for every UTI. Always. Our UTIs are called complicated UTIs because we cath and have neurogenic bladders. Infectious disease specialists recommend 2 weeks of antibiotics for complicated infections.

i recommend having a urologist manage your UTIs, not a primary care doctor. Primary care doctors just aren't experienced enough.

as you can see, there are a lot of variables....

[gjnl]

Here are a couple of threads about using Microcyn Technology electrolyzed (super oxidized) water as a bladder instillation to help reduce bladder infections.

http:///forum/showthread.php?133414-...t=hydrocleanse
This is a huge thread. Read the first page, then skip to the last 10 pages or so to get an idea about the product and the process

http:///forum/showthread.php?232394-...t=hydrocleanse

http:///forum/showthread.php?133414-...t=hydrocleanse

All the best,
GJ

[Chaz19]

GJ - I've really appreciated all the information that you put together. If I could make a request for a summary and possible different protocols that can be put in place. I think when you're healthy it's easy to sort through information but during acute stages you/I need something that is simple, accessible and transferable to others (i.e. physicians). Again, thank you for all of your work – just some feedback for mircocyn 101.

[skyeg3]

Thanks everyone for your help. The doctor is a urologist with Kaiser. I will ask him why he has not tried a different antibiotic. I finished a 10 day cipro course 5 days ago and I think my infection is back.

Here is my cath technique, I think its pretty clean but its not hospital approved by any means.

I use a speedicath with the hydrophilic coating. I put a paper towel below my wang to shield it from my pants. I clean the tip with a wetwipe. I attach the catheter to a tube extension while it is still in the wrapper. I hold the catheter by the end and guide it in all without touching any part of the catheter that goes inside me. I don't wash my hands. As soon s I am done i pull it out and the suction empties everything in the tube to the toilet.

My hope is that by doing it this way no infection can ever swim up the catheter and into my bladder as I am sure the extension grows bacteria. I replace it once a week because they are $3 a piece. I suppose I could try twice a week.

Sometimes a pube will get in the way of the opening and the catheter will rub on it as it slides past. I suppose I should trim more.

One thing that i think might help would be more powerful wipes to clean the tip with, like betadine wipes. Do those exist? only thing is I need to be able to use them. I am a c6 and pretty resourceful but have no hand function.

[skyeg3]

When you perform intermittent self catheterizations you are causing friction on the interior of your urethra each time. If you have had numerous infections of late I would re-look at the type of catheter you are using.

pbr

I use speedicath with a hydrophylic coating.

it would be advised to get an ultrasound of bladder and kidney annually to check for bladder and kidney stones and check your kidney for hydronephrosis (fluid around the kidney that is caused by pressure backing up from your bladder)

If you haven't seen an urologist, I would recommend doing so and getting a cystoscopy, especially with numerous UTIs of late. The cystoscopy will look at the lining of your urethra and bladder.

pbr

Thanks for the info. The doctor actually is a urologist. I will ask him to do an ultrasound and a cystoscopy.

[Quadcessible]

Experience over time has taught me that when back to back infections occur it generally is because the 1st infection was not completely cured. 10 day's on CIPRO isn't uncommon. Get the urine cultured to ensure the proper antibiotic is being used, do your best to stay clean while cathing.
Good luck