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    Bladder problems/UTI?s

    I’ve had bladder problems on and off that involves pain from bladder spasms and voiding. Having your pants get soaked while you are trying to live your life or when you’re out in public is not fun.

    I do have Botox bladder injections done every 5 to 6 months, which I?ll be having again in about a month from now. My urologist has said The voiding problem is likely due to bladder spasm in and the need to have Botox injections done again.
    Most days I try to drink around 80 ounces of water. Also, the catheter is changed with a sterile changing kit about every week and a half to two weeks.
    For bladder meds I take - mybetriq er 50 mg, toltordine er 50 mg and pyridium if needed for pain. Also, urologist prescribed sterile saline for bladder flushing 2 to 3 times per week

    With all this said, whenever a culture of my urine is tested it still comes back with the presence of one, sometimes two, bacteria strains will cause an infection. I understand there?s a difference between colonization, which is going to happen with the presence of a SP catheter, and a true infection in the bladder wall. After taking antibiotics my bladder does spasm much less and I have significant pain relief.

    Any suggestions on how I can cut down on the presence of bacteria or what I can use to flush the bladder to help improve some of the symptoms, like the pain and bladder emptying or avoiding.?

    Thanks
    Last edited by KyleP2112; 14 Aug 2019, 12:59 AM.
    C4/5 incomplete, 17 years since injury

    "The trick is in what one emphasizes. We either make ourselves miserable, or we make ourselves happy. The amount of work is the same.” - Carlos Castaneda

    "We live not alone but chained to a creature of a different kingdom: our body." - Marcel Proust

    #2
    Being colonized goes along with having a chronic indwelling catheter. You can minimize UTIs with maintaining a closed system, securing the catheter to prevent pistoning in/out of your urethra (or stoma if an SP), cleaning the catheter outside your body and the meatus/stoma area daily, being sure that there are never dependent loops in your drainage bag tubing, and avoiding raising the bag above your bladder. If you have a SP, also keep any pubic hairs trimmed or shaved 1-2" around the stoma.

    Detrol LA (tolterodine) and Myrbetriq ER (mirabegron) both should help to reduce bladder spasm, but not necessarily with a high bacterial count; UTI or colonization. Wondering if the Botox is still working for you at all. Many find that the effectiveness becomes less and less with repeated injections.

    Why do you need to change the indwelling catheter so often? In the absence of serious clogging, monthly is sufficient, and while it seems counterintuitive, more frequent changes actually increase your risks of UTI.

    What type of catheter are you using? If latex, you may have a latex allergy, which can worsen any bladder spasm due to bacterial count.

    Lastly, have you discussed the possibility of interstitial cystitis with your urologist? It is not common in people with SCI, but can occur. Biopsy of the lining of the bladder is required to make this diagnosis definitively.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

    Comment


      #3
      The last time I had Botox injections will be about six months ago when I get it done again. Last time this was done my bladder was very calm, much more comfortable, and relaxed. Prior to this I had actually gone about or year and a half since having bladder injections done. Hopefully repeating bladder directions with Botox doesn’t lose its effectiveness for me.

      Basically the catheter is changed So often because I find my bladder spasms and discomfort increasing the longer the catheter is in. It does make a lot of sense that changing the catheter more often actually increases the risk of infection.
      I’ve been using the silicone coated elastomer catheter. I did try the duet catheter with two balloons which felt really good. Unfortunately this type of catheter is more expensive and I don’t believe it is covered by my insurance (Medicaid,, Medicare)

      No I haven’t discussed interstitial cytisis with my urologist… Can you tell me more about it? Just looked up this issue on the Internet. I have had urinalysis and a cystoscopy done in March (6 months ago). The urologist reported that my bladder looked healthy though he wasn’t looking for this issue exactly.
      Thanks so much for getting back to me
      Last edited by KyleP2112; 15 Aug 2019, 9:59 AM.
      C4/5 incomplete, 17 years since injury

      "The trick is in what one emphasizes. We either make ourselves miserable, or we make ourselves happy. The amount of work is the same.” - Carlos Castaneda

      "We live not alone but chained to a creature of a different kingdom: our body." - Marcel Proust

      Comment


        #4
        Originally posted by KyleP2112 View Post
        Also, urologist prescribed sterile saline for bladder flushing 2 to 3 times per week
        Why did your urologist prescribe flushing your bladder 2 to 3 times a week? As KLD mentioned I have been using a closed bag system for around 6 months and my recurring UTIs that I was having has decreased. It's not perfect but it's much better.

        Comment


          #5
          I agree. Routine irrigation in the absence of clogging is not recommended, as it usually requires breaking the closed system, and increases your risks for UTI.

          (KLD)
          The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

          Comment


            #6
            Seems like some of the habits I’ve gotten into over the years, when it comes to the urology/bladder/catheter department, really are not so good. It’s never too late to learn…

            So today I have less bladder spasming and pain but as I speak I am still getting wet pants as my bladder is voiding some. Not good
            C4/5 incomplete, 17 years since injury

            "The trick is in what one emphasizes. We either make ourselves miserable, or we make ourselves happy. The amount of work is the same.” - Carlos Castaneda

            "We live not alone but chained to a creature of a different kingdom: our body." - Marcel Proust

            Comment


              #7
              Originally posted by KyleP2112 View Post
              Seems like some of the habits I’ve gotten into over the years, when it comes to the urology/bladder/catheter department, really are not so good. It’s never too late to learn…

              So today I have less bladder spasming and pain but as I speak I am still getting wet pants as my bladder is voiding some. Not good
              What kind of catheter are you using?

              Comment


                #8
                I have been using bard silicone coated elastomer supra pubic catheter, 22FR, 10 mL balloon.
                C4/5 incomplete, 17 years since injury

                "The trick is in what one emphasizes. We either make ourselves miserable, or we make ourselves happy. The amount of work is the same.” - Carlos Castaneda

                "We live not alone but chained to a creature of a different kingdom: our body." - Marcel Proust

                Comment


                  #9
                  Originally posted by KyleP2112 View Post
                  I have been using bard silicone coated elastomer supra pubic catheter, 22FR, 10 mL balloon.
                  Take a look at the Duette Catheter. http://www.poiesismedical.com/produc...tte-tutorials/

                  Comment


                    #10
                    I tried the Duette catheter when the company that sells it shipped a ?sample? to me. Having the second balloon seem to agree with my bladder but the issue is the cost of these catheters.
                    Has anyone had experience with getting their insurance, whether it?s private insurance or Medicaid or Medicare, to pay for the cost of these catheters?
                    C4/5 incomplete, 17 years since injury

                    "The trick is in what one emphasizes. We either make ourselves miserable, or we make ourselves happy. The amount of work is the same.” - Carlos Castaneda

                    "We live not alone but chained to a creature of a different kingdom: our body." - Marcel Proust

                    Comment


                      #11
                      Could the SCI nurse or someone else share their approaches to staying healthy, avoiding infections, while using an in dwelling supra pubic catheter? I have a pretty good idea of the closed system approach, but could someone outlined that as well? Thanks again
                      C4/5 incomplete, 17 years since injury

                      "The trick is in what one emphasizes. We either make ourselves miserable, or we make ourselves happy. The amount of work is the same.” - Carlos Castaneda

                      "We live not alone but chained to a creature of a different kingdom: our body." - Marcel Proust

                      Comment


                        #12
                        Originally posted by KyleP2112 View Post
                        I tried the Duette catheter when the company that sells it shipped a ?sample? to me. Having the second balloon seem to agree with my bladder but the issue is the cost of these catheters.
                        Has anyone had experience with getting their insurance, whether it?s private insurance or Medicaid or Medicare, to pay for the cost of these catheters?
                        GJ used the Poiesis Duette catheter. These catheters were covered by Medicare. His supplier was Edgepark, who accepts Medicare assignment for payment. I know he had frustrations with Edgepark, but learned to manage them, their weaknesses and deficiencies, over time.

                        Comment


                          #13
                          Originally posted by SCI-Nurse View Post
                          You can minimize UTIs with maintaining a closed system, securing the catheter to prevent pistoning in/out of your urethra (or stoma if an SP), cleaning the catheter outside your body and the meatus/stoma area daily, being sure that there are never dependent loops in your drainage bag tubing, and avoiding raising the bag above your bladder. If you have a SP, also keep any pubic hairs trimmed or shaved 1-2" around the stoma.
                          • Closed System: Avoid disconnecting your catheter from the drainage bag. I recommend attaching a new leg bag with extension tubing to the catheter when a new catheter is inserted, and keeping it attached. We used to tape the connector to remind everyone to never disconnect. At night, unstrap the leg bag from your leg and use a short piece of extension tubing to go from the outflow valve of the leg bag to a bedside drainage bag. In the morning, detach and clean the bedside bag with a 10% bleach solution and allow to air dry.
                          • When in bed, avoid having any loops of your catheter drainage bag dependent (below the level of the urine in the bag).
                          • Use a securement device (Statlock is one brand name) to secure your catheter and prevent it from pistoning (sliding in and out of your stoma).
                          • Wash the area around your stoma, the stoma itself, and the catheter outside your body daily with an antiseptic soap. Dry well. Avoid ointments or strong antiseptic solutions applied to the stoma or surrounding skin.
                          • Avoid using a dressing around your stoma if possible.
                          • Keep any hairs trimmed very short at least 1-2" around your stoma.


                          (KLD)
                          The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                          Comment


                            #14
                            Originally posted by KyleP2112 View Post
                            I tried the Duette catheter when the company that sells it shipped a ?sample? to me. Having the second balloon seem to agree with my bladder but the issue is the cost of these catheters.
                            Has anyone had experience with getting their insurance, whether it?s private insurance or Medicaid or Medicare, to pay for the cost of these catheters?
                            My Duette catheters are covered by workers comp.

                            Comment


                              #15
                              Originally posted by KyleP2112 View Post
                              I tried the Duette catheter when the company that sells it shipped a sample to me. Having the second balloon seem to agree with my bladder but the issue is the cost of these catheters.
                              What is your insurance? Medicare covers one indwelling catheter a month; more frequent changes as you cite above may have been the cause of you needing to pay out of pocket.

                              (KLD)
                              The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                              Comment

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