UTI's, Indwelling Catheter Solution?

[Bby-G]

Hello there,

I would greatly appreciate any advice from knowledgable people about what to do with a ravaging UTI from an indwelling catheter while waiting for a urodynamics and cysto to solve the indwelling catheter removal problem.  Having had a UTI myself, I can only imagine the utmost discomfort having one this long must be.

A brief backgrounder to my question.

A quad-male, who has previously voided on own (into condom) until it stopped one day, has had a sphincterotomy (which worked once), has had another sphincterotomy - which didn't work and for the last year has had an indwelling catheter in place because the urologist didn't have another solution hence, has had various UTI's until currently having a more aggressive UTI to send him to hospital for IV-antibiotics.  Meanwhile, the culture that was taken couldn't detect any distinct bacteria so they couldn't supply a specific antibiotic so they gave him a general one Novo-Furantoin to attempt to combat the infection which is not working.  Earlier in the year he was able to ward off infections with general prescribed antibiotics such as Macrobid, Amoxi, Cipro, etc. However now those little bacteria are getting smart and are causing unbearable bodily discomfort and burning sensations. While in the hospital, they did Xrays, ultrasounds, blood work and couldn't find anything "out of sorts" but felt confident that there wasn't a kidney infection. Though, the dysreflexia was starting up they managed that while he was there.

My question now would be, "what next steps would one take?" I know we will probably be going back to the emergency room to get more help, but has anyone had any luck transferring from an indwelling catheter to something else?   We know that the indwelling catheter is the source of the UTI's and would like to go back to condoms but do not know what to do in the meantime.  Also, any advice to help alleviate the current UTI situation would be helpful.

Thanks very much,
Bby-G

[Claire Lewis]

Bby-G,

I'm probably not the most knowledgable person here however I am a nurse and have worked on spinal units.
I just want to clarify as few things so that I know I've got correct information.

I presume the medical team are still investigatiing as to why the chap suddenly stopped voiding .
This involved initally a sphincterectomy which had good short term effect? However was repeated with no effect.
He has since had an indwelling catheter but you did not state which type I.E urethral or supra pubic.

the next step as you ask
1. would need to establish what type of catheter he was using as some people react with latex and different makes (although I'm not entirely sure a particular make would cause a UTI).
2. if it is a urethral catheter then maybe look at having a supra pubic one placed in.
3. it may be that they can only perform a certain amount of sphincterotomy before they will cause trauma to the tissues and therefore the procedure will be useless.
4. has there been trauma caused by the first Sphincterotomy which hasn't been addressed.
5. I'm very weary of people having numerous antibiotics which as you seem to indicate have not really worked and the bugs are becoming more tolerant and therefore useless
6. One drug you haven't mention which is used in the UK quite alot for UTI is Trimethoprim however I have not heard of NOVO or macrobid before and am guessing that these are USA named drugs ( which may be the same as Trimethoprim)

for an interim measure is he drinking gallons of water each day and also is he having Cranberry juice? this is a better non medical way however dont over do it on the cranberry as this can have other long term problems ( if you have way too much)

I need to stress that this is just a few thoughts that I have based on my experience. I'm am in no way a urology expert but I'm hapy to discuss further if you want to message me.

hope this helps a little

Claire

[Bby-G]

Hello Claire,

Thank you very, very much for your thoughts.   It is good to have those questions out in black and white to keep the focus of our pursuit in mind. Sometimes trying to keep the UTI's at bay we forget the actual problem.

I am amazed at how quickly some doctors here conclude surgery is a solution. A second urologist is being seen now as the first one did not seem to investigate the reason why voiding had stopped. It is good to know the second urologist is a bit more determined to investigate further but our medical system here seems a bit slow and we have to wait for a chance at a urodynamics test.  Hence the long wait with a foley/urethral catheter and numerous UTI's. 

If there was a way one could void consistently sitting up (some times it functions, but not all the time which leads to dysreflexia) then the wait wouldn't be such a problem if there wasn't a catheter causing the UTI's.   Intermittent catheters won't work in his work-day scenario.

He is good at keeping up drinking with fluid intake but I guess to a certain extent one can only drink so much (water and cranberry).

We will most defnitely take your suggested questions about the possible causes of voiding stoppage to the urologist. 

Thank you again for your thoughts.

Sincerely,
Bby-G

[Andy]

Hi Bby-G

Welcome to the forums, if you find time plesse add a few lines in 'Introductions' thanks

Claire thanks for such a prompt detailed reply

Andy

[Claire Lewis]

Hi BBY G

Just some other thoughts that have popped into my head.

could it be a prostate problem that has caused a stricture in the urethra and therefore prevented voiding ( I'm sure the urologist would have picked up on this as it's quite a common problem for chaps)

could there be bladder problems at the top where the tube meets the bladder ie tone or muscle  problem.

is you catheter care meticulously and rigorously clean. perhaps a shower gel that has tea tree in it (an natural antispeptic) would help any general nasties on the body which may compromise. ( I'm sure this is probably not needed but every little helps)

is it a urology problem?? has something changed neurologically that may have stopped voiding. is your neurosurgeon aware of current problems. I know that wont help whats happend but might at least answer why it's happened.

brains frazzled for a while now!

speak soon

claire

[Bby-G]

Hello Claire,

We've been busy going to doctors and hospital as a UTI had gotten out of hand, and haven't had a moment to check this site.  Thank you for your ideas!  I am definitely going to bring them up in discussion with the urologist. This is all very timely as we have completed a cysto and a urodynamics test in the last few weeks and we're supposed to have a follow-up appointment with the urologist once everything is done. It will be interesting to find out what he concludes or suggests.

Can hardly wait for the appointment, these UTI's are just agony to watch one suffer through, which I am know is hardly comparable to having one.

Keeping my fingers crossed. I'll let you know what happens in case it generates more ideas on your side. 

Thank you very, very much for your thoughts.
Bby-G