Dr. Michael Kennelly from the United States and colleagues presented on factors that may predispose someone to develop a UTI. Risk factors include among others having diabetes, and bowel dysfunction. Other causes include bacteria inserted by product use for catheterization into the bladder, urethral and bladder trauma from product, non-hygienic procedure, low fluid intake and voiding frequency, post void residual urine left on the bladder, previous UTIs, bladder and kidney stones, possible BOTOX injections and others. The authors suggest that simple steps such as hand washing before catheterization is key to avoid infections.
Professor Jean Jacques Wyndaele, a Urologist, spoke about the value of assessing sensation in the bladder after SCI. Bladder sensations include bladder fullness, contraction, pain due to inflammation, stones. Many patients do have some bladder sensation and this is important the muscle in the bladder can be trained and made stronger for bladder emptying. Complete bladder emptying is important to prevent UTIs.
Dr. Rami Al-Ahmar, a doctor in Jordan, spoke about the need to avoid the use of Foleys and indwelling catheters, prevent constipation and have a stable bladder management routine as a way to reduce bladder pressure and prevent infections. Bladder augmentation surgery can be done when leakage due to high volume is a problem but this procedure is not recommended.
Dr. Fiona Stephenson highlighted the importance of intermittent catheterization to lower bladder pressure and risk for UT (lemon juice. “It is important to draw the catheter slowly so there is no urine left in the bladder to prevent UTIs”. To avoid infections sip fluids throughout the day and take vitamin C (lemon juice) if symptoms worsen seek medical help.
Denise Tate, PhD, ABPP, FACRM
