It is common for people with an SCI to rely on a form of catheterisation to empty their bladder. This increases their risk of urinary tract infections, but there are many ways to help prevent the problem
After suffering a spinal cord injury, most people rely on a form of catheterisation or a bladder management programme, which puts them at great risk of urinary tract infections (UTIs). When individuals rely on a bowel management programme too, UTIs could be caused by bacteria from stool entering the bladder as it is being emptied.
People with full functional bladder control are able to empty their bladder completely and rid it of all bacteria. However, for many people with SCI it is impossible to empty the bladder completely – even with a good bladder management programme. Thus bacteria remain in the bladder and could result in a UTI.
The Model Systems Knowledge Translation Center points out some of the more vulnerable groups: “People with SCI who use an indwelling Foley or suprapubic catheter may be at higher risk for UTI than those who use a clean intermittent catheterisation technique or have an external sheath or condom catheter.
“Women may be at a higher risk for UTI than men, as the female urethra is shorter and located closer to the anus. This can make it easier for bacteria from the colon to enter the bladder through the urethra.”
Single-use catheters
The first step in lowering the incidence of UTIs is therefore to rely on single-use intermittent catheters, preferably those that include some form of lubrication (so that there is no need for the device to come into contact with potentially contaminated substances). Moreover, be sure never to reuse these catheters.
It is also important to make sure that your hands or those of the person performing the catheterisation are clean before beginning the process.
Prevent a full bladder
It is important to empty your bladder on a regular basis and ensure that it is completely empty, as this will help prevent overdistention of the bladder as well as bladder and kidney stones. When there is too much urine in the bladder, it overstretches, which could result in damage to the walls. Excess sediment and calcium can also form in the urine if the bladder is too full.
Hydrate
Be sure to drink lots of water to stay hydrated and help your body flush out bacteria, maintain body temperature, ease the flow of stool through the bowel and
keep skin healthy. The colour of your urine can assist in determining whether you are drinking enough water. The lighter the shade of yellow, the more water you
are consuming. If the colour is bright or dark yellow, you are not drinking enough water. Be sure to consult a
doctor if unsure, or if your urine is any other colour than yellow.
Healthy diet and exercise
While the food you eat and your activity levels do not necessarily relate directly to preventing UTIs, they do assist your body in fighting bacteria and infections. Make sure to eat balanced meals full of the essential vitamins, and consult a health professional before you start taking any form of supplements.
Good hygiene
Cleanliness is key to preventing the spread of bacteria. Always wash properly both before and after bladder and bowel management, and after accidents.
Overall, it’s important to look out for early signs of infection or symptoms of UTI. Early signs of infection include gritty sediment or mucus in the urine, and dark, cloudy or foul-smelling urine.
Symptoms of a UTI include fever, feeling tired, chills, muscle spasms, nausea, headaches, lower back pain, and autonomic dysreflexia if the SCI is at T6 or above.
