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Urinary tract infections (UTIs) are caused when bacteria invade the bladder or kidneys.  UTIs can also affect the ureters and urethra. People with SCI have an increased risk of developing urinary tract infection, usually caused by incomplete voiding, catheter use, and/or elevated intravesical pressure.

Urinary Tract Infection Causes

Most people with SCI lose regular urinary function and require bladder management to void urine and keep their bladder and kidneys healthy. Additionally, people with SCI frequently require bowel management which provides an opportunity for bacteria from the bowel to enter the urethra and bladder. Bacteria contaminated urine that remains in the bladder for 4-6 hours promotes this bacteria growth.

Bacteria in the bladder can be difficult to eliminate. Frequent and full voiding of the bladder is the best way to evacuate bacteria from the bladder, but people with SCI have more difficulty with frequent urination and fully voiding their bladder, thus increasing the risk of infection.

Intermittent Catheterization

Any time a catheter is inserted into the urethra, it can cause bacteria that normally dwell outside on the skin to invade the bladder. Intermittent catheterization poses less risk for UTI than an indwelling catheter, but it’s important to be sure the bladder is voided usually every 4-6 hours. Not using intermittent catheters in a timely fashion increases the risk of UTI, as does inadequate fluid intake, and failing to wash equipment and hands before use.

Indwelling Catheter (Foley)

Indwelling catheters provide a pathway for bacteria to enter the bladder, increasing the risk of UTI, especially if the catheter is blocked, there is an increased risk of infection for other medical reasons, or fluid intake is insufficient and urine becomes concentrated.

Symptoms of a Urinary Tract Infection

Not everyone experiences the same symptoms of UTI, but the most common symptoms are:

  • Fever
  • Chills
  • Leakage or voiding between catheterizations
  • Increased spasms of legs, abdomen, or bladder
  • Feeling the need to catheterize more often (frequency)
  • Feeling the need to catheterize immediately (urgency)
  • Burning of the urethra, penis, or pubic area
  • Nausea
  • Headache
  • Mild low back pain or other aches
  • Feeling “lousy” or tired
  • Gritty sediment in the urine
  • Mucus in the urine
  • Dark, cloudy or bad-smelling urine

UTI Prevention Tips

Catheters: If you use an intermittent catheter and begin to feel symptoms of a UTI, increase the intervals of time between voiding: 2-4 hours instead of 4-6 hours. Increase fluid intake, and be sure all equipment and hands are clean before using the catheter.

For an indwelling catheter, the most important prevention technique is fluid intake. Urine should be only slightly yellow, or clear. If it isn’t, increase fluid intake some more. If you feel symptoms of a UTI changing your catheter – along with increasing fluids – may help. Catheters can become colonized with bacteria and increase UTI risk. Generally speaking, changing an indwelling catheter once a month should be sufficient, but for people at risk for UTI, changing it more frequently can help.

Cranberry Juice: Drinking cranberry juice, or taking a cranberry extract pill, can help prevent UTIs, as it makes it difficult for the bacteria to adhere to the bladder and colonize.

Drink Water: Adequate hydration is an essential part of preventing UTIs. Water helps maintain body temperature, flushes out bacteria from the bladder, and eases the flow of stool.

Diet and Exercise: A healthy diet and regular exercise routine boosts the body’s immune system, helping to prevent UTIs and other medical complications. A balanced diet that includes protein, vegetables, fruits, and whole grains, and is low in sugar, carbohydrates, and caffeine (or other diuretics) is best to keep the body strong, hydrated, and healthy.

Vitamins: Vitamin and mineral supplements may be helpful, but it is important to consult a medical professional before taking any supplements. Vitamins A, B6, C12, C, D, and E help boost the immune system, as well as Zinc and Magnesium.

This information is not meant to replace the advice of a medical professional. You should consult your health care provider regarding specific medical concerns or treatment.

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