Urinary Tract Infection Considerations

Is there any way to avoid urinary tract infections?

There are certain strategies in the areas of diet, increased fluids, hygiene, and catheter care that can help to limit urinary tract infections. Monitoring fluid intake is important. Some people with MS have reported that using cranberry juice or cranberry extract in gel cap or tablet form, or avoiding caffeine, can decrease infections.

Wiping the urethral area several times a day and frequently changing incontinence pads as they become wet can minimise the amount of bacteria. Keeping pubic hair clipped is helpful. When cleaning the anus (back passage) wipe towards the lower back so contaminants do not get wiped in the direction of the urethra.

Wearing gloves is advised when caring for any area that may be open or exposed to bodily fluids. Of course catheters must be properly cleaned or they can become a vehicle of infection.

How are urinary tract infections diagnosed and treated?

Symptoms of a UTI can be very similar to bladder problems caused directly by MS (for example, urinating frequently), so a GP or nurse will need to test for infection. Some people seem to get more infections than others, even with exemplary hygiene. People doing intermittent self-catheterisation are likely to have bacteria in their urine that can be seen in the laboratory, but this is different from having a real infection.

The diagnosis of a urinary tract infection is made by a urinalysis and a urine culture in which urine is collected in a sterile manner and tested for the presence of bacteria. An antibiotic will be prescribed, and symptoms will usually go away 1 to 2 days after starting the medication. It is essential that the medication be taken as directed for the complete time period indicated.

If someone routinely takes medications to control urgency or urinary incontinence, these medications might be stopped while there is an infection.

What should I do if there is leakage around the Foley or suprapubic catheter?

Strategies to control leakage will depend on the cause of the problem.
Blockage check to see if the catheter is draining properly. If there is no urine in the drainage bag, the catheter may be obstructed, so check for kinking of the catheter or drainage tubing.

Bladder spasms increase fluids to dilute urine. Ask about medications to reduce spasms, such as Detrol® or Ditropan® UTI If you suspect an infection, advise your health care professional.

Constipation A Fleet® or mini-enema may be necessary. Talk with your health care provider. Note: Increasing the size of the catheter will probably not stop leakage and may cause serious injury to the urethra.