Urinary Tract Infection (UTI)
Urine that is held too long before being eliminated often leads to infections of the bladder or kidneys. Although many people can have a UTI without any symptoms, there is usually at least one sign or symptom.
Urinary Signs & Symptoms of Infection
- A burning sensation when urinating
- Feeling the need to urinate more often than usual
- Feeling the urge to urinate but not being able to
- Leaking a little urine
- Foul smelling urine
- Cloudy, dark or bloody urine
- Chills & fever
- Pain
- Worsening of spasticity, weakness or neurological symptoms may be the first sign of a urinary tract infection
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.
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.
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.