5 Ways to Reduce UTI’s

Urinary tract infections (UTIs) are the second most common infection in the body, and in some cases, it can lead to serious problems if left untreated or not recognized. Urinary tract infections are most commonly an infection in the bladder, a part of the urinary system that stores urine until it is ready to exit the body. In more severe cases, the kidneys can also become infected because of a urinary tract infection. More rarely, other parts of the urinary system can also become infected from UTIs. In the most basic sense, bacteria is what causes this uncomfortable infection, and women get urinary tract infections more commonly than men, due to women having shorter urethras (a part of the urinary system that connects the bladder and where urine exits the body).

Symptoms and further complications because of a urinary tract infection are dependent on where the infection is located in the urinary system. Urinary tract infections in the bladder can lead to symptoms such as a strong, persistent urge to urinate; burning when urinating; cloudy urine; blood in the urine; and pelvic pain, especially in women. Infection of the bladder specifically can cause symptoms such as blood in the urine, discomfort in the lower abdomen, and pelvic pressure. A UTI in the urethra, while rare, can result in symptoms such as discharge and burning with urination to occur.

In the most serious form, infection in the kidneys can lead to nausea; vomiting; upper back and side pain; shaking and chills; and high fever. If the infection does reach one or both of the kidneys, the bacteria can cause damage that will permanently reduce kidney function. Especially in individuals who experience kidney problems already, this is quite a serious problem. In the worst situation with the smallest chance, the infection can also reach the bloodstream through the kidneys, which allows the bacteria to potentially reach other organs.

Because urinary tract infections in the bladder are common to happen, knowing how to prevent UTIs is important. Below are 5 ways to reduce these infections:

1. Refrain from using the same catheter more than once.

Although sterilizing/ washing and reusing catheters may work for some individuals, the majority of people experience recurring urinary tract infections when catheters are reused. Using a urinary catheter one time and disposing of it can reduce urinary tract infections significantly. Luckily, most major insurance companies, such as Medicaids, Medicare, and even VA, cover sterile and single-use catheters. Reusing catheters and using indwelling catheters can often lead to infections, which can cost insurance companies more.

2. Hydrophilic catheters can be the answer to reduce infections.

These types of catheters help you avoid discomfort and infection by lessening friction and injury to the urethra, which can occur with other types of catheters. Unlike conventional catheters, hydrophilic catheters have a surface that remains smooth and slippery all the way from insertion to withdrawal, due to a layer of lubrication that is bound to the catheter surface and water-activated. Since the pre-lubricated coating is activated by sterile water, there is no need to touch it, which reduces the risk of contamination that can arise because of stray bacteria or pathogens that may be on your hands.

3. Use catheters that have an introducer tip attached, such as a closed system catheter.

Most closed systems have an additional safety feature known as an introducer or insertion tip. The introducer tip permits the pre-lubricated urinary catheter to bypass the highest concentrations of bacteria found in the first few millimeters of the urethra, rather than pushing the bacteria further into the urethra whilst inserting the catheter. This will help fight against and prevent urinary tract infections.

4. Catheterizing correctly is key.

Learning and knowing how to catheterize correctly can help avoid irritation and infections, such as UTIs, that can occur when a technique is executed incorrectly. Your doctor or primary care nurse can help and show you how to catheterize properly once you are comfortable with a catheter. They can also show you how to keep the equipment sterile for usage.

5. Use insertion supplies.

Insertion supplies are conveniently packaged along with the urinary catheter in most closed system kits, many hydrophilic catheters, and some intermittent catheters to assist in creating a disinfected environment. Insertion supplies usually comprise of benzalkonium chloride wipes, sterile gloves, an underpad, and a col


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Bladder Problems – Spina Bifida

Bladder Problems

Many people underestimate the bladder’s importance and what is required to keep the organ healthy. In conjunction with the rest of the urinary system (kidneys, ureters, and the urethra), the bladder has the important function of storing urine until the body is ready to urinate. Due to factors such as lifestyle habits and bacteria entering the body, the bladder is often ignored until a problem arises in the urinary system. Typically, the most common and recognizable bladder problem is a urinary tract infection. This infection occurs when bacteria enters through the urethra and into the bladder, or the bladder is unable to empty properly, which leaves residual urine in the bladder that can become infected. Bladder infections are the most common form of urinary tract infections, but infections can also occur in the kidneys and urethra. If infection in the kidneys occurs, it can lead to severe problems and cause permanent damage to the kidneys if it happens frequently or is not attended to quickly. An infection in the urethra is possible but is less common.

Even more serious forms of bladder problems are urinary incontinence, which is a lack of bladder control and urine leakage, and urinary retention, an inability to empty the bladder properly. These two types of bladder problems can be caused by an array of factors including neurogenic disorders. These neurogenic disorders include an injury to the spinal cord, multiple sclerosis (MS), and spina bifida (a birth defect of the spine that often causes paralysis). Urinary incontinence and retention can also be happening due to the consequence of an underlying physical disease caused by an irregularity in the bladder. It can be related to old age as well. Bladder cancer, which is found in the lining of the bladder, is also a serious medical issue that involves blood in the urine, lower back pain, and a persistent urge to urinate.

If neurogenic disorders, such as multiple sclerosis or spina bifida, are experienced along with either urinary retention or incontinence, this is known as neurogenic bladder. This condition is simply the term for when normal control over the bladder is lost, caused by damage to the central nervous system. People living with neurogenic bladder are usually affected in one of two ways. Flaccid bladder is when the bladder is excessively and overly stretched, which allows exceedingly large quantities of urine to be reserved before exiting the body. The bladder stretches and can hold a limit of 2000 milliliters of urine, which may lead to leakage of the urine. In some illnesses or disorders, such as spina bifida, flaccid bladder will usually occur in combination with a complication of a sphincter muscle that will not open. On the other hand, spastic bladder happens when the bladder is very stiff, which means the bladder is not able to stretch as it should. Therefore, the bladder cannot hold the amount of urine that is considered normal as well. The bladder also may not be able to empty properly. This increases the chance of a urinary tract infection, since the urine that is left behind serves as a pool for bacteria to grow and thrive in the bladder.


Symptoms of Bladder Problems

The symptoms of the bladder and urinary problems are dependent on the underlying cause(s) and which bladder problem a person is being affected by. Below are what the symptoms are of the above-mentioned problems with the bladder:

Urinary tract infections can include symptoms such as bloody, foul-smelling, or cloudy urine; feeling the strong need to urinate frequently, even when the bladder is already empty; burning sensation or pain while urinating; and/ or a mild fever in some individuals. If a urinary tract infection spreads to the kidneys, symptoms can include feeling tired or generally ill; night sweats; very bad abdominal pain in some individuals; fever above 101 degrees fahrenheit; aching in the back, groin, or side; flushed, reddened, or warm skin; and/ or nausea and vomiting.

Symptoms of urinary incontinence can include small or large quantities of urine leaking without warning or without feeling the urge to go to the toilet; the requirement to wake up to pass urine two or more times during the night (known as nocturia); an unexpected urge to get to the toilet to urinate; and involuntarily leakage when sneezing, coughing, laughing or exercising.

Individuals living with urinary retention can experience a weak flow of urine; an urgent sense to urinate but inability to start the urine flow; discomfort; a feeling of bloat in the lower abdomen; dribbling because of overflow incontinence; and/ or numerous visits to the toilet.

Typical symptoms of spastic bladder can include the need to empty the bladder frequently, uncontrolled leakage, spontaneous emptying.


Causes

Medical conditions creating bladder or urinary issues are typically categorized as either neurogenic or non-neurogenic conditions. Some conditions may cause urinary retention, or the conditons may prevent the bladder from emptying completely and require a form of treatment. For the conditions that can cause urinary incontinence, collecting devices, or a urisheath and bag, offer comfortable solutions for men. There are also special pads available, which are designed specifically for women that have urinary incontinence.

Some conditions that eventually or immediately result in damage to the nervous system include injury to the spinal cord, stroke, diabetes mellitus, multiple sclerosis (MS), and spina bifida. Symptoms of these conditions can widely vary based on where the neurological injury occurs and what level of severity the injury is.

There are other medical conditions that cause bladder issues as well. An example of a non-neurogenic medical condition producing bladder and urinary problems is benign prostatic hyperplasia (BPH), also known as an enlarged prostate. Benign prostatic hyperplasia can have a huge impact on men who are diagnosed with this condition and their daily lives, as urinary symptoms may appear as the prostate grows. Symptoms can become very bothersome, and if severe enough, an intermittent catheter, medicine or an operation may be needed.

Other non-neurogenic medical conditions that can cause bladder problems involve benign prostatic hyperplasia or enlarged prostate; enfeebling of the pelvic floor due to age, pregnancy, and/ or childbirth; surgery on the prostate or bladder; bladder cancer; aging; and botox injections of the bladder to control urinary incontinence.


Catheters

Some people who suffer from specific bladder problems may find that they prefer to use catheters compared to other forms of treatments. In some cases, these medical devices prove to be the most effective treatment, especially for those experiencing urinary incontinence or retention. Many options are available for both men and women, and what catheter is right for every person depends on what is recommended by doctors’ orders and what adequately accommodates every lifestyle. Intermittent catheterization includes inserting and removing a catheter multiple times a day, whenever the bladder needs to be emptied. This form of catheterization is one of the most favored forms of catheterization due to this method resulting in less infections in the bladder and the rest of the urinary system. A sterile catheter is inserted into the urethra and then into the bladder every time urine must be passed and does not require a collection method for urine. However, if a urinary collection bag would suit someone else’s lifestyle better, indwelling catheters, such as the Foley catheter, work well for some bladder problems as well. Indwelling catheters are catheters that are not removed from the urethra and usually involve urinary collection bags. These bags are either fastened to the ankle, thigh, or stomach and are typically easy to hide under clothing. Other forms of catheters include external catheters, stoma catheters, and other types of urinary collection bags.


When to Consult a Healthcare Professional

Those individuals who live with or experience problems with the bladder may put off going to see a healthcare professional due to any embarrassment they may feel about their conditions. However, bladder problems are more common than what some people may think. In some cases, having an issue with the bladder may be an indication of a more significant and potentially hazardous health condition. Therefore, listening to the bladder and informing healthcare providers of urinary changes should be taken very seriously.

Bladder problems can be caused by many factors, including numerous medical conditions and injuries. These issues may also be an indication that another area of health needs attention.


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Catheterization for Spinal Cord Injuries

Spinal Cord and Spinal Injuries

The spinal cord is located within the spinal column and has two basic functions. It can act as a nerve center and can work without the brain. The spinal cord carries sensory impulses to the brain and motor impulses from the brain. The fibers of the sensory root carry stimulations to the spinal cord (position sense, touch, pain, and temperature) from joints, tendons, and body surfaces. The motor roots carry signals from the spinal cord. The spinal cord also controls stretch reflexes, bladder, and bowel control. Thirty-one pairs of nerves exit from the spinal cord and innervate the entirety of the body and the limbs. Spinal nerves communicate to where it emerges and passes through the spinal vertebrae. There are eight cervical (neck), twelve thoracic (chest), five lumbar (lower back), five sacral (sacrum bone) and one coccygeal (tailbone) nerve(s). The spinal cord also acts as a nerve center between the brain and the rest of the body. It is a crucial part of the body, which means an injury to the spinal cord can be catastrophic to a person’s life and health.

The National Spinal Cord Injury Statistical Center (2014) estimated that the annual incidence of spinal cord injury, not including those who die at the scene of the injury, is approximately 40 cases per million population in the U.S. Injuries to the spinal cord more often than not begin with an unexpected, devastating strike to the spine that fractures or dislocates the vertebrae. The damage occurs in the same moment of injury and impact, when bone fragments, disc material, or ligaments that have been displaced bruise or tear into the tissue of the spinal cord. Depending on what has been injured, people with spinal cord injuries can also have their bowel and bladder control, as well as stretch reflexes, impacted by the trauma of the injury. Every injury to the spinal cord depends on the situation. Some individuals will be able to have a nearly full recovery of the injured areas and body. Other injuries will unfortunately result in complete paralysis. These factors all depend on how severe the injury is, where the injury occurred, and what caused it.

Causes of injuries to the spinal cord can vary. Common causes, however, are usually vehicle crashes, falls, and acts of violence (i.e. gunshot wounds). The National Spinal Cord Injury Statistical Center (2014) outlined that motor vehicle accidents account for 38 percent of reported spinal cord injury cases, which accounts for the majority of injuries. The second most common cause of injuries is falls at 30 percent, followed by acts of violence at 14 percent—primarily gunshot wounds. Other causes can be injuries from sports, diving, and industrial accidents.


Ranges in Injuries

Loss of neurologic function and paralysis typically occurs below the level of the injury. Therefore, the higher the spinal injury is on the spinal column, the greater loss of function is in the body. Below is a list of nerves, where they are located, and what part of the body is impacted when those areas are injured.

Cervical spinal nerves (C1 to C8) can be found on the spinal cord in the neck area and control impulses to the back of the head, the neck and shoulders, the arms and hands, and the diaphragm.
The thoracic spinal nerves (T1 to T12) emerge from the spinal cord in the upper mid-back area and have control over signals to the chest muscles, certain back muscles, many organ systems, and even some parts of the abdomen.

Lumbar spinal nerves (L1 to L5) emerge from the spinal cord in the low back region of the body and control stimulations to the lower parts of the abdomen and the back, some parts of the leg, the buttocks, and some parts of the external genital organs.

The sacral spinal nerves (S1 to S5) are located on the spinal cord in the low back and have control over any signals to the thighs and lower parts of the legs, the feet, most of the external genital organs, and the area around the anus.

Injuries to the spinal cord can be categorized as either tetraplegia or paraplegia in most cases. Tetraplegia (also known as quadriplegic) normally results from to an injury between the C1 and T1. This type of injury is typically associated with a loss of feeling or movement in the upper body such as the head, neck, shoulder, arms, hands and/or fingers. Paraplegia may result from an injury between levels T2 and S5. This type of injury can affect the lower part of the body the most, which includes the stomach, hips, legs, and feet/toes.

Incomplete tetraplegia and paraplegia is when the spinal cord’s ability to transport messages to or from the brain is not completely lost. Those with incomplete injuries to the spinal cord can still retain some sensory function if treated immediately, and they may still have motor activity below the injury site that they can control. On the other hand, complete tetraplegia and paraplegia entirely stops nerve communications between the brain and spinal cord to parts of the body below the site of injury. In these cases, there is a total absence of sensory and motor function in the sacral sections S4-5.


Neurogenic Bladder

The National Spinal Cord Injury Statistical Center proclaim 40 new cases of spinal cord injury per million of the population per year. More than 80 percent of those same individuals display at least some level of dysfunction in the bladder. Neurogenic bladder is the overall name for most bladder issues after an injury or illness. Neurogenic bladder is a complication where a person lacks bladder control due to a condition with the brain, spinal cord, or nerves.

Various muscles and nerves must work in combination with each other for the bladder to hold the urine, until it is ready to be emptied. Nerve messages also go back and forth between the brain and the muscles that control the bladder. If these nerves are harmed by injury, the muscles may not be able to constrict or relax at the correct time. Most spinal cord injuries affect the functions of the bladder because the nerves that control the involved organs originate in the segments near the lower end of the spinal cord. Although the kidneys continue to produce urine after injury, bladder control can be lost entirely. The chance of bladder and urinary tract infections (UTIs) increases at this point.

Disorders of the central nervous system commonly cause neurogenic bladder as well. These disorders can include birth defects of the spinal cord, spinal cord injury, multiple sclerosis, cerebral palsy, Parkinson’s disease, spinal cord or brain tumors, and Alzheimer’s disease. Damage or disorders of the nerves can also cause neurogenic bladder. This includes nerve damage (neuropathy), nerve damage because of long-term and heavy alcohol use, nerve damage due to long-term diabetes, and nerve damage from a herniated disk or spinal canal stenosis. Symptoms of neurogenic bladder depend on what the cause is of the neurogenic bladder.


Clean Intermittent Catheters

Spinal cord injuries will often require individuals to perform intermittent catheterization, or take other medical steps to help manage their bladders. This could include behavioral techniques, physiotherapy such as massage therapy, transurethral and suprapubic catheters, as well as condom catheters and penile clamps. Intermittent catheterization is when a catheter is meant to be inserted and removed throughout the day in order to drain the bladder. This is an excellent choice for anyone with a condition or injury that does not allow them to empty their bladder properly or if urinary incontinence is being experienced.

Spinal cord injuries often require catheterization because the trauma to the spine may cause damage to the nerves that control the functions of the bladder. As seen above, there are numerous options for catheterization. Depending on your situation and condition/ injuries, as well as what other treatments your body responds to, catheterization may be best for your health and comfort. Choosing which catheter is best suitable for spinal cord injuries relies on where the injury is located and how complete or incomplete the injury is. Consulting your doctor and following the care and health regimen they order for you should always be a top priority.


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