Catheters And Urinary Tract Infections

People with indwelling catheters (those that are left inside the body for more than just a day or two) are very susceptible to urinary tract infections (UTI). Obviously the bladder is no longer completely inside your body with only the urethra and the ureters as outputs and inputs. So the inside of the bladder is no longer sterile.

But here are some things I did not know after I had my suprapubic catheter inserted.

Colonization Versus Infection

Yes, having a urinary catheter does mean that your bladder will now contain bacteria* – more than just the normal stuff –  that can cause a UTI. This is called colonization. I know, it sounds pretty scary doesn’t it? Bacteria are colonizing my bladder. Shudder. But that does not mean you have an infection. This was a bit confusing to me at first. But think about it in terms of getting sick. The viruses that gives us colds or the flu are all around us all the time. But obviously we aren’t sick all the time. We can co-exist peacefully with bacteria.

But things can develop into an infection. The way the doctor described it to me was that it’s a bit like a continuum. On one end you have colonization, where the little bugs live happily without making you sick. On the other end is an infection, which means the bacteria have invaded the tissues and cause you to become sick.

*Fungus – a type called Candida – can also cause infection.

Signs And Symptoms Of Infection

These may not be the same for everybody, but basically it comes down to how you feel. The most common signs of infection are fever, chills, aches and/or nausea. You might also notice a strong and different (usually unpleasant) smell to your urine. Or the urine might be bloody or cloudy.  You may also have pain in the rectum and/or testicles (for men – obviously:)), and possibly back pain or flank (your side) pain. You may also have a strong urge to urinate – even though you can’t because you have a catheter in. You can find a more detailed summary of symptoms from The Mayo Clinic.

If you start having these symptoms, you need to get to a doctor pronto. You’ll need to be put on antibiotics to stop the infection. Always make sure you take the full course of antibiotics. If you stop taking them when you start feeling better, you might allow your bacteria to become resistant to the drug, which is obviously not good. In fact, this is the reason why you can’t just stay on antibiotics for the whole time you have a catheter in. Heck lots of folks live with one forever. If you take antibiotics for a long period of time, your bacteria can become immune to the drug.

How To Ward Off Infection

Ideally, you want to avoid ever getting a UTI if possible. But once you are colonized, the usual preventive actions may not have much effect. For example, it may not help much (or at all) to try to wipe everything with alcohol or try to sterilize every little thing, or trying to stay in a sterile environment all the time. The bugs are already in there. So the main task is to keep the colonizing bacteria from invading your tissues. Some of the best ways to do this are:

1. Drink plenty of fluids – like a LOT more than people without catheters normally would drink. This will help to flush out the bacteria – to encourage them to keep moving along. Not everyone can take a super large amount of fluid by mouth though, so you should definitely make sure it’s OK to do this by talking to your doctor.

2. Do not let urine from the drainage back find its way back into your bladder. So always keep the bag lower than your bladder. This allows gravity to help things continue to flow in the correct direction, i.e. AWAY from your bladder, not back into it.

3. Empty your drainage bag often – at least every 8 hours if you can; every 2-4 hours is preferable during the day.

4. Change your catheter once per month. I have my doctor do this, but lots of folks, especially those who will have a catheter for the rest of their lives, often can do this themselves.

5. Keep as healthy as you can so your immune system can fight off invading bugs. This means getting as much exercise as you can and eat a balanced healthy diet.

I hope this information is helpful for you. I wish I had found such an article before I suffered my UTI, which came about 3 weeks after I got my suprapubic catheter. If you have to live with a urinary cath of either kind (urethral or suprapubic), you will be more susceptible to urinary tract infections. But knowing how to avoid them, plus how to recognize them and take the correct action if you do get one, can help minimize their occurrence and the damage they can cause.

Below is a video of a young lady showing you what a suprapubic (SP) catheter is and offering some tips on how to live with one, even if it’s only for a few weeks or months. It isn’t specifically about dealing with or preventing urinary tract infections. But it does give you a good idea of what an SP catheter is.

Good luck!