Urinary tract infections

A urinary tract infection (UTI) is an infectious disease of the efferent urinary tracts caused by pathogens. People with spinal cord injuries are at increased risk of suffering from a urinary tract infection. Urinary tract infections are identifiable through specific symptoms (symptomatic). The infection can spread into the kidneys and blood stream, leading to threatening clinical pictures.

A distinction is made between acute (sudden, often with symptoms of the disease) and chronic inflammations. Bacteria may also be detected in urine without there being any indication of an inflammation (no discomfort, no inflammation cells in the urine). This is referred to as asymptomatic bacteriuria and generally does not require treatment.

Where can urinary tract infections be located?

• Urethral inflammation (urethritis): Restriction of the inflammation to the front sections of the urethra
• Cystitis: Inflammation of the bladder
• Pyelonephritis: The renal pelvis and renal connective tissue are inflamed by bacteria

What are the causes of a urinary tract infection?

A UTI can occur for a number of reasons. The most frequent cause of this is germs from external sources getting into the urethra or bladder. This risk is increased in people who are catheterised. Therefore, it is very important to observe good hygiene practices during intermittent third-party catheterisation, as well as during self-catheterisation.

UTIs may also be caused by residual urine, stones in the bladders or kidneys, an overactive bladder or flow impairment in which urine is backed up towards the kidneys (reflux).

What are the symptoms of a urinary tract infection?

The symptoms experienced by people with spinal cord injuries may be completely different from those of able-bodied people.

• Raised temperatures (>38°C)
• Pain / sensation of tension in the lower abdomen
• Odorous, cloudy urine
• Itching, burning, strong urge to urinate
• Uncontrollable passage of urine
• Needing to urinate more frequently
• Increasing spasticity
• General feeling of discomfort
• Raised heart rate

How are urinary tract infections treated?

There is no need to treat asymptomatic colonies of bacteria appearing in the bladder. In the case of symptomatic urinary tract infections, ensure that you drink plenty in order to ensure that the bladder is well flushed. Ensure that you pass water regularly. If this alone is insufficient, the infections are treated with antibiotics.

Antibiotics must be taken precisely as prescribed. In particular, they should be taken precisely for the prescribed length of time. While the symptoms may disappear relatively early after you start the course of treatment, the bacteria will not have disappeared completely. If the course of treatment is not completed, the germs may become resistant to the antibiotics.

How can I protect myself against an infection?

The following points support therapy to treat an infection, although prevention against contracting an infection in the first place is the best thing.

• Regularly drink plenty of fluids (1.5 to 2 litres per day)
• Pass water regularly
• Maintain good personal hygiene, but not excessive
• Maintain clean catheterisation practices
• Keep your hands clean

Under certain circumstances, there may be no need to use specific disinfectants for catheterisation at home. The risk of infection is higher in hospital than at home. Therefore, whenever you stay in hospital, we would urge you to use a disinfectant for catheterisation and a suitable mucous membrane disinfectant both for disinfecting your hands and for disinfecting the urethral orifice.