If you use intermittent catheters (ICs) for bladder management, you may be concerned about urinary tract infection (UTI). First, the good news – by using intermittent catheters instead of an indwelling urethral catheter (Foley), you are already ahead of the game in terms of prevention: Research suggests that intermittent catheter users experience fewer UTIs when compared to indwelling urethral catheter users. So keep up the good work!
You may be surprised to learn that most IC users have bacteria living in their bladder and urethra. However, having bacteria in your urine is not necessarily a problem and does not always mean you have an active infection. This is known as asymptomatic bacteriuria and does not require treatment if you feel healthy and are free from symptoms.
Symptoms of UTI include:
- Fever above 100F
- Chills (uncontrollable shivering)
- Urinary frequency (having to go more often)
- Pain or burning sensation when urinating
- Blood in the urine
If you experience these symptoms or think you may have a UTI, contact your healthcare provider immediately for guidance — you may require antibiotics to treat the infection.
While prevention of UTIs is not always possible, there are things you can do at home to decrease risk.
The American Urological Association recommends the following practices for intermittent catheter users:
- Wash hands before catheterization. Make a clean workspace for catheter preparation and avoid touching the catheter on dirty surfaces
- Use a new catheter each time and avoid reusing catheter supplies.
- Cleanse the genital area daily with mild soap and water, cleansing from front to back. Cleansing after sexual activity or bowel program is also recommended.
- Keep the bladder as empty as possible by cathing every 4-6 hours.
- When cathing, slowly remove the catheter to ensure that all the urine has been drained.
- Do not allow the bladder to overfill – this can contribute to UTIs. The amount of urine removed should be less than 500mls. If routinely higher, the cathing schedule or fluid intake may need to be adjusted.
- Drink water! Dehydration can increase your risk of UTI. Unless medically contraindicated, drink between 2-3 liters of fluid each day. Drink moderate amounts throughout the day to avoid suddenly overfilling the bladder – the goal is steady production of urine. By staying hydrated, you will continually fill and empty the bladder, giving bacteria less of an opportunity to “settle in”. A good way to assess hydration is by examining the color of your urine – aim for light yellow champagne-colored urine. Darker urine indicates dehydration.
- Sexually active females should avoid spermicidal lubricants, as this can weaken the body’s defenses against UTI.
- Consider using hydrophilic catheters if possible. If not, make sure to apply a generous amount of lubricant to the entire catheter to minimize trauma during insertion. Trauma from a dry catheter can increase the risk of UTI.
- If male, make sure you are correctly positioning the penis during catheter insertion. This will decrease trauma to the urethra. The penis should be gently pulled straight and held upwards towards the naval.
- Eat fermented foods, such as yogurt with live and active Lactobacillus cultures. These beneficial bacteria can reduce the number of illness-causing bacteria in your system.
- If catheter insertion is difficult, make a trip to the urologist for an evaluation. Male catheter users may need catheters with special tips to navigate the prostate.
If you experience frequent UTIs, talk to your urologist. There are medications and adjuvant therapies that may help. If intermittent catheterization is not possible and you are currently using an indwelling urethral catheter, ask your doctor about suprapubic catheters. A suprapubic catheter is a thin tube inserted through your lower abdomen into the bladder that stays in place and drains urine into a collection bag. Research suggests that long-term suprapubic catheters can cause fewer urinary tract complications (including UTIs) than long-term indwelling urethral catheters and are a good option for people who cannot self-cath.
For more information on bladder and bowel management, please speak to your doctor, and for additional information visit https://www.bladderandbowel.org/ - an online community dedicated to serving individuals with bladder and bowel dysfunction.
ABC Medical is a supplier of durable medical equipment and does not provide medical advice or treatment. This article is for informational purposes only. You should seek medical treatment from a licensed medical provider.