Intermittent catheters and managing risks of infection

 

As an intermittent self-catheterisation (or ISC) user, you may find that you develop urine infections from time to time. It is hard to be sure just how common urine infections are, but it is estimated that 4 out of every 5 people using ISC will have at least one urinary tract infection (UTI) in a 5 year period, and on average each person will have 2.5 UTIs per year1. Despite how common UTIs are, infection is something that you can help to manage and reduce with the right preparation and knowledge.

 

What are urinary tract infections?

 

Urinary tract infections are divided into upper or lower UTIs depending on which part of the urinary tract is affected. The urinary tract consists of the kidneys and the ureters (the tubes which drain water from the kidneys into the bladder) and the bladder and urethra (the tube which you use to pass urine). Lower urinary tract infections are much more common than upper UTIs and include the bladder and urethra. Upper UTIs are potentially more serious as they can involve the kidneys.

Whilst it might seem a bit daunting that you can get a UTI from using ISC, it is important to remember that the risk of getting a UTI is actually much higher if you don’t use intermittent self-catheterisation. In fact, one of the key reasons ISC will have been recommended to you is to reduce the chances of developing a urinary tract infection.

 

How do I know if I have a UTI?

 

UTIs can be uncomfortable and sometimes make you feel quite unwell. Typical symptoms include2 feeling as though you need to pass urine all the time, pain or a burning sensation when you do pass urine, and a strong smell associated with cloudy looking urine. If you are an MS patient you may also find that your MS symptoms become more aggressive, this can sometimes be the first sign that a urine infection is present. Some people with MS think they are having a relapse when actually the change in their condition is caused by a UTI. With both MS and other neurological conditions, tiredness or fatigue is also likely to get a lot worse when you have an infection. Track your energy levels throughout the day, to see if your feelings of fatigue are more severe than usual. If you think you are experiencing symptoms of a UTI it is important to contact your local nurse or GP as you may need a short course of antibiotics.

 

How can I manage and prevent infection?

 

The good news however is that there is a lot you can do to minimise the chances of developing a UTI. There are three key points to remember: make sure you use a good clean technique when you catheterise, make sure you empty your bladder fully and often enough during the day, and remember to drink plenty of liquids. Making sure everything is clean when you catheterise can be difficult to manage sometimes – especially if you are away from home or not feeling very well. Following the routine your nurse has showed you is very important and will ensure correct catheterisation every time. In addition to this, however, there are some simple ways you can help to make the process easier, wherever you are.

Washing your hands just before catheterising is important. This can be more difficult if you are travelling or away from home without access to a sink, but using an alcohol gel instead of soap and water can be helpful. You will also need to make sure the area where the catheter will be inserted is clean. Soap and water work well, however disposable wet wipes work just as well and can be easier to use. Remember to clean yourself from the front to the back to avoid transferring any bacteria from the anal area to the perineum where you will insert the catheter. If you need to use water for washing whilst travelling, consider using bottled water as this is more likely to be clean than tap water.

When you come to introduce the catheter be careful not to touch the end you actually insert and aim to make sure that you fully empty your bladder each time you use the catheter. Insert the catheter until urine is draining. Once it stops draining withdraw slowly to give any more urine which might be in the lower part of the bladder a chance to drain out. It is important not to let the amount of urine in your bladder build up too much, so do make sure you use your catheters regularly as your nurse has advised. Most people find they need to self-catheterise between 4 and 6 times each day. You should aim to drink at least 1.5 litres of fluids throughout the day to help to flush through the urine and prevent pooling in the bladder. Staying hydrated is essential to prevent infections, and also to keep your body and mind in optimum condition.

These are some of the more straightforward ways in which you can reduce your chances of developing an infection, but often it is the most straightforward that are the most effective. If you find that you keep contracting regular infections, talk to your nurse as they will be able to look more closely at what is happening in your particular case and give you more help and advice. ISC should fit into your life, not control it. Whilst there is always the risk of infection, you can easily take control with a clean and effective everyday routine. For more help and advice on intermittent catheterisation get in touch with one of our expert nurses, who would be happy to help.

 

Just head across to our Learn section for information of intermittent catheters. Or, if you fancy a chat, we can put you straight through to one of our Bard nurses. 

 

1 Vahr et al (2013) Evidence based Guidelines for Best Practice in Urological Health Care: Catheterisation Urethral intermittent in adults; Dilatation, urethral intermittent in adults

2 Vahr et al (2013) Evidence based Guidelines for Best Practice in Urological Health Care: Catheterisation Urethral intermittent in adults; Dilatation, urethral intermittent in adults