Urine test results with CIC

hank1953 · June 13, 2018, 7:29pm

After almost 2 years of CIC, I finally had a urine test. All previous urine tests were normal. This time, however, there were abnormal readings:

1. Cloudy

2. PH > 8.5

3. Protein 1+

4. Leukocyte esterase 3+

5. WBC >= 60

6. Bacteria : many

7. Triple Phosphate crystals : many

I've read that these are to be expected if you do CIC, as long as there are no other symptoms like fever, they normally can be ignored. However, I just wonder if there are any easy ways to kill off the bacteria, without antibiotics. Currently, my urine is too alkaline, which is a good breeding ground for bacteria, which in turn make my urine even more alkaline.

Regarding the Triple Phosphate crystals, I've seen them for a long time, clinging on to the walls and bottoms of my pee bottles over time, refusing to be rinsed off. They look like sugar granules, except they are clear as glass. They then cling on to each other and can become very thick, very hard to scrubbed off. They are the precursor to one form of bladder stones, and even in the granular form, can cause irritation to the uretha wall and prostate, if you pee very little and/or with a weak stream. They usually settle at the bottom of the bladder so they will try to come out first. If there are not enough urine following to flush them out, they will linger inside your uretha wall. This happened to me occasially, when I often tried to pee before I really needed to, out of the concern that my bladder might be getting too full. The irritation makes you feel like you have to pee, even there's not much to come out. Getting more liquid in and peeing more volume each time seems to avoid this problem.

This also explains what happened to me before when I was CICing 4, 5 times a day. At that time, I could only pee a small amount before self cathing so I am now sure the crystals were still inside the uretha. I felt irritation and urgency quite often, sometimes even right after the cath. I could not explain it at the time, so I thought that I had OAB. I ended up having to go back to the meds in addition to CIC, which seemed to solve my 'OAB' problem. I think what the meds did was helping me to pee more volume, and that was enough to flush the crystals out. I wonder if this situation may apply to others here as well. Hank

Jimjames · June 14, 2018, 1:15am

Like you said, it's expected with CIC and to be ignored except if you're symptomatic. At one point when I stopped CIC for three months I said to myself, "well, let's clear up all that cloudy (leucocytes) urine and get back that sterile urine". So, I did a course of antibiotics and everything went clear. Did I feel any different. Not at all. Better looking urine but where's the beauty contest smile So then after three months I started CIC again and the gang of benign bacteria came back. I haven't treated it since because I still CIC a few times a week.

Since you were so clear for so long, you probably contanminated yourself at one point which is to be expected. You could do a course of antibiotics and clear yourself out maybe for several more years but I'm not sure you would be accomplishing anything other than getting better looking urine and adding a wee bit of antibiotic resistance to the equation.

There are a number of ways to acidify urine if you want to research it out, but I think you will find studies both ways. Some say UTIs thrive in alkaline urine and some say the opposite. You could try just a temporary water flush which could clear things out but make sure you take some electrolytes with it because drinking too much water can sometimes have a downside.

Jim

hank1953 · June 14, 2018, 11:43pm

Thanks Jim for your valuable inputs, as usual. I am not going to go the antibiotics way since I will continue self cathing anyway. Btw, Do you think the only way the bacteria can enter the bladder is by the penis ? Not through other internal mechanism ?

What do you think of my theory of the urine crystals irritating the uretha, causing OAB like symptoms, if you don't void naturally enough ?

Hank

Jimjames · June 15, 2018, 12:12am

Makes sense. Should you ever decide to stop CIC, then I think a round of antibiotics to "clean things up" is understandable although probably not really necessary. Really don't have enuf of a knowledge base one way or the other re crystals irritating the urethra. But why would you think CIC wouldn't do as good -- if not better -- a job of getting rid of them since it drains the bladder completely. Now, if you really wanted to get rid of them -- and I'm not saying there's a reason or you should -- you could try a simple bladder irrigation with sterile saline or water. What you do is take a barrel syringe (no needle) and fill it with say 50-100ml of sterile solution, then inject slowly through the catheter (barrel mates nicely with plastic funnel) into the bladder. You could then either leave it for a minute or so and draw it out, or draw the syringe back and forth slightly creating a "washing machine" effect in the bladder. Then draw out the fluid. Repeat if you want until everything is crystal clear. Some say this might help prevent UTIs although that's not your problem but, who knows, it might be enough to clear out your system as a bonus. The next step is to use an antimicrobial such as Microcyn or even an antibiotic wash out solution.

A few years back I tried all of the above, except the antibiotic wash out solution, but to be clear I'm not recommending anyone do this although with care I don't see too much harm. Nowadays, I keep things simpler and just CIC when I need to which is a few times a week.

Jim

hank1953 · June 15, 2018, 2:20am

I am already trying bladder irrigation with a 60cc syringe. Will try the washing machine technique. Thanks. Hank

Jimjames · June 15, 2018, 2:55am

Just be careful and move the plunger up and down gently. I got a "pinch" when I did it a bit too vigorously. What I was probably feeling was the bladder sucking into the catheter tip when I pulled the plunger out. A more gentle technique and possibly more liquid (100cc?) might help in that regard. Of course all this should be done after you completely empty your bladder via CIC. So in effect, I first self cahted, then I irrigated, and lastly when to the cupboard and opened a can of sardines. YMMV.

Jim

hank1953 · June 15, 2018, 4:18am

Sounds like a good plan, except for the sardines. Hank

hank1953 · June 15, 2018, 4:22am

I don't think CIC is as good as a strong normal urine flow in flushing out the sediment that settles at the bottom of the bladder. Hank

hank1953 · June 15, 2018, 4:31am

I just found out that the crystals can be dissolved by white vinegar. Should I mix vinegar in the flushing solution ? Hank

Jimjames · June 15, 2018, 8:39am

They sometimes use vinegar but you want to mix it with either sterile water or sterile saline. I believe it's only 5% or less vinegar but you should look it up. I believe they also sell acidic acid bladder solutions that should do the same thing.

Jim

hank1953 · June 15, 2018, 6:06pm

Thanks Jim. This is great information! Hank

hank1953 · June 15, 2018, 6:14pm

Look at what I just found:

OBJECTIVES:

To identify the optimum volume of acidic bladder washout solution to dissolve catheter encrustations and to compare the effectiveness of different bladder washout delivery devices.

MATERIALS AND METHODS:

Urinary catheter encrustation was generated in vitro using a model of the catheterized bladder adapted from previous work. An acidic bladder washout solution (Suby G) was applied via the catheter in the model and retained for 15 min. The amount of encrusting material dissolved was measured by colorimetric analysis of the magnesium and calcium content of the solution returned after the washout procedure. The relative effectiveness of different volumes of washout solution and different washout delivery devices (Optiflow, Bard Ltd, Crawley; UroTainer, B/Braun Medical Ltd, Aylesbury; and a bladder syringe) in dissolving catheter encrustations was compared to the 'standardized' conditions commonly used in practice.

RESULTS:

There was no statistically significant difference between washouts with 100 mL and washouts with 50 mL for any of the delivery devices tested. Gentle agitation with 50 mL Suby G did not significantly improve the dissolution of encrustation but the total amount of material dissolved when two washouts with 50 mL Suby G were used sequentially was significantly better than a single washout with either 100 mL or 50 mL.

CONCLUSIONS:

Under controlled laboratory conditions, smaller volumes of acidic bladder washout solution (50 mL) are as effective as the 100 mL commonly used in practice, but two sequential washouts with 50 mL are more effective than a single washout. The newly designed Optiflow delivery device is at least as effective as the other devices tested. This study provides new evidence which may contribute to decision-making by practitioners in relation to catheter care.

Comment in

The dissolution of urinary catheter encrustation. [BJU Int. 2000]

PMID: 10619947

[Indexed for MEDLINE] Free full text

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