I am now in the middle of my 3rd UTI since starting CIC in earnest last Sept. ( 4 times per day ). The first time was just inexperience but the last two were due to severe irritation of the urethra which rubbed off part of the protective mucous lining and allowed opportunistic bacteria to take hold. The first irritation was caused by not usinf sufficient lubrication and the second was from holding it in for 16 hours during a trip and not cathing.
The latest lab report is the same as the others: colonization with Enterococcus species. My symptoms are also always the same: rapid increase in burning and pain while urinating over the course of an hour or two followed by pink urine and having to pee every minute a few drops while also screaming.
The first time I was given Macrobid and the last two times Cipro. In all three cases the symptoms all but disappeared within 3 hours of taking the first pill! But of course I have to finish the whole 5-day bottle.
I wanted to invite everyone who has had experience with UTIs due to CIC or cathing in general to share their knowledge about this dark-side of cathing. Also guys who have avoided UTIs are welcomed to share their secrets.
Thanks to everyone.
Neil
Be careful with cipro. The side effects can be bad. It's one if those meds uros tend to over prescribe. Look up floxed .
I will weigh in for what it is worth.
It sounds more like you are just super sensitive and it does not take much send you into a UTI. I have been self cathing for about a year with no problems, (4-5 a day)
If you are not using the "Speedee cath" mfd. by Coloplast, I would highly recommend it.
This last month I realized it was going to be necessary to Increase my usage and was a little afraid that I was going to run out before next shipment and since I was in between Uros , and basically had no one to increase my scrip, I was able to reuse the compact 1 time by rinsing it with 91% alcohol and rinsing it with bottled water then putting it in a new 1 gallon zip lock baggie and then dumping the remainder of the lubrication into the zip lock baggie and that was plenty of lube for them to be reused. Smooth as silk too! I did this at least 30 times to stretch my 90 count to a 120 count, I know it sounds risky but after the first couple of times it was like a very simple process, my point is that even doing that there were no problems, and the lube was plenty. Just something I did but it caused no UTIs.
Maybe the ones in the large bags are not as well lubricted as the ones in the plastic compact tubes?? (Those are the only ones i use, just FYI.)
Good luck Neil, not good to have to keep going on antibiotics!
Hi Neil,
If you can add to your story and refresh me on a few things.
1. Do you know which Enterocccus you had? Is it always the same? How far apart where the UTi's? Three in six months if I read this correctly?
2. How much Macrobid did he give you? Did your doc do a culture after you were asymptomatic to make sure the Enteroccous really left your system?
3. What catheter are you using these days and what is your routine such as washing hands, type of antiseptic, etc.
4. What are your natural void volumes if any and what are your cath volumes? Are the totals over 400ml and how often/ How much came out of the catheter after you held off for 16 hours?
5. How long did you wait from when you had the symptons until you started taking the antibiotics?
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I had a couple of UTis when I first started CIC probably due to trauma as my urethra was very sensitive back then. The second UTi was probably because the first one wasn't treated properly. Developed into epidyimytis, no fun. Finally found a uro who treated it properly. Your five day course of antibiotics sounds very short for what is considered a complicated UTI, regrdless if it went away so soon. Since then I've been colonized (asymptomatic UTI) about 3/4 of the time but only symptomatic and treated maybe 1-2 times per year. Always hard to know but I think I can trace the cause to careless/rushed technique and trauma from experimenting with new catheters which never worked out!
Jim
Thanks guys. I have always used the Speedicath hydrophilic 14 coudes. I open the catheter package part way and squeeze in a small amount of Surgilube gel that adds additional lubrication to the hydrophilic coating for a smooth ride through my large prostate. I wait about one minute and the gel slides down nicely and coats the catheter which I then slowly pull out to start the dive bombing.
I wipe around the tip of the penis and inside the spread meatus with Dynarex sterile towelettes. The spray (Vetricide?) was too harsh for me and caused skin irritations.
During the day my NVs and PVRs total less than 400ml but at night I am awakened about 3 to 4 am and cannot NV and the CV is 500 to 600ml. I cath just before bed at around 11:30pm and then again at 7 am and those are less than 400ml total.
I finally did a cath this afternoon after being off for over 2 days. It went well and the CV was 350ml with a NV just before of 100ml though I try not to do a NV just before the cathing to have more bladder pressure to dilate the urethra for easier penetration.
My first UIT last Fall was because I missed the dive bomb entry and hit an unclean part of the penis and was too lazy to start over, so that one I deserved. I since learned my lesson.
The symptoms started about mid morning but became very severe early afternnon. I could not reach my PCP so my wife advised me to take a Cipro which I had left over from my biopsy in Feb. This was on Thursday. The symptoms were almost gone by dinner time and I saw my PCP yesterday who gave me 3 more days of Cipro since I already had two days.
Thanks guys.
Neil
Sorry Jim - a few more answers to your questions.
The lab report just says Enterococcus species but not which one. It was the same every time. I do not know how much Macrobid I was given but it also was very effective in a few hours.
My last UTI was in Dec when I rushed the entry and riped away part of the mucous lining. I was tested again in early Feb and was totally negative then even for colonization just before my biopsy with Dr.K.
Am I weird?
Thanks.
I was just wondering if the short course of antibiotics was enough to clear the infection and if the other two infections were just part of the same. Therefore the questions on dosage, duration, how far apart were the utis etc. Also, since you cleared so fast was wondering if really a true UTI that's why I asked how long you waited to get treated.
Anway, if you contaminate yourself like you might of, or traumatize the urethra, that's enough for some of us to get a UTI. You might ask your uro about taking a pholactive dose after a mistake or trauma. For example, I took one Macrobid yesterday and one today prophalactively because I was testing the new flex coude's and didn't want to get colonized. I wouldn't do that very often but it's a strategy.
Jim
Thanks Jim. The wipes I use have alcohol on them which irritates my skin. Can you recommend any good antispectic ones without alcohol? My continence nurse says I should not use antiseptic wipes or spray but just clean wipes as daily use could lead to bacterial-tolerance over time! Seems we just can't win at this!
I do appreciate all the advice here but my main purpose of this thread was for everyone who has had UTIs to write in and discuss their experience - not many takers so far so maybe UTIs are not that common with CIC.
Take care.
Neil
Neil,
Alcohol wipes irritate my skin as well. Stopped using them. Providone Iodine Swabsticks (I like the three packs) do not irritate, are very moist and give good coverage, however they are a bit of a mess so not sure I would travel with them. Dynarex BZK swabsticks also do not irritate, however some of the packets are on the dry side, so you may have to open more than one for coverage. Then there's the Microcyn/Veratacyn/Puracyn/Hydrocleanse sprays. No sting, no mess. They swear by this stuff over at the SCI forums but sometimes I wonder if it has the anti microbial qualities the manufacturer claims. Still I use it sometimes.
Interesting what your nurse says about antiseptic wipes. Doesn't mean she's right but interesting. What exactly are "clean wipes"?
FWIW my cath PA told me to wash my hands but not to bother even wiping my penis head or meatus. She's also the one that ignored my plea for antibiotics which eventually turned into epidymitis. Oh yeah, she also gave me red rubber catheters and told me I could use each one for a week if I cleaned it with soap and water after I used it. After checking with my insurance company (200 a month with Medicare) I declined that offer and threw the catheter away after every use.
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So, sorry, my story may have gotten buried in my advice to you, but sounded like you needed a little with all your UTIs 
I'll fast forward past the first three months of CIC where I had multiple UTIs due to trauma and bad advice and neglect by the catheter PA's.
After that I was colonized not all but much of the time but only needed be treated 1-2 times a year for symptomatic UTI's. I think I touched the catheter once in the middle of the night and was too lazy (or too asleep) to throw it away and probably got contaminated. Another time I tried a new coude and stuck myself which probably created a micro tear. And another time I probably didn't need with antibiotics but since I wasn't cathing much I just wanted to get uncolonized. But keep in mind that I pretty much only cath at home which is more sterile than on the road with public bathrooms.
Overall the literature talks about UTIs with CIC, but hard to tell the real incidence. Here, it seems that the incidence of UTIs is low. But if you've been only doing this 6 months, my guess is that you will have less UTIs in the next year than you had in the last 6 months.
Jim
Thanks as always Jim. By clean wipes she meant alcohol-free as she thinks repeated use of alcohol can cause bacterial resistance after a while. But I agree it wan't to clear. I will call her tomorrow to clarify.
I also wanted to ask you if the next time I get these acute symptoms if I should just tough it out for 24 hours rather than reaching for the antibiotic bottle? I was reading that acute UTIs tend to resolve themselves anyway just like the flu but it is one thing to read about it and another to experience it!
Maybe the lack of response to this thread means that most guys don't have UTI issues with CIC. But then those are the ones I would really like to hear from here so they can share their secrets with all of us. But I guess when things are going well most people just get on with their lives and don't follow forums and blogs.
Thanks again for all your good advice. Maybe my Gat Goren procedure in May will open up my urethra like the Niagara river in Springtime and then I wouldn't need CIC!
Neil
Neil,
Did a little research and I emphasize "little" so please take the following with that caveat...
Alcohol and therefore in theory alcohol based wipes d onot cause bacterial resistance. Problem here is that alcohol should not be used on sensitive tissue or damaged tissue. That's why it stings.
Providone Iodine does not cause bacterial resistance.
BZK wipes (Benzalkonium Chloride) and some other antiseptics may cause bacterial resistance. More study needed. These are alcohol free wipes that do not sting and are commonly found in urologists offices.
Anti bacterial soaps may cause bacterial resistance.
That said, all of the above are often recommended by doctors and in the literature for CIC, with the exception of alcohol which can sting and irritate.
Is this another "who knows?". Who knows
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It's the weekend. I think you'll probably here from more fellows tonight and tomorrow, however based on what I've read here, most people here who CIC don't have very many UTIs -- maybe one a year or less. Not to say it isn't a problem for many, and is so listed as one of the side effects of CIC. Don't know how much those statistics take into effect the SCI (spinal chord injury) community however. They have their own challenges, among them no feeling when they cath which makes them more suseptible to micro trauma from cathing which can cause UTI's.
Jim
Not sure if this helps but my old knee doc used to rub down my knee with alcohol before giving me injections. My new knee doc uses iodine. I asked what's the difference? She said alcohol evaporates so fast, the area can become contaminated before they do the injection. Iodine doesnt evaporate and maintains the stearyl field before and after the procedure.
Hi Jim - thanks for this but now I am really confused! The Dynarex wipes I use contain both alcohol and BZK so if I drop the alcohol the BZK may develop a bacterial resistance and if I keep the alcohol then I wouln't get that but I will continue to irritate the skin (I use polysporine for relief).
Iodine is messy and stains. So maybe I should try the sprays again but the one I have here did sting somewhat (MicrocynAH).
Maybe my post for this thread was too personal and it looks like I just want help for myself rather than being a thread for all things UTI? I may try a different tack in a few days and make it just a general request for guys doing CIC and not discuss me.
I will talk again tomorrow with my continence nurse and see what she says but unless someone is doing CIC I take their advice with a grain of salt (around the rim!).
Thanks
Can you give me a product number or PM me a link to the Dynarex wipes you use. The ones I have are alcohol free. Are you getting a burning or stinging from the Dynarex with alcohol?
Yes, Providone Iodine is messy and can stain sinks, etc, if you don't wipe off right away. I still use it however, but since I only cath every once in awhile not a big deal.
Microcyn doesn't sting at all but again not sure it's just snake oil. Still, I do use it sometimes and in fact used it the other day to spray off the Providone Iodine!
I'm sure you will get more responses but sometimes people here don't get notified about new threads on a timely basis. I got notified on this, but sometimes I don't.
On the bright side, maybe not a lot of UTI issues with CIC here and my guess is that with time your UTI's will diminish their frequency.
If you speak to your continence nurse, ask her for a source for her statements. Well, maybe that's not the way to make friends with the medical community but you get my drift
Jim
Thanks Jim. I recall the nurse who tried to teach me CIC last summer (nurse cratchet) said not to use sterile wipes or sprays unless they contained alcohol since I would quickly develop a bacterial resistance.
So the wipes I continue to use which she gave me and I reorder from amazon are:
Dynarex Obstetrical Towelettes Cleaner and deodorant
NDC# 67777-244-01
with a small amount of BZC and alcohol and other stuff.
Also they are made in China and since changing production to there from here there have been some quality control issues.
Thanks Jim.
Hi Jim and Niel
Havent been able to get on this board for a month or two due to graphical interface not working on my laptop but for some reason it started working again.
I get a UTI a few months ago whille trying to CIC while travelling. I find unless I can use a private restroom I get rushed and either damage the urethera or contaminate the catheter itself and get an infection. So far I haven't taken antibiotics right away, I just monitor it with the test strips, drink lots and lots of water and pop a couple of the wife's cranberry caps and so that has worked within a day or so.
At home I use the generic baby wipes I buy from my local grocery, on sale they are about ten bucks for a box of five hundred. Use one to wipe my hands, another to wipe the penis and then bombs away.
For me at least it seems the longer I have been self cathing the less problems I have. Luckily I can still do a litle bit of a NV. I have settled into a 4x day schedule about every six hours and usually the voids are around 200 to 250 but the first in the morning is four hundred or a little more if I have two consecutive of four hundred then I add an extra CIC every four hours until the void is about one hundred..
I'm thinking that for me anyway, keeping the bladder empty actually makes more difference than what wipes I use....
Yes, unlike the Dyranex BZK wipes, these have a little alcohol, probably not enough to sting. Hopefully enough to kill the bacteria on its own and overcome any resistance ordinary BZK wipes may or may not cause. The alcohol would not be necessary with Providone Iodine, but again a little messy. What I did like about the Providone Iodine (esp the three pack) is that they were very moist while the BZK were often dried out. Some of the Amazon reviews of the ones your nurse recommends mention that they are sometimes dried out. A dried out pad suggests to me that the alcohol may be gone and that there may not be enough BZK to do the job. Anyway, I'll order some for my arsenal. Made in China, with some quality control issues? Go figure.
Jim
Hi Jw,
Studies suggest lower bladder volumes equal lower incidence of UTIs. In fact, I've read more than once that if you drop the catheter on a public bathroom floor, you should pick it up, rinse and use it because you will have more chance of infection from the full bladder than from the compromised catheter. In a 100 years I would never take that advice but it does suggest emptying your bladder is important!
You might want to try the new Coloplast Flex Coudes. They are the closet thing to a closed system out there meaning the catheter is almost 100% protected from contamination either by yourself or from the air. They may be a good solution for you in a public restroom although they do take a little longer to use than the regular ones.
Jim
Hi Jim
i was thinking I'd like to try the new Flex Coudes but I get my Speedicath's from the VA. I've read I need a prescription for samples and as I don't get down to see my PCP very often (its a 500 mile trip) I guess I'll keep using what the VA sends until I can get a script..
If you fill out the Coloplast request form, I believe they will contact your supplier for you. Whether or not the VA responds is another story.
Jim