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Thread: Infections and ISC, how many is too many?

  1. #1

    Default Infections and ISC, how many is too many?

    The obvious answer would be 1 as I don't like infections, but I was wondering as I seem to have quite a few over the past few months how many infections would I need to have to consider other options for my neurogenic bladder? I guess what I'm really asking is is it normal to get regular UTIs whilst doing ISC ? Been doing it for around 6 months now, maybe longer and must be averaging at 1 a month, I take cranberry juice regularly and always try to keep my fluids up.

  2. #2


    I seem to match you and get 1 a month - the dr told me that infections were normal and a hazard of ISC - i would say if you get an infection more than that or it affects the whole URinary tract including bladder then maybe another option is best as these are painful and put you out of action until antibiotics kick in

  3. #3


    sirleakalot (neat name btw.)

    Whilst I don't have to do ISC for my IC - I do have some experience with catheters from both a patients view and as a home-caregiver years ago with someone from my family.... With the foley type indwelling catheters (the ones who stay inside) the risk for UTIs is just insane basically... even if you take REALLY good care and maintain it as clean and sterile as possible.

    With the ISC type cathing it's a mixed bag... basically anytime you shove something up the urethra and especially past the sphincter you have a chance of introducing foreign materials, bacteria, into the bladder...
    From what I have seen and read is that one of the problems with ISC is the lack of a sterile environment to begin with as you do it on the go.
    Now whilst the modern type self-lubing ISC catheters come sterile packed with insertion helping packing and are ready-lubed and thus themselves offer a minimal risk its thus usually not so much the actual cath if used properly but the other "things":

    - HANDS
    - Glans / area around the urethral opening on the glans penis.

    As you do this throughout the day - with some regularity - this becomes a bit of a hazardous procedure in terms of cleanliness... as it's really difficult to create a clean working environment (aka: sterile field) to do the procedure "on the go".

    what can be recommended is that you start to carry:
    - Sterile gloves. (those can be bought packed pair-wise) ... or at least latex / nitril gloves and some antiseptic fluid.
    - an antiseptic solution for mucous tissue (Octenidine dihydrochloride - "Ocentisept" - for example)... this can be bought in small scale pump-dispensers and is easy to carry.
    - individually packed sterile cotton balls (or swabs, but the balls are more practical)
    - maybe: sterile field drapes (this is basically a laminated piece of fabric, comes at various sizes an can be found individually, sterile-packed... ) ... I guess this would make it far less practical on the go... and more supplies needed... but if you're prone to UTIs... maybe worth the additional work.

    Put on the gloves - now if they're sterile... there's a bit of a procedure to follow as not to get them "contaminated" whilst putting them on... descriptions are easy to find though...
    if they're non-sterile - it's easier... put them on and liberally spray on the antiseptic solution - "rub" it in for at least 30 seconds and MAKE SURE you don't touch anything "contaminated" after that... (so I suggest having already undressed, and the utensils (Cath, antiseptic) ready.
    if you have the individually wrapped Catheters - before you rip open the wrapping, apply antiseptic to the opening area ....
    Then apply the Ocentisept to the galns penis using some more antiseptic on the cotton balls... remember to give the antiseptic some time to do its thing (like 30-40 seconds).

    And then follow with the actual cathing-procedure as shown to you by the doc / nurse.

    With ISC the positive aspect is that the actual catheter does NOT remain in place for a long time, so it's unlikely for new baceteria to "travel" along the cath... (build up inside , etc..) ... so most likely if you get frequent UTIs you are actually introducing the harmful bacteria DURING the insertion already, which is an indication that you aren't working clean enough.
    The procedure as described above should eliminate MOST of the related issues.

    Keep in mind, that even in an hospital's ER it's not an easy task to maintain sterile fields...
    and it's even more of a "lost cause" somewhere on a public toilet... the procedure as described does certainly NOT create what is called a sterile field - it basically only takes care of the worst potential problems.

    hope that helps.

    Also you can always (and should) talk this over with your uroligist, as maybe the UTIs are caused by something else as well.

  4. #4


    I have been on ISC for almost 2 years and I seem to get on average one UTI every three to four months, however on the whole I find that binge-drinking cranberry jucie when I start to show any signs of it, and also drinking at least a half-litre a day anyway, to help keep them at bay. Since I started ISC I have had only 2 UTIs that needed antibiotic treatment.

    Because my entire urinary system is paralysed and numb I cannot feel pain when I get a UTI so once a week I pee into a bottle to check for cloudiness and any bad smells that might indicate a UTI developing. Increased incontinence between cathetering is another indication for me.

    A few other things I find help keep everything sterile:

    1) I use the Hollister Vapro catheter which not only is it sterile-packaged, it also has a "sleeve" which means that at no point in the process is the actual catheter itself exposed to air, fingers or anything else. This totally eliminates the risk of accidentally touching the catheter as you insert it.

    2) If I'm out and about and need to use a public bathroom I will use the disabled bathroom where possible, because there's a sink in there and its possible to wash my hands and then use the catheter without touching anything inbetween. If no disabled facility is available, doing it at a urinal is better than using a stall, because stall doors and locks are just the filthiest part of any public bathroom.

    3) I don't carry sterile gloves but I do keep a travel-size bottle of antibacterial hand-cleaning gel in my pocket. I use a non-alcohol-based one so I can use the same stuff to wipe the urethral opening as well. Wiping the urethral opening is the most important thing because that's where the bacteria are most concentrated. And only wipe ONCE; don't be tempted to go back and wipe a second time because that just reintroduces the same bacteria back onto the skin. If you must wipe more than once, use a separate wipe.

    Overall I've had fewer UTIs since I started ISC than I did in the last year before I started; because previous to starting ISC my bladder would never empty fully so there was always a pool of stale urine sitting in there.

  5. #5


    Some great advice and insight from the last 2 posts - many thanks

  6. #6


    Quote Originally Posted by EPO1 View Post
    A very good post overall, what could be added to it is that failure to prevent an infection by following the advise outlined is not necessary down to failure of creating and maintaining a sterile field outside the human body during the catherisation procedure. It is a known problem for males to carry bacteria inside the lower urethra (glans end - to those medical professionals among us). All that happens from there is that the cath' as it is being inserted, will help the bacteria travel back up to the bladder.

    A good source to verify this assertion of mine - is any good STI information website. Yours lovingly, your favourite uneducated lout, acorn.

  7. #7


    If your getting infections regularly you should see a urologist to find out why?
    I hope you get better soon

  8. #8


    This method was suggested for me but I chose not to do it. I have a very hard time with catheters as it causes spasms. So not an option. I also have neurogenic bladder. I have no feeling to it. When I first became incontinent I had a lot of infections because I was retaining urine. I chose to use diapers instead of a cath, and they put me on a medication(doxizosin) to help with the retention. As far as infections go they are very common with catheters. Something you can do is to drink a lot of water, also try looking into D-manos. This is a natural supplement that help keep that bacteria and sugars out of the urethra. These are often what cause the infections. So this supplement can help. I have also been told that cranberry juice does not help men as much as women, and that it does not actually help a ton and that water is better. But catheters are a huge source of infection. If the infections are so often it may out way the benefits of ISC. So maybe it is time to look into a new option.

  9. #9


    Thanks for the suggestions, have another appointment with uro soon, but will certainly buy some antibact gel. Good tip about the urinals too, but I think I'd be too self conscious doing it in front of others. Will look into the vapro cathether, depends if I can get from my NHS Trust, #postcodelottery

  10. #10


    I get the Vapros on the NHS, and I believe that since the restructuring of the NHS last year, availability should be the same across the country (unless you are in Wales or Scotland, in which case it may be different). Your urology clinic might have samples for you to try, and you should be able to arrange a swap with your GP. They are supplied by a company called Fittleworth, in case they ask.

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