Urinary tract infection in Neuro-urological patients

Q 1. How are the symptoms of Urinary tract infection (UTI)?

A. Common signs and/or symptoms are:

• Strong urge to urinate that doesn’t go away
• Burning sensation or discomfort when urinating (dysuria)
• Passing frequent, small amounts of urine
• Cloudy urine with increased urine odour
• Pink, red, or brownish urine
• Pain above the pubic bone in women

If you have a symptomatic UTI, you may have other signs and symptoms in addition to or instead of traditional signs and symptoms of a UTI:

• Fever
• Incontinence
• Unpredictable need to urinate
• Malaise
• Lethargy or sense of unease
• Discomfort or pain over the kidney or bladder
• Sudden occurrence of high blood pressure (autonomic dysreflexia)

Q 2. What is asymptomatic bacteriuria?

A. Asymptomatic bacteriuria is the presence of bacteria in the urine without symptoms. It is much more common in patients with spinal cord injury than in the general population. The condition varies depending on bladder management-for example, clean intermittent catheterisation or an indwelling catheter. It should not be routinely screened for or treated in patients with neuro-urological disorder.

Treating asymptomatic bacteriuria does not have a urological effect but causes many more resistant bacterial strains to develop. For this reason, it should not be treated in patients with neuro-urological disorders.

Q 3. What investigations are required?

A. Laboratory findings like a lot of bacteria or white blood cells in the urine confirm the diagnosis.

Q 4. What is the cause of UTI in Neurogenic bladder?

A. In neuro-urological patients, UTI can be caused by:

• Weakened defence mechanisms
• Inability to empty the bladder completely
• Catheterisation

Q 5. What is the management of UTI in Neurogenic bladder?

A. If an antibiotic treatment is necessary for UTI, your doctor may prescribe a 5- to 7-day course of antibiotic treatment that can be extended up to 14 days, depending on the extent of the infection.

Q 6. What is the prevention of recurrent UTI?

A. If UTIs keep coming back in patients with neuro-urological disorders, it may be a sign that the underlying problem-for instance, incomplete bladder emptying or bladder stones-is not being addressed completely.

Sometimes improving bladder function and or removing a stone will solve the problem. If not, your doctor may consider individualised approaches like dietary supplements.