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Recurrent Infection. Doing Clean Self Intermittent Catheterisation. Undergone Surgery For Pelvic Lipomatosis, Augmentation Cystoplasty. Cause Of Infection?

Posted on Fri, 26 Apr 2013

Question: I was operated twice viz. for Pelvic lipamatosis in 2008 and then Augmentation Cystoplasty in the year 2009 and since July2009, I have been doing CIC (clean intermittent catheterisation by self) Of late, I am afflicted by same infection almost every month viz. Escheria coli , inspite of using the recommended course of antibiotic suggested by my urologist .What is the reason forsuch recurring infection within short periods?Is there a way out as the antibiotic(Meropenem) is costly and to be administered by IV only. My creatine , which usually is within 3-3.2 rises even upto 4.8-5.0 during the infection period.My surgeon who had operated me had told that I will get infection once in every 6-8 months only. Kindly suggest what I have to do.for my problem.

Answered by Dr. Dr. P. T. Patil (7 hours later)

Hello,

Thanks for your query.

Based on the facts that you have posted it appears that you have undergone surgery for Pelvic Lipomatosis and Augmentation Cystoplasty 4 years back and now doing Clean Self Intermittent catheterisation (CSIC) to drain urine from your bladder.

Every time you do catheterisation, there are chances of bacteria entering from exterior in the bladder and that is the reason for getting repeated episodes of UTI for which you have to take antibiotics intra venously.

Please ensure to observe utmost aseptic precautions while doing self catheterisation. As for as possible use new sterile disposable catheter every time to drain the bladder. You can have a trial of passing urine without doing CSIC by giving manual pressure over supra pubic area and try to pass urine naturally.This helps in few patients who have undergone Augmentation Cystoplasty.

Get your urine culture done to find out the organisms causing infection and antibiotics to which they are sensitive to, so that you can take appropriate antibiotic as per culture report.

Hope I have answered your query.
Please feel free to ask if you have any more questions I shall be happy to help you.
Thanks with Regards.
Dr.Patil..

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr. P. T. Patil (15 hours later)

Doctor, kindly explain main aseptic precautions to be followed before Selfcatheterisation, in detail, for which I shall be thankful to you. What is the best soap for washing the hands before CIC ?

Answered by Dr. Dr. P. T. Patil (8 hours later)

Hello,

Thanks for follow up.

You can use normal bathing soap to wash your hand

Wash your genitals with soap water.

Clean the genitals and glans of the penis with soft cotton soaked in anti microbial solution (Betadine)
Put little local anaesthetic jelly in urethra gently.

Take a fresh sterile urethral catheter and apply little jelly to the tip and pass it gently through urethra till it enters the bladder and urine starts draining.

Empty the bladder completely.and take out the catheter gently .

Wipe out tip of the glans with clean dry cloth or cotton.

Thanks and Regards.

Dr.Patil

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Raju A.T