I CIC & suffer recurrent UTI’s - anyone with experience of bladder washing/instilling?

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Following two unsuccessful procedures for retention problems I’m following a 4 x day CIC regime. 

Unfortunately I keep getting recurring UTI’s which are treated with antibiotics and then shortly return. The latest of which is an ESBL infection which has been unsuccessfully treated with carbapenems for a month.

I read on a separate SCI forum that some sufferers have started incorporating a bladder wash/inistillation procedure into their CIC regime whereby once or twice a day they instill 20cc of Microcyn/Microdacyn/Puracyn into the bladder after voiding - everyone who does this seems to report a huge drop in UTI’s.

So I’m wondering if anyone on this forum has tried this regime and what the results have been?

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10 Replies

  • Posted

    Hi Markie,

    My husband has a permanent Foley urethral catheter which I manage for him.  I know it's not the same as CIC (His hands couldn't manage that) but I think the risk of infection is about the same.  Maybe with CIC therre's more trauma every time you do it which gives the bugs in the bladder something to grip onto - any damage to the bladder lining compromises it which then encourages bugs to get a grip and build colonies.

    He takes a prophylactic (preventative) 100mg dose of trimethoprim daily.  This drug doesn't suit everyone, I know, but he has had no infections since he's been taking it every day. I also give him a daily probiotic to help counteract the undesirable effects of the antibiotic.

    In addition I do a bladder washout every 4 days.  I don't know the products you mentioned but I see it's used for healing minor wounds etc so it probably introduces a low amount of antibiotic into the bladder which deals with a bug problem before it starts. The washout I use is a citric acid and saline product and it's main purpose is to keep the Foley catheter free running as colonies of bugs can clog the drainage holes. 

    It's a wonderful world!  I think the product you mention sounds like it's worth trying as being on permanent antibiotics is no fun.  What you really don't want is to be given Cipro (or another fluorquinolone) in an attemp to get rid of the bugs. If you have had Cipro already please don't take it again, if you haven't had it, please don't ever take it.  Take a look at the Fluoroquinolone antibiotic discussions on here to see what I mean. My husband was given it twice for rucurrent UTIs then the third course nearly killed him.

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  • Posted

    I have used Microcyn by its various names for bladder distillation. But the first question is what are your UTI symptons are are you without symptons? If without symptons, then in most cases you should not be treating with antibiotics regardless of what your urine culture says. You might also want to try a hydrophillic catheter if you aren't as you may find less trauma and UTIs. 

    As to Microcyn, it's not an antibiotic but some sort of patented formulation of what looks like diluted bleach. Yes, some swear by it over at the SCI forum but I have some reservations about putting any form of bleach in my bladder on a long term basis. You might first start with simple sterile saline or sterile wate4 after CIC, Then very gently pull the syringe plunger up an down to move the saline around. Then cath again to get the fluid out. I did this for awhile but stopped after not seeing much benefit but everyone is different. 

    As to phophalactive daily antbiotics, this would be my very last solution.

    Jim

     

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    • Posted

      Thanks for your replies.

      My uti symptoms are painful bladder/burning in prostate region, urgency to go, cloudy, smelly pee, as well as sweats. Lab results show <1.000 cfu/mL extended-spectrum ß-lactamase (ESBL) Klebsiella pneumoniae which is resistant to all mainstream antibiotics, as a well as a couple of carbapenems which doesn’t leave many treatment options left.

      The uro says normal colonization is not a problem but that ESBL infections must be treated. Since I’ve already tried many options including a PICC line for a couple of weeks getting pumped with a carbapenem which didn’t help I was wondering whether to give the bladder instillation a shot since everything else has failed.

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    • Posted

      Jim,   Welcome back,  we haven't heard from you for a while.   

      When people are talking about washing the bladder, are they using a special catheter or foley, with two or three tubes in it, or special connections at the distal end ?   If you do this do you need to use only sterile water or solution (no tap water) ?  Can you boil water to get it sterile, or do you buy it somewhere ?

      Thanks,

      Thomas

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    • Posted

      You might want to get another treatment opinion from an infectious disease specialist. As to bladder installations, might be worth a try. I haven't seen anything published on Microcyn so all you have is anecdotal there. Also, I believe installations are more preventative than curative but that doesn't mean you shouldn't try. 

      Jim

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    • Posted

      You get like a 60ml syringe barrel (no needle) that will butt against the plastic funnel of most catheters. You put in the solution and then inject in through the same catheter you have just self cathed with. Then you can either leave the solution in for a while (some leave it in until the next CIC), remove it right away, or swish it around a bit before sucking it up with the syringe. Just be very gentle. You can buy sterile water and/or sterile saline online or i suppose you could boil your own but you might want t research that a little or ask your uro. 

      Jim

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    • Posted

      Well I thought anything that might potentially reduce the monthly UTI's and courses of antibiotics I endure would be worth a try. I was alternatively considering trying octenisept which is indicated for catheter insertion but contraindicated for bladder instillation, but cant find any information on anyone trying this - anecdotal or otherwise.

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  • Posted

    I'm avoiding UTIs by keeping my urine pH level close to 7, and by self cathing once a day just before bedtime. If you have repeatedly UTIs, you might want to bring it a little lower than 7, making more acidic. Acidic urine will kill the bacteria, which is usually the cause of UTIs, and keep them under control. Hank

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