Diagnosing and Treating UTIs When You Have a Spinal Cord Injury

Unfortunately, urinary tract infections (UTIs) can be all too common when you have a spinal cord injury. Here’s what you should know about how UTIs are diagnosed and treated, and what you can expect.

Learn about how urinary tract infections are diagnosed and treated.

A urinary tract infection (UTI) occurs when bacteria enters the bladder and grows out of control. People with spinal cord injuries often use catheters to help them urinate, which can increase the risk for contracting this type of infection.

Why does a catheter potentially increase your chances of getting a UTI? Because a catheter may allow a direct path for bacteria to enter your bladder. A certain amount of bacteria lives in your bladder without causing issues. However, increases in bacteria to infectious levels can cause a UTI.

If you have a spinal cord injury and notice symptoms and signs of a UTI, it’s vital that you make an appointment with your healthcare provider as soon as possible. Left untreated, a UTI can have serious consequences. The infection can spread to the kidneys, causing permanent damage. It can also result in sepsis, a potentially life-threatening complication of an infection.

Diagnosing UTIs

First, your physician or their assistant will discuss the symptoms you’ve been experiencing. They will be looking for one or more of the common signs of a UTI. These may include (but are not limited to): fever, change in urinary urgency or frequency, incontinence/leakage, muscle spasms, fever, back pain, and cloudy or foul smelling urine.

Your doctor will likely run some tests to see if an infection is present, including a urine sample test to measure the amount of bacteria present in your urine.

Lab analysis of urine is sometimes followed by a urine culture, which can tell the doctor what bacteria is causing your infection and which medications will be most effective. If you have a urine culture greater than 10,000 colony-forming units of a urinary pathogen (a medical term for the amount of bacteria in your bladder), you may be diagnosed with a UTI.

Treating UTIs

Depending on the results of your urine sample and culture, and on whether you have any drug allergies, your healthcare team may prescribe antibiotics as the first line of treatment. Some commonly prescribed antibiotics include: fluoroquinolones (e.g., ciprofloxacin), trimethoprim, sulfamethoxazole, amoxicillin, nitrofurantoin, and ampicillin.

Some important things to know about UTI treatment:

• It’s important to take the entire amount of prescribed antibiotics so that the full colonization of bacteria causing the UTI is destroyed
• If you see signs of improvement or feel better, do not stop or reduce your prescribed antibiotic treatment — sticking to the plan will help ensure a full recovery
• If you use an indwelling catheter, changing your catheter at the midpoint of your antibiotic treatment program will reduce the risk of bacteria re-colonization (i.e., from continuing to use your old catheter)
• Unless your doctor recommends it, you won’t need to have a repeat urine culture after you’ve completed your antibiotic treatment program (providing that your signs and symptoms have improved or gone away)
• If you experience signs that your UTI has returned, or if you find yourself having recurring urinary tract infections, your healthcare team may recommend additional tests or treatments

Once your UTI has been treated successfully, your physician may tell you some ways to prevent future infections. These tips could include drinking plenty of water and following good hygiene habits when handling your catheter supplies.