UTIs

 
Urinary Tract Infections (UTIs) are quite common in the Spina Bifida population. There are two types of UTIs: the bladder (cystitis) or the kidneys (pyelonephritis). These can present with no symptoms (asymptomatic) or with systems (symptomatic).
  • Signs of infection to look for are:
  • Urine looks or smells different, e.g. a 'fishy' smell
  • Wet in between catheterisation when usually dry
  • Needing to go more often
  • Burning or stinging sensation
  • Blood in urine
  • Temperature, headaches, vomiting
When someone has cystitis, they generally need to pass urine more often than usual and if sensation is present they may have to hurry to the toilet (urgency). The urine looks cloudy instead of clear and may smell different from usual. Drink extra fluids and take your child to your GP or Paediatrician who may prescribe a course of antibiotics. Ensure that laboratory testing is carried out to confirm the presence of a UTI.
 
A much more serious situation arises in pyelonephritis in which the infection affects the kidneys causing a high temperature, tummy ache, backache, and sickness and, may cause scaring to the kidneys.
 
The PDF document has more details on why UTIs are common in children with Spina Bifida, how CIC lessens the chances of urinary infections, medicines and other remedies
 
How to Prevent UTIs
  • Maintain adequate fluid intake by encourage your child to drink at least 4 cups a day and carry a drink bottle with them at all times. (The aim is to increase this fluid intake to 2 litres)
  • Ensure regular complete bladder emptying
  • Relieve constipation
  • Ensure the use of appropriate catheter size and type
  • Maintain a strict hygiene routine
Bowels
 
People with Spina Bifida are often constipated and pressure from an overfull bowel may add to the difficulty of emptying the bladder. They may also have poor control over their bowel in the same way as they have over the bladder. Since most urinary infections are caused by bacteria which normally live in the bowel, it is important to wash this part of the body carefully. Girls should be taught always to wipe from front to back and not from back to front.
 
Key points
  • In children with Spina Bifida urinary tract infections are mainly due to the bladder not emptying properly
  • Poor drainage from the bladder encourages infections to spread to the kidneys where they may cause damage
  • Good drainage is as important as fluid intake
  • Intermittent catheterisation ensures good drainage and protects the kidneys. It may also encourage social continence

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