Prevention
How to prevent problems and maintain a healthy bladder and kidneys
Self-management tips
Urine that is smelly, dark in colour and/or cloudy without other signs (such as fever, increased spasms) rarely needs any treatment.
Look for the presence of blood, sediment or other debris that may indicate an infection or other problems.
Action:
- Drink plenty of fluid, unless you are told not to drink a lot of fluid for other reasons
- Aim to drink 6-8 glasses per day or drink the maximum amount you are allowed.
Urine that is smelly, dark in colour and/or cloudy without other signs (such as fever, increased spasms) rarely needs any treatment.
Look for the presence of blood, sediment or other debris that may indicate an infection or other problems.
Action:
- Drink plenty of fluid, unless you are told not to drink a lot of fluid for other reasons
- Aim to drink 6-8 glasses per day or drink the maximum amount you are allowed.
Make sure you know which equipment comes from where, the cost and who’s paying for it.
Action:
- Always have at least 3 months’ supply on hand in case your order is delayed.
Ensure your suprapubic catheter or indwelling catheter is changed every 4 weeks.
Action:
- Always have contact details of your healthcare professional handy (especially when being discharged after your spinal cord injury) to arrange a catheter change, or know where to go in an emergency.
Ensure you have an ‘emergency’ supply of basic equipment – catheters, drainage bags, and so on.
Action:
- Make sure to always take a few extras in case you are held up and don’t get back when you thought you would.
Know which medications you are taking for your ongoing bladder management. It is important that you understand how each medication works, why you are taking them and the possible side effects.
Action:
- Ask your GP to explain your bladder medications and why you need to take them.
Make sure you know who is available to give you advice. Bladder problems can be really frustrating and interfere with many aspects of your life, if they remain unresolved.
Action:
- Always have a contact list handy
- Your community nurse, GP or other healthcare providers such as a urologist should be able to assist you
- Carry your AD Emergency Treatment card (for more details, read the Autonomic dysreflexia module) and medications.
If you feel ill, have a raised temperature or experience other symptoms, such as increased spasms, pain or autonomic dysreflexia, seek medical help immediately.
How to prevent a urinary tract infection
Empty your bladder at regular intervals to prevent it from getting too full
- If you do intermittent catheterisation, do it regularly (usually every 3-4 hours).
- If you use an indwelling catheter, change it every month.
Drink plenty of water to flush out the bacteria
- The colour of your urine can help guide you to drink enough water.
- Your urine should be yellow or golden in colour.
- You may need to drink more water if your urine is darker.
Cut down on drinking unhealthy liquids
- Reduce intake of liquids such as alcohol, caffeine and sugar drinks.
Eat a healthy diet and exercise
- This can help to boost your immune system and fight off infections.
Maintain good hygiene
- Maintaining good hygiene and keeping the area clean is a good way to stop the infection from spreading further.
Use of antiseptics (to weaken and slow the growth of bacteria)
- Current research does not support taking Hiprex with vitamin C or cranberry as an effective treatment of urinary tract infection.
- If you think cranberry helps, take tablets instead of drinking the juice which has added sugar.
Use of antibiotics
- Take the antibiotics exactly as prescribed and over the prescribed time frame.
- Do not stop taking them when you begin to feel better but finish the full course.
- If you have frequent UTIs, your doctor may recommend continuing to take a low dose antibiotic. A decision should balance the benefits of this against the risk of developing a drug resistant bacteria.
Quick Link
What does research tell you?
Cranberry products, such as tablets, capsules or juice, are not effective in preventing urinary tract infections in people with neurogenic bladders managed with intermittent or permanent catheterisation.
How to prevent bladder and kidney stones
- Pass intermittent catheters at regular intervals using the correct technique. This will prevent urine staying in the bladder for too long.
- Drink plenty of fluid (6-8 glasses of water is recommended per day) to avoid urine becoming too concentrated.
- Do or engage in as much exercise as possible.
- Changes in diet may help reduce some types of stones.
- Consume a high-protein diet. This reduces the level of chemical (citrate) in urine, which prevents stone formation.
- Limit or cut down foods with high amounts of oxalate. Food such as spinach, beetroot, sweet potato, grapes, capsicum, celery and liquids such as black tea.
- If your blood phosphate level is low, you will need supplementation.
- Request a kidney (renal) ultrasound every year to check for stones or other problems.
What does research tell you?
Increase your water intake and add lemon juice to the water. Lemon juice is high in citrate, a chemical, which may stop calcium from binding to other stone constituents thus preventing stone formation and recurrence. While the evidence on diet is mixed, the experts agree that a normal calcium intake and a low salt intake may help prevent stone recurrence.
Routine follow-up and tests
In general, your GP or continence nurse is the first point of contact for most bladder-related problems. You may also want to contact your community nurse or case coordinator.
It is recommended to have a ROUTINE FOLLOW-UP with your GP once a year to check your bladder and kidney health; more often if you have bladder problems.
As part of the yearly review of your upper and lower urinary tract function, you should have the following tests done:
An ultrasound of your bladder and kidneys is a useful, cost-effective, non-invasive method for long-term routine follow-up.
An ultrasound of your bladder and kidneys is a useful, cost-effective, non-invasive method for long-term routine follow-up.
Electrolytes, urea and creatinine (EUC)
Estimated glomerular filtration rate (eGFR).
Urine albumin to creatinine ratio (ACR).
Other tests may be ordered less often or as needed. These may include:
An x-ray or CT scan of kidneys, ureters and bladder (KUB).
An x-ray or CT scan of kidneys, ureters and bladder (KUB).
A nuclear medicine test that uses small amounts of radioactive material to see how urine flows through the kidneys, ureters and bladder.
A test assessing pressure and flow in the lower urinary tract when your bladder is filling and emptying.
Take home messages
EMPTY
your bladder fully every 4 to 6 hours
COMPLETE
full course of antibiotics, as prescribed
SCHEDULE
an annual check-up of bladder & kidneys with your doctor
QUIT
smoking
MAINTAIN
good hand hygiene when catheterising
AVOID
straining to empty your bowel as this can weaken the bladder neck muscles and cause urine to leak
DRINK
plenty of water