Thankfully I've only had one UTI, and that was during a bout of TM...probably due to the cath.

The urologist explained it this way.
He said that when the bladder doesn't empty completely, sometimes portions of the bladder wall get over stretched and that can cause the "cement" that holds the cells together to break down in those areas.
If there are bacteria, viruses or fungus present, the created space between the cells allows those pathogens to get in there and hide out. Then when the bladder does empty, those spaces close over, trapping the pathogens; where they escape the natural disinfecting nature of the urine, as well as antibiotics/antifungals.

When the bladder then gets over stretched again, the pathogens are released and are able to cause infection and/or re-infect other areas of the bladder wall that are over stretched.

My UTI did not respond to oral meds, so the urologist did an infusion of the bladder to stretch it and expose the bacteria/fungus to the medication. I think that he used a mixture of an anti-fungal, steroids and ABs. He then left the installed cath in place, which remained for 2 weeks, to ensure that the bladder emptied and the bladder wall didn't get over stretched during the healing process. That allowed the cells of the wall to heal over.

The procedure did come with a warning that if the bladder wall cells didn't heal over, that it could predispose it to more infection, because the procedure itself caused an overstretch of the bladder wall. Luckily, that didn't happen.

For after care, he said that it was important to empty the bladder completely and suggested what Sally does...to press down on the area above the pubic bone while leaning forward to ensure complete emptying.
He also said that if urinary retention remained a problem, that using a cath might be a good idea to ensure emptying and prevent infection, but he said that the cath itself increased the risk of introducing bacteria.

In the end, he felt that if I could strengthen the abdominal wall and pelvic floor, that in itself would support the bladder from the tissues outside of it to prevent over distension.
He added that, because I hadn't stretched those structures through pregnancy, that it was likely to be more successful...so I don't know if it is as successful for those who have had children.

The urologist then gave me some exercises to increase the strength of the lower abdominal wall and the pelvic floor. These are just sustained contractions that are done while sitting and leaning forward, to the side and back; with the hips flexed up wards (sort of like a reverse sit-up), first with one hip at a time, then with both together.

He said that it was equally important to drink plenty of fluids to keep the bladder flushed; despite possible incontinence or difficulty with voiding due to the neurological issues.
I do drink a lot of fluid and do the exercises regularly while at the computer or while sitting pre-meditation and haven't had any problems with infections since.

For those who get chronic UTIs, you might inquire about getting an infusion treatment to clear the bladder wall of possibly trapped bacteria/fungus. My treatment took around an hour and wasn't uncomfortable to have done. Sort of like a prolonged PAP for the ladies...don't know how it goes for the men though, because it does involve a cath.

With love, Erika

Thank you for the information, Erika.

I don't believe I would care to have the procedure you described done on me. But, my history with UTIs will be different than the majority with this disease.

I started having chronic UTIs at the age of 4. The cause of my UTIs was diagnosed as retention, bladder not completely empting. I was on medication once a month due to UTIs.

The thought was I needed to be cathed, which was done once a month and hospitalized for the procedure once, to stretch the Urethra. This was supposed to help retention, it did not This was done until the age of twelve with no change in the frequency of UTIs.

A Urologist whom I started seeing at the age of 13 told my mother not to allow any doctor to cath me as this was not doing anything for me but causing pain.

To this day I still deal, off and on, with chronic UTIs. Unfortunately, I now find I can have UTIs but I am asymptomatic.

Erika, thanks so very much for this info!! It's very timely for me, as I am on abs for the second time in a month for a UTI…they are becoming chronic.
Are there urologists who specialize in MS bladder issues?

I did go to a urogynecologist. He placed a camera in the bladder and filled it with water; we watched as the muscles went into full tilt spasms…it was weird. I did void the same amount he inserted, so my bladder was behaving, but that was a few years ago.

I am very fastidious with my hygiene, but with all of the bladder/bowel issues, those little germs can travel far and fast

Hi Debbie,

The procedure you had is called a Cystoscopy. I have also had this done a few years ago and everything came back normal.

There have been many times through the years where more than one antibiotic has to be tried before the UTI is gone. I just finished a second antibiotic recently for another asymptomatic UTI.

This explains a Cystoscopy, the reason for having one and what it can show:
http://www.nlm.nih.gov/medlineplus/e...cle/003903.htm

Erika - I'm actually starting PT for my bladder in a couple of weeks. My urologist basically said the same thing. He said they found that doing PT can be as effective as medication and/or surgery. Since I don't want to go either of those routes at this point, I'm doing the PT. I'm sure it involves pelvic floor exercises. I'll let you know.

I am a retainer and luckily have only had 1 UTI in my life. I have been very lucky in that regard. UTI's can be so sneaky and tricky. I honestly did not know I had one. Being a retainer has that risk of UTI's associated with it. When he did the testing this time, about a month or so ago, I'm now retaining about 200 ml. Based on that we know the retention is getting worse and I'm in hopes that the PT will help with all of it.

Good luck!