Struggling with Kidney Infections and Urostomy: Need Advice

hi, wonderding if ANYONE can help? i have suffered from repeatedKidney infections for the past 5 years, the last 2 being very difficult . i am almost permently now on antibiotics and since joining this wonderful sight have discovered that the antibiotics that i have been taking Trimethoprim are not any use for people with no bladder ie Urostomy, i read this on the Shaz's Ostomy page, wondering anyone have read this and if they have had the same probilom as me? i have heard that urinary infections gohavnd in hand with urostomy's but feel my situition is never as it should be is it? please can anyone help with advice?

than you love from grace.

Hi Grace

It must be frustrating! You are wise to maintain your kidney health.

I am assuming you have an incontinent urostomy (meaning no new bladder was created and you wear a pouch). With this type of urinary diversion, infection is one of the frequent complications. Possible causes could include urine refluxing (going backwards and up) to the kidneys, and kidney stones. There may be other reasons, including pouch hygiene.

Have you seen your urologist rather than your general practitioner for follow-up? Imaging the urinary tract system could help diagnose or rule out issues.

A couple of general pointers helpful in preventing infection:

Be sure to wash hands thoroughly before changing your pouch. You may also want to change your pouch system more frequently (every 3-4 days) as bacteria can grow in the pouch. I had one physician who advocated putting a small amount of Betadine in the pouch to kill bacteria, I personally haven't read studies to prove this helped though the literature may be out there.

Staying hydrated is important, though one study suggests forcing too much fluid may nullify the good effects of antibiotics. Adding 1-2 glasses of cranberry juice or taking cranberry pills may help to acidify your urine; this has proven beneficial to preventing certain bacteria from clinging to the urinary organs. Vitamin C in large doses may also be of benefit, but would check with a urologist first as it can also cause issues with stone formation.

When giving a urine specimen an ostomy nurse or urologist should catheterize your stoma in a sterile manner to get an accurate specimen. It should not be taken from the pouch even if it is clean since it is not sterile (though I see this manner of collection a lot!) If catheterization is not possible, I'd suggest removing the entire appliance, and having the nurse or physician clean the stoma with sterile technique, and place a sterile cup under the stoma to collect the urine. (Yes, it takes a while!)

I recall a couple of patients years ago that were on long-term antibiotics as a preventive measure due to frequent infections; it was years ago and not certain why or if this is a frequent practice.

Have you seen the urologist who did your original surgery? Though any urologist could help, your surgeon may have more specific knowledge on how your urinary diversion was constructed...may be beneficial.

Hope some of the ideas will help.

Hi Grace and Whoa---I have had a urostomy (radiation damage to bladder) since 1983, I  have frequent infections and stones. My Urologist says that the infections can be a result of the urine backing up into the kidney (reflux) as Whoa explained. I take trimethoprim 100mg every day.

I have found that I have to plan ahead to avoid getting dehydrated. I stay out of the sun and always have water with me. I take extra care changing my appliance and try to be as sterile as I can--I too am frequently on stronger antiobiotics which can wear you down. BUT-I have had my urostomy for 25 years and I have been living a relatively "normal" life with it--- So, I guess my best advice Grace is to plan ahead!  Also, Whoa I'm so glad you joined us at Meet An Ostomate! Your knowledge and experience is impressive and I think we are lucky to have you!!