Urinary Tract Infections in Neuro-Patients

Abstract

The majority of neurological diseases may have an impact on lower urinary tract function. High intravesical pressure, post-void residual and incontinence are the main consequences of this dysfunction. All the mentioned conditions are inductive factors for urinary tract infections (UTIs). In addition, the potential complications of neurogenic urinary disorders (reflux, stone formation, incomplete emptying of the bladder), and the methods of urine drainage (intermittent or indwelling catheters, urinary diversion) contribute even more to UTIs. In neuro-patients, all UTIs are considered as complicated ones and there is a different microbiology as compared to the general population. In this chapter, inductive factors for UTIs in neuro-patients will be analyzed and the potential solutions will be exposed. There is a special mention in asymptomatic bacteriuria, which is correlated to neurogenic urinary dysfunction and it is clinically total different from UTI. Asymptomatic bacteriuria should not be treated as the treatment has a negative final outcome for the patient.

Adult Neurogenic Lower Urinary Tract Dysfunction and Intermittent Catheterisation in a Community Setting: Risk Factors Model for Urinary Tract Infections

“…Individuals with high intravesical pressures and impaired bladder compliance are more prone to UTI's than those with low intravesical pressure and high capacity bladder that it is emptied periodically by IC. The risk factors are the high intravesical pressures in the first case and the risk of bladder over-distention in the other case [52].…”