[Maria]

It sounds as though we are talking specifically about females so then we consider what age group, sexually active and if so, monogamous, using protection, anal, gential penetration, oral sex, post coital urination, meds utilized such as oral contraception, antibiotics, other meds and so forth plus the overall spinal condition as well as overall health condition of the person and other considerations.

Prior to my first spine surgery yet also before my first documented spine injury, I had numerous UTIs. I was catheterized quite often and seemed that even if I didn't have a bladder infection there was irritation of the urethra that was problematic enough to make me feel like I was having a UTI thus treated in this manner. On hospitalization for first spine surgery when male nurse trying to cath me w/o anesthesia I crawled up to the head of the bed.. wasn't happening. I remember telling the nurses to knock me out if they were going to cath me so they waited until I was under to do so. Was later told I had a urethral stricture likely caused from either multiple infections and/or multiple caths.

After my first documented spinal injury and prior to my first surgery I experienced not only frequent UTIs (was monogamous and on oral contraception but no other meds) I experienced something akin to stress incontinence without the stress. Just leaking. Urologist thought it related to my spinal condition at L5S1. Neurosurgeon wasn't sure but thought perhaps it would be relieved with surgery at L5S1.

Had some very sophistocated urodynamic testing (editing prior post as recalling more on this) and was recommended to go under general anesthesia and fill the bladder up completely and have it empty under general anesthesia because it was difficult in an awake state with a catheter in my bladder, and one in the rectum (for pressure) over more than several hours of testing to get an accurate dx re emptying (neurogenic bladder). Was told that with multiple UTIs the bladder wall was much less elastic and under general anesthesia while the bladder capacity was being tested, there were treatments to stretch out the bladder wall and injections.

I do remember speaking to few patients that had undergone the treatment to stretch the bladder wall and not being impressed with what they had to report. The Neurosurgeon I was seeing made sure to get a Uro (one of his choice) consult while I was catherized/hospitalized and the testing he performed was much simpler and I was prescribed Ditropan for frequency.

After my first discectomy I no longer had the incontinence. The Neuro didn't take credit for this as I recall only asked about recurrence and I saw the Uro several more times but didn't want to take the Ditropan on a regular basis. Not until after my 2nd discectomy which was at L4 and failed did I experience a similar but slighter level of leakage (incontinence) and for a very short period of time. I was advised to come in immediately to r/o Cauda Equina as I recall.

Ok suggestions to avoid routine UTIs
Stay hydrated, drink enough water
As mentioned before, void when needed, wipe front to back.
Precautions re relations/intimacy w/new partners
Perineal hygine
Undergarments w/o dye, clean

See your doctor when you've urinary complaints such as burning, frequency, urgency, pelvic or back pain of unknown origin, leaking or incontinence and just general malaise, temp.101 or greater (even low grade increase), nausea... just best to check it out.

I've edited this post because there was too much info there but suffice to say of course one should get a diagnosis re UTI (urinary tract infection vs. other such as neurogenic bladder).

Wondering which came first the chicken or the egg in terms of bladder probs again I have to say throw into the mix all the reasons one might have frequents UTIs as well as incontinence and the best I can say is if you are symptomatic with any urinary complaint, don't wait too long to see if it's going away on it's own (I think most people are seen again with acute complaints such as burning, frequency and urgency. I didn't go right right away for the incontinence as I was *embarrassed* and had no other symptoms. Make an appt. with your PCP. I've seen some nasty consequences of undiagnosed bladder infections/urinary complaints gone unchecked, let alone something that might or might be related to the spine.

I have to think that somehow the incontinence I had was related to my disc bulge just because it stopped so dramatcally post my 1rst L5S1 discectomy. The UTIs.. while I've only had one since in the last 25 plus years and I can't say that I can give my L5S1 discectomy credit for that though perhaps partial credit?