Does odour in urine mean I'm not emptying bladder properly?

Everyday living
1

Hi everyone

I stopped self catheterising for several months now and haven’t had an infection since but since doing this my urine has the smelly odour; so I’m wondering if it’s because I’m not emptying properly.

I’m so happy not to have an infection (though I’ve had some symptoms but the tests just come back clear). I do have more accidents but I’m continuing to drink plenty of water.

Do you think this is caused by not emptying properly, I haven’t changed my diet.

I was told by my continence nurse that not using a catheter can cause kidney damage in the long run and I should take 1 a day antibiotic, for the infections. (by the way I’m SPMS). Not keen on the idea of the one a day antibiotic.

I do take D-Mannose.

Can anyone give me advice on this please.

2

hi corkie

smelly odour is to me a sign of infection but if you have had a test that came back clear???

also i take a one a day antibiotic and i haven’t had an infection since starting this.

like you i had doubts about long term use of an anti biotic but at least i’m not having relapses due to UTIs.

obviously i haven’t answered your question but surely someone will be along soon who can.

good luck

carole x

3

Hi, I have an spc, so empty my bag at closer quarters to my nose than as would be normal!! My urine very often does have a strong smell. I have rarely had a uti.

In a morning when my night bag is emptied, the strong can be quite overpowering!

But of course there is a highly concentrated almost 2 litre of urine there!

I drink loads of water and my catheter drains well, so nurses say there’s nothing to worry about.

If you are drinking lots of water and going to the loo several times a day, you should be OK, but you could be retaining urine.

Retention can be tested by a scanning machine by a district nurse.

Pollxxx

4

I would have thought the smell has to be made by something - microbes?. But if so, clearly not to be enough of an infection for an infection test to be made positive.

As Poll wrote, “Retention can be tested by a scanning machine by a district nurse.” Also, my MS nurse told me my MS team also had a scanner.

Keeping your bladder well flushed seems to be keeping infections that cause positive tests or usual symptoms at bay. I haven’t heard about kidney damage though.

5

Hi Corkie

Normally a strong smell would be related to a UTI so if you’ve had a clear test then it can only be due to retention, unless you’ve been eating a lot of asparagus.

As Poll said, you can have your bladder ultra sound scanned to check how much you are retaining, does your continence nurse use one of the portable scanners? Maybe you could ask for a test?

If you are retaining more and having more accidents, then maybe you could think about a long term antibiotic or about starting to ISC again, unless that was itself causing infections. It all depends on why you stopped I suppose. Maybe try again but with a different catheter type?

Sue

6

Thank you all so much for your replies, my continence nurse has tested my bladder and said there was over the rate recommended and therefore I should be self catheterising. I think I will give her a call, perhaps I can be shown how to do it again.

Around 9 infections last year that’s why I’ve stopped using a catheter.

But thank you most kindly for the replies.

7

Hi Corkie

What you should perhaps do, is try out quite a few different catheters. Getting infections from self catheterising could be a problem of technique, or of hygiene (which is really related to technique) or from the actual equipment (again, related to technique). And ask for at least 5 of each type to give them a proper trial.

I don’t think when first taught to do it that I was necessarily given very good instructions or assistance. i had an appointment with a continence nurse and a rep from a delivery company, I was shown a few catheters and asked to pick one (which if you’ve no idea what you’re looking at is lucky a lucky dip). Then I was asked did I want to try doing it on the loo or using a mirror on the bed. I opted for the loo and utterly failed. Then tried on the bed. And utterly failed. Eventually the nurse did it.

I then spent a good two months doing it twice a day on the bed, using a mirror and a night bag each time to collect. I can’t tell you how difficult I found it, getting into the right position, balancing a mirror, having accidents, and going through catheters like no tomorrow.

Eventually I decided to just try doing it sitting on the loo. Hey presto, managed it first time. I think all the time staring into the mirror had taught me something about my anatomy that prior to ISC I just didn’t know. I also didn’t know initially what it was supposed to feel like when you get it right.

To begin with, for about the first 2 years I used Actreen Lite Mini. They’re quite stiff catheters, which I think helped to begin with. Easy to open and coated with lubricant so quite easy to use. However, they are quite hard too. So after a couple of years I decided to try out a few others. Now some of these are so floppy, I’ve likened it to trying to push a piece of cooked spaghetti into my urethra. I think that if the catheter is too floppy, you’re more likely to get an infection from Trying to get it in the right place. I’ve settled on Speedicath Compact Plus. I also had a while of using Lofric. I had trouble getting the water bubble in the Lofric to burst at first, and they are a little bit floppy as well but I did manage quite well on them, generally though I do better with Speedicath.

In the last two years I’ve only had one nasty UTI which took a while and several antibiotics to get rid of and one simple UTI since then. I think my technique is now pretty good and I test my wee all the time so I know pretty fast if I’ve got one.

I should think you will manage to get your technique sorted once you’ve tried a few different catheters and settled on one that works best for you. Keep taking the D-mannose, that should help matters as will drinking lots of water. I tend to only take D-mannose when I go on holiday, because that’s the time when I’m most likely to get a UTI I’ve found, unfamiliar bathrooms make proper hygienic technique harder.

Good luck with it. And ask for help if you need it either from your continence nurse, the delivery company (their nurses can be surprisingly helpful) or of course from us on this forum.

Sue

1 Like
8

Apparently, tests sometimes come back negative because the bug multiplies slowly and growth culture isn’t monitored for a long enough period. Also, some bug levels may be too low to trigger a positive result, yet the low level may still cause symptoms.

9

Thank you Sue, I do know where you’re coming from, never thought I’d end up knowing that part of my anatomy, to be a bit crude I always thought that area was for s*x. I was using speedicath catheters and I had one year with several infections and one year almost infection free. Last year was a disaster, it was almost as if my bladder had rejected having things inserted into it.

10

Thanks mrbowen, I’ll order some more test strips, in fact my test strip did show a slight infection but my ms nurse tested on Monday and the nurse at my surgery have tested more than once, I’ll order those test strips right away.

11

I’ve tried cheaper test strips, but the best ones are the most expensive, ie Siemens. Also, if not kept absolutely dry, the leucocytes square gains a slight pink tinge to it, making you think you have an infection when you haven’t.

So, I tend to either keep them out of the bathroom, or in a waterproof bag.

Sue

12

I’m on a one a day antibiotic. I ISC all the time and was forever getting infections. The urologist advised me to rotate 4 different types of antibiotics (for 3 months each) so I don’t become resistant to them.

Sarah

13

That’s interesting and one of the reasons I declined them; if it comes to it, I’ll bear that in mind Dogtanian.

14

Thanks Sue, I’ve already ordered them, not sure where they are coming from. I do keep them out of the bathroom, in an envelope out of the sun, also don’t order too many at a time, but it is possible that the last couple of times they were contaminated.

I’ll be careful in future.