Normally, the urethra (lower urinary tract), bladder, and ureters (upper urinary tracts) are sterile environments. Urinary tract infections develop when bacteria enter the environment of the urinary tracts or bladder and are able to grow and colonize the area. Symptoms include pain and burning when urinating, a feeling of needing to urinate urgently without being able to pass urine, and sometimes fever or chills. This type of infection, known clinically as cystitis, is much more common in women than in men.
A single episode of UTI can normally be treated effectively with a single course of antibiotics. In some cases, however, this is not enough. If UTI becomes chronic, a stronger treatment may be required.
Gentamicin Bladder Irrigation
For people who are affected by chronic UTIs, or who require prophylactic antibiotic treatment before catheterization, bladder irrigation with an antibiotic called gentamicin is a standard treatment. The antibiotic solution can be introduced via an existing catheter, or may require a patient be catheterized.
The term bladder irrigation refers to the fact that a solution of sterile antibiotic-containing liquid is used to irrigate or wash out the bladder. This allows the antibiotic to wash over the entire interior surface of the bladder, as well as the urethra. By irrigating the bladder in this way, any bacteria present are exposed to antibiotic. This treatment therefore helps clear up chronic infections by delivering a strong dose of antibiotic to the entire bladder and lower urinary tract.
In addition, bacteria that are introduced into the urethra or bladder in the hours after irrigation will be exposed to residual antibiotic. For this reason the bladder irrigation can be used to prevent infection following catheterization. In fact, this treatment is so successful that people who use a catheter in the long term can virtually eliminate the risk of cystitis with regular use of antibiotic bladder irrigation.
Gentamicin bladder irrigation is a minimally invasive procedure which can be uncomfortable or even painful for the patient. However, there are few risks involved and recovery time is minimal.
Defoor W, Ferguson D, Mashni S, Creelman L, Reeves D, Minevich E, Reddy P, Sheldon C. Safety of gentamicin bladder irrigations in complex urological cases. Journal of Urology. 2006 May; 175 (5):1861-4.
Marco Arap, MD, Steven P. Petrou, MD. Efficacy of Intermittent Intravesical Gentamicin Sulfate Solution for Recalcitrant Recurrent Cystitis in Women.