Prevention of Urinary Tract Infections in Patients with Spinal Cord Injury
Since urinary tract infection (UTI) is one of the most serious complications in patients with spinal cord injury (SCI), effective measures must be taken to prevent its occurrence.
Standardized Procedures：
After thoroughly washing hands in strict accordance with the six-step hand hygiene technique, aseptic principles must be strictly observed. An appropriate disinfectant should be used to disinfect the urethral meatus and the surrounding skin and mucosa. Each cotton swab should be used only once and must not be reused. Sterile drapes should be placed correctly to avoid contamination of the urethral opening and to maintain the maximum sterile barrier.
Key Preventive Measures During Catheter Insertion：
During catheterization, patients may experience urethral spasm. Therefore, all maneuvers should be performed gently, and patients should be instructed to relax and cooperate during the procedure. The catheter should be inserted to an appropriate depth based on the patient’s urethral length. Throughout the procedure, mechanical injury to the urethral mucosa must be avoided. Even in patients with sensory impairment and reduced pain perception, forceful manipulation should never be applied.
During bladder emptying, special attention should be paid to preventing urine reflux, which may lead to ascending infection.
Maintain cleanliness and dryness of the perineal area：
During intermittent catheterization, the perineal area and the skin and mucosa around the urethral meatus should be cleaned or rinsed daily with clean water to maintain hygiene, which can reduce the risk of urinary tract infections. Cleansing is generally recommended 2–3 times per day. However, in patients with spinal cord injury (SCI), especially those with fecal incontinence or watery diarrhea, cleansing should be performed promptly to prevent bacteria from feces from entering the urinary tract.
Given the shorter urethra in females, special attention should be paid to keeping the perineal area clean and dry, maintaining relative asepsis of the urethral opening, and preventing infection by intestinal bacteria.
For patients with urinary incontinence who use diapers or disposable collection bags, these products should not be reused and their duration of use should be minimized. The perineal area should be kept dry, and if necessary, tools such as a hair dryer may be used to prevent local moisture, which can promote bacterial growth.
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