BobAug14Q. I’m in my 23rd year as a T9 para. I manage my bladder with intermittent catheterization, drink plenty of water and cath at least four or five times a day to make sure my bladder doesn’t get too full. I rarely had problems with bladder infections until recently. Over the past few years it seems like I’m fighting one after another. I try to flush them by drinking extra water, but more often than not, I end up on a course of antibiotics, which messes with my gut.

In a previous Para/Medic you wrote about an antibiotic called Neosporin G.U. that goes directly into the bladder and can be used on a daily basis. A friend’s urologist has him on a similar system, but it’s a mixture of saline and Gentamicin — he says it has kept UTIs at bay. Does one solution work better than another? And if you use them regularly, do they contribute to antibiotic resistance?

— Jeff

A. Good questions, Jeff. This is a topic that appears quite a bit on SCI-related sites, including CareCure Forum and Apparelyzed.com, which discuss a myriad of solutions that can be added via catheter to the bladder to help reduce UTIs. The solutions can be added during clean intermittent catheterization (CIC) by way of a 60cc syringe that fits into the end of the catheter, or in the case of a suprapubic catheter or indwelling Foley, adding the solution and clamping the catheter for 20 minutes.

To track down answers, I turned to Dr. Michael Kennelly, director of urology at Carolinas R