Chroic UTI & Bladder Irrigation treatment

  Hi there,
  Due to a C5/6 injury, I have lived w/ incontinence for almost 7 years and use an indwelling foley cath.  I have had recurring UTI's throughout this time, but lately have had a chronic infection that I can't shake, and that most antibiotics can't touch.  My internal med doctor once prescribed CiPro & Sulpha together, and that seemed to work, however, it returned shortly after the medicine was gone.  Due, also, to too much penicillan a year and a half ago to get rid of a combo of meningitis, encephalitus and herpes of the brain, I have a bad candida problem and no longer want to use any antibiotics.  I've been using bladder irrigation w/ sterile water, as my doctor suggested, but have been told two different ways of doing it...one of which causes extreme discomfort.  
  My questions are; Which way is the correct way to do this? and, after the sterile water is put in, how long should it stay there before draining it?
  *Any* help with with would be Greatly appreciated!!
  Thank you very much!!

[HFHS M.D.-CK]

_
Dear Lora,
Spinal cord injury often involves urinary tract problems.  Renal failure, urinary tract infections, and incontinence are common.  Renal function should be periodically monitered with blood tests and ultrasound examination to make sure that any bladder disfunction is not resulting in renal damage.  Infections are best prevented by helping the bladder to empty without the use of a chronic indwelling catheter.  Options include clean intermittant catheterization or a surgical approach such as ileovesicostomy (opening the bladder to the abdominal wall).  Incontinence can be manged by surgically diverting the flow of urine or external collecting devices.  A chronic indwelling catheter is the method of last resort as it is associated with renal failure, infections, subsequent total incontinence and erosion of the urethral tissue.
Bladder irrigations are an uncommon method of treating urinary tract infections.  Certain bladder yeast infections respond to antifungal agents placed in the bladder.  Patients who do not make urine or do not fill their bladder (dialysis patients) may need antibiotic solution irrigation of the infected bladder.  Your irrigations with water may decrease the severity of infection, however manipulation of the bladder pH or adding an antibiotic to the water may improve the results.
More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653 6568). We can also arrange local accommodations through this number if this is
your need. Please bring any physicians