Urinary tract infection in patients with neurogenic bladder dysfunction

Recurrent urinary tract infections (UTI) are a significant problem in all patients with neurogenic bladder leading to high morbidity, poor quality of life and a limited life expectancy. For the diagnosis of UTI, a urine specimen taken by bladder puncture or catheterization is required. In patients with neurogenic bladders, clinical symptoms and leukocyturia must be present together with bacteriuria in order to qualify as UTI. The spectrum of pathogens differs significantly from that in patients with normal bladder function. Culture and antimicrobial susceptibility testing must, therefore, be performed prior to the initiation of antibiotic therapy. This is also important in the prevention of the emergence of antimicrobial resistance. The main way to prevent recurrent UTI in the neurogenic bladder is by restoring the normal low-pressure reservoir function of the bladder and is the aim of neuro-urological management.