Urinary Tract Infection and Neurogenic Bladder

Urol Clin North Am. 2015 Nov;42(4):527-36. doi: 10.1016/j.ucl.2015.05.006. Epub 2015 Jul 7.


Urinary tract infections (UTIs) are frequent, recurrent, and lifelong for patients with neurogenic bladder and present challenges in diagnosis and treatment. Patients often present without classic symptoms of UTI but with abdominal or back pain, increased spasticity, and urinary incontinence. Failure to recognize and treat infections can quickly lead to life-threatening autonomic dysreflexia or sepsis, whereas overtreatment contributes to antibiotic resistance, thus limiting future treatment options. Multiple prevention methods are used but evidence-based practices are few. Prevention and treatment of symptomatic UTI requires a multimodal approach that focuses on bladder management as well as accurate diagnosis and appropriate antibiotic treatment.

Keywords: Antibiotic prophylaxis; Antimicrobial resistance; Bacterial interference; Neurogenic bladder; Probiotics; Spina bifida; Spinal cord injury; Urinary tract infection.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Catheter-Related Infections / diagnosis
  • Catheter-Related Infections / drug therapy
  • Humans
  • Intermittent Urethral Catheterization / adverse effects
  • Mannose / therapeutic use
  • Phytotherapy
  • Plant Preparations / therapeutic use
  • Probiotics / therapeutic use
  • Therapeutic Irrigation
  • Urinary Bladder / physiopathology
  • Urinary Bladder, Neurogenic / complications*
  • Urinary Bladder, Neurogenic / therapy
  • Urinary Tract Infections / diagnosis*
  • Urinary Tract Infections / etiology
  • Urinary Tract Infections / prevention & control
  • Urinary Tract Infections / therapy*
  • Vaccinium macrocarpon


  • Anti-Bacterial Agents
  • Plant Preparations
  • Mannose