Catheterising and UTI Prevention: There Are More Options Than You've Probably Been Told

Recurrent UTIs in catheter users are common, often expected, and frequently undertreated, not because the options don't exist, but because most people navigating this experience are never told about them. This episode covers the full landscape of catheter and UTI prevention with the kind of clarity that is still too rare in clinical settings.

The Reality Nobody Promises Away

Keira McGarrity spent the first six months of intermittent self-catheterisation dealing with constant infections. She was eventually put on antibiotics for two years. The infections eventually settled but without a clear explanation of why.

That trajectory is more common than most patients are prepared for. Angie Rantell is honest about this and her honesty is one of the most helpful things in this episode.

"We can never promise no UTIs. We can't promise no UTIs because actually that's not normal. Women are prone to UTIs. It's about trying to reduce and risk assess and prevent." ~ Angie Rantell

That framing from elimination to reduction shifts the goalposts in a way that actually serves people better. One UTI a year compared to six is a meaningful improvement, even if the goal of none feels out of reach.

The Whole Picture

Catheterising and UTI prevention is never just one thing. Technique matters. Product choice matters – the coating, the size, the length of the catheter. Lifestyle factors matter. Hydration, bowel regularity, hygiene approach, positioning. When infections are recurring despite everything, Angie goes back to basics before reaching for the next intervention.

"One of the most important things to do is go back to basics because often, sometimes the simplest things that were started with have then been forgotten along the way." ~ Angie Rantell

Catheterising and UTI prevention is a whole-picture process and the picture includes not just what someone is doing when they catheterise, but everything around it.

Beyond Long Term Antibiotics

What many people living with recurrent UTIs don't know is how wide the treatment landscape actually is. Angie walks through it in this episode: from vaginal oestrogen for postmenopausal women, to methenamine Hippurate as a NICE-recommended non-antibiotic option, to bladder installations with gentamicin, to something that surprises most people entirely: UTI vaccines.

Available in the UK for around five to six years, these vaccines are not yet widely used, they tend to appear as a fifth or sixth line treatment in specialist centres, and they only cover specific bacterial strains. But the fact of their existence represents something genuinely hopeful for people who feel they have exhausted every option.

Understanding the full spectrum of what exists and knowing that a local service reaching the end of what it can offer is not the same as the end of what is possible, is one of the most practically useful things this episode offers.

"Just because you may not get the answers first time, there are second opinions, there are other services with more in-depth things." ~ Angie Rantell

The Psychological Layer

Continence care and quality of life include the fear that builds around intermittent self-catheterisation when it keeps causing infections. Keira describes bracing before every attempt, her whole body tense, making the process physically harder and more painful. That tension is not a character flaw. It is a predictable nervous system response to something that has repeatedly hurt.

Recognising that the mindset brought to catheterisation has a direct effect on how the body responds and that self-compassion is not a soft extra but a practical tool is one of the threads that runs through this entire episode.

Listen to the full episode with Angie Rantell and Keira McGarrity now.

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