top of page

Neurogenic Bladder

Bladder instillation with gentamicin or vinegar for prevention of bladder infections

Purpose of bladder instillation: People who do self-catheterization to empty their bladder can develop recurrent bladder infections.

To fight infections our first step is to make sure that the catheterization technique is clean. Our second step is to make sure the bladder pressures are under good control; urodynamics is a test we may perform to check bladder pressures. Our third step is often to start bladder irrigation, which is washing out of the bladder with tap water. When this doesn’t work, we do bladder instillation of vinegar and if that doesn’t work then we do bladder instillation of gentamicin. Instillation is different from irrigation in that the fluid stays in the bladder for several hours. Fig. 1: A full bladder with many bacteria (in green.)

Bladder Instillation 01.png

Fig. 1

Steps of Bladder Instillation

Step 1: Catheterize as you normally would to empty the bladder. Fig. 2: An empty with bladder fewer bacteria.

Step 2: Perform bladder irrigation to get the bladder cleaned out (fig. 3).

Fig. 2

Bladder Instillation 03.png

Fig. 3

Step 3: Prepare instillation solution. If gentamicin, your doctor will provide a prescription. If vinegar, dilute 1 part table vinegar in 19 parts tap water for a 5% solution (fig. 4).

Fig. 4

Step 4: Completely empty the bladder and then instill 30ml of gentamicin or vinegar mixture (fig. 5).

Fig. 5

Step 5: Remove the catheter and allow the gentamicin or vinegar to sit in the bladder overnight while you sleep. The liquid will come out when you catheterize next time. If you need to catheterize in the middle of the night, it is okay; you will get a little less exposure to the treatment but nothing bad will happen.

bottom of page