In this video, Dr. Sachin Malde discusses the following:
● A bladder instillation treatment is filling the bladder with a chemical, or a solution, through a catheter.
● Non-antibiotic instillations are typically used to treat bladder pain, they use chemicals that replenish the depleted GAG layer-or glycosaminoglycans-of the bladder.
● The majority of instillations conducted at Dr. Malde’s practice are antibiotic because his patients are typically experiencing pain caused by underlying chronic infection.
● For antibiotic instillations, gentamicin and amikacin are employed for the majority of typical UTI causing pathogens.
● Enterococcus, however, can be resistant to gentamicin. Therefore, vancomycin can be utilized.
● Though treatment frequency varies between practices, Dr. Malde typically recommends beginning with daily instillations, for a two week period. From there, they reduce the frequency in response to the patient’s symptoms.
● Once the antibiotic is instilled in the bladder, Dr. Malde recommends holding it in the bladder as long as possible and, ideally, overnight.
● Dr. Malde explains that, after a few initial treatments at his clinic, bladder instillations can be administered by the patient at home.
● Although patients can experience some discomfort due to catheterization, to minimize this a much smaller catheter is given.
● Because the antibiotic from an instillation does not absorb into the blood, the common side effects associated with antibiotics are usually avoided.
● Similarly, the risk of infection via the catheter is very low because the antibiotic itself would eradicate any potential new infection introduced by the catheter.
● Bladder instillation is not effective if the location of the infection is in the urethra, ureters, or kidneys.
● Bladder instillation is a good option for patients who experience C. diff, thrush or allergy with oral antibiotics.
● Antibiotic instillations are intended for use alone, not in tandem with oral antibiotics.
● Studies report a 70-80% success rate for bladder instillations.
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Check out the playlist for the entire interview: • Dr. Sachin Malde
Learn more about antibiotic resistance & how to treat complicated UTI here: • Antibiotic Resistance ...
Learn about whether it’s safe to treat a UTI without antibiotics here: • Is It Safe To Treat A ...
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About Dr. Sachin Malde
Dr. Sachin Malde is a Consultant Urological Surgeon at Guy’s and St Thomas’ Hospital and the HCA London Bridge Hospital, London. He specializes in the management of bladder diseases (urinary symptoms, UTI, bladder pain, incontinence, bladder cancer), benign prostate enlargement, and pelvic floor disorders. He has expertise in the detailed investigation and treatment of male and female urinary incontinence, bladder pain, and recurrent and chronic UTI, and has an interest in new and novel techniques for treating these conditions. He also offers a range of treatments for other renal and urinary tract conditions, including minimally invasive treatments for bladder overactivity, incontinence, complications of previous surgery, fistula, and prostate enlargement.
Dr. Malde qualified from Guy’s, King’s and St Thomas’ School of Medicine in London, and completed his postgraduate research into the evaluation of men with incontinence after prostate surgery at University College London, for which he won the Gold medal for outstanding research. He underwent specialist fellowship training in female, functional and reconstructive urology at University College Hospital London, and has a strong academic interest having published extensively in peer-reviewed journals. He is also a panel member of the European Association of Urology Guidelines panel on male lower urinary tract symptoms.
About Live UTI Free
Live UTI Free is a patient advocacy and research organization. We do not endorse specific treatment approaches, clinicians or diagnostics methods. The content of this video does not provide medical advice. It is intended for informational purposes only. The medical and/or nutritional information is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen. liveutifree.com/
Post-production: Melissa Wairimu / kreativlee_