Gentamicin Bladder Instillations to Prevent Urinary Tract Infections in Patients With Spinal Cord Injury

Inclusion Criteria: * Provision of signed and dated informed consent form and agreement to complete the daily dosing log as instructed by the study coordinator. * History of traumatic spinal cord injury (SCI) or non-traumatic spinal cord disease, (SCD) with sustained neurological dysfunction * At least 6 months post-initial hospital discharge following SCI/SCD onset * Neurogenic bladder * Ability to perform daily instillation on self or with help of others and willingness to adhere to the study regiment. * History of at least 2 documented urinary tract infection (UTI) during the previous 6 months (prior to screening) * Have a designated physician or health care provider for routine care * Use of clean intermittent catheterization or catheterization through a stoma (i.e. Mitrofanoff) as their primary method of bladder management Exclusion Criteria: * Concurrent use of systemic oral or intravesical antibiotic prophylaxis * Documented or self-reported history of gentamicin allergy * Female patients who are currently pregnant or attempting to become pregnant * Patients with a history of 8th cranial nerve disorder * Co-morbidities like cancer and chronic disease that could impact patient safety OR significantly affect the rate of UTIs and/or quality of life (QOL) substantially * Urological co-morbidities like bladder cancer and history of kidney disease. * Current UTI at screening (assessed via urine analysis and culture and symptoms) * Concurrent enrollment in a similar clinical trial * Concurrent use of contraindicated diuretics (ethacrynic acid, furosemide) * Current use of other contraindicated or disallowed concomitant medications or receiving treatments that may influence the results from this study. * Known allergy to aminoglycoside antibiotics; Otological symptoms at baseline (i.e. tinnitus. severe dizziness/vertigo) * At the discretion of study team, individuals who are unable or unlikely to comply with procedures and/or for whom study participation is not recommended (e.g. unable to arrange transportation, cognitive and/or behavioral challenges that preclude meaningful participation, poor health, etc.)