TY  - JOUR
A1  - Zare, Mary
A1  - Vehreschild, Maria J. G. T.
A1  - Wagenlehner, Florian
T1  - Management of uncomplicated recurrent urinary tract infections
T2  - BJU international
N2  - Objectives: To discuss optimal management of recurrent urinary tract infections (UTIs) in women. About every second woman experiences at least one UTI in her lifetime, of those 30% experience another UTI, and 3% further recurrences. Especially young healthy women without underlying anatomical deficiencies suffer from recurrent UTIs (rUTI), which are associated with significant morbidity and reduction in quality of life.
Methods: This is a narrative review, investigating publications dealing with recurrent UTI in women. Risk factors and options for management are discussed.
Results: The increased susceptibility of women to rUTI is based on the female anatomy in addition to behavioural, genetic, and urological factors. However, why some women are more likely than others to develop and maintain rUTI remains to be clarified. Invasive characteristics of certain uropathogenic Escherichia coli that are able to form extra- and intracellular biofilms and may therefore cause delayed release of bacteria into the bladder, may play a role in this setting. Treatment recommendations for an acute episode of rUTI do not differ from those for isolated episodes. Given the nature of rUTI, different prophylactic approaches also play an important role. Women with rUTI should first be counselled to use non-antibiotic strategies including behavioural changes, anti-adhesive treatments, antiseptics, and immunomodulation, before antibiotic prophylaxis is considered. In addition to the traditional treatment and prophylactic therapies, new experimental strategies are emerging and show promising effects, such as faecal microbiota transfer (FMT), a treatment option that transfers microorganisms and metabolites of a healthy donor’s faecal matter to patients using oral capsules, enemas, or endoscopy. Initial findings suggest that FMT might be a promising treatment approach to interrupt the cycle of rUTI. Furthermore, bacteriophages, infecting and replicating in bacteria, have been clinically trialled for UTIs.
Conclusion: Due to the limitation of available data, novel treatment options require further clinical research to objectify the potential in treating bacterial infections, particularly UTIs.
KW  - recurrent urinary tract infections
KW  - diagnostic algorithm
KW  - preventive strategies
KW  - faecal microbiota transfer
KW  - bacteriophages
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/71824
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-718240
SN  - 1464-410X
N1  - Open access funding enabled and organized by Projekt DEAL.
VL  - 129
IS  - 6
SP  - 668
EP  - 678
PB  - Wiley-Blackwell
CY  - Oxford
ER  -