Urology
Probiotics and urinary tract infections
Beerepoot M.A.J.
Almost half of all women will experience a urinary tract infection (UTI) during their lifetime.
A large number of UTI’s is experienced by postmenopausal women. Due to the absence of estrogen in postmenopausal women intavaginal lactobacilli disappear, vaginal pH increases, resulting in a higher chance of vaginal colonization with Enterobacteriaceae, and therefore a higher chance to get a UTI. In postmenopausal women suffering recurrent UTI’s, antibiotic prophylaxis can be considered a highly effective manner to reduce the amount of recurrences. However, frequent exposure to antibiotics can lead to antimicrobial resistance and side effects. Therefore, the need for alternative therapies as prophylaxis for recurrent UTI’s is growing. Vaginal estrogen therapy has already proven to be effective by restoration of a lactobacilli dominated vaginal flora. Lactobacilli impede intravaginal colonization by competition with uropathogens, which protects against urogenital infections. Therefore, lactobacilli are a potential alternative in the prophylaxis of UTIs. Effectiveness of oral lactobacilli therapy compared to antibiotic prophylaxis is the objective of a study recently started in the Netherlands: the NAPRUTI-study ("Non-antibiotic versus Antibiotic Prophylaxis for Recurrent Urinary Tract Infections"-study).
References