Urology
The probiotic approach: an alternative treatment option in urology
Hoesl C.E., Altwein J.E.
OBJECTIVE: The prophylactic and therapeutic use of probiotic microorganisms is a wide and still controversial field. The review paper is aimed to summarize recent findings on the health-benefiting effects of probiotics in urological diseases. The use of certain beneficial strains against urogenital infections, bladder cancer recurrence and renal stone formation is discussed.
METHODS: Literature search of PubMed documented publications and abstracts from meetings.
RESULTS: Various clinical trials have now been performed which substantiate the beneficial effects of the probiotic strains L. rhamnosus GR-1, L. fermentum RC-14 and L. crispatus CTV-05 against urogenital infections, such as urinary tract infections and bacterial vaginosis. The potential of L. casei Shirota to reduce the recurrence rate of bladder cancer is one of the most intriguing examples for the use of probiotics in medical practice. The use of O. formigenes in the prevention of calcium oxalate stone disease was only recently suggested and needs to be further investigated.
CONCLUSION: Clinical trials increasingly provide a profound scientific basis for the use of probiotics in medicinal practice including urology. Efforts to make probiotic products available which are validated according to the guidelines recommended by the WHO and FAO and produced according to Good Manufacturing Practice will contribute to the acceptance of probiotic therapy by both the physicians and the patients.
Eur Urol. 2005 Mar;47(3):288-96
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The rationale for probiotics in female urogenital healthcare
Reid G., Burton J., Devillard E.
Urogenital infections are a major reason that women visit their family physician and are referred to gastroenterology, gynecology, urology, and infectious disease specialists. The association between abnormal vaginal microbiota and increased risk for sexually transmitted infections, bladder and vaginal infections per se, and a higher rate of preterm labor indicate the need to better understand and manage urogenital health. The concept of probiotics arose from the realization that humans are inhabited with microbes from birth and that these organisms play a role in preventing disease. Defined as "live microorganisms, which when administered in adequate amounts confer a health benefit on the host," probiotic strains have already been shown to effectively prevent diarrhea and to hold potential in preventing and treating tonsillitis, caries, renal calculi, and respiratory infections.
This review provides a rationale for the use of probiotics in maintaining female vaginal and bladder health and as a treatment option for recurrent bacterial vaginosis, urinary tract infection, yeast vaginitis, and sexually transmitted infections. We consider only probiotic strains that fulfill the United Nations/World Health Organization Guidelines for Probiotics in being fully characterized and clinically documented through scientific investigations describing known or presumed mechanisms of action.
Although medical practitioners as yet are unable to access these probiotic strains, an awareness of recent and ongoing research for probiotics is important, as results are encouraging. The concept of probiotic therapy is familiar to many consumers and although it has historically lacked credibility in the medical community, perceptions are changing.
MedGenMed. 2004 Mar 29;6(1):49
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Lactobacilli for prevention of urogenital infections: a review
Marelli G., Papaleo E., Ferrari A.
Urogenital infections are a worldwide shared problem that represent the most common reason for a woman to decide to visit to gynaecologist or urologist. The origin of the uropathogens in uncomplicated urinary tract infection and bacterial vaginosis is the fecal flora. Key element of pathogenesis namely the ability of the pathogens to survive exposure to the microflora that exists on the external urogenitalia, in which lactobacilli predominate. Some health food appear to contain > or = 1 common Lactobacillus strain; L. rhamnosus GR-1 was found to be the best of a group of 34 Lactobacillus strains isolated from dairy, poultry, health food. Recently has been reported the first clinical evidence that probiotic lactobacilli can be delivered to the vagina following oral intake. These L. strains possess the ability to adhere to and colonize tissues and the capacity to inhibit the pathogenesis of disease-causing organisms that make them effective probiotic agents. In particularly, two strains, Lactobacillus GG and Lactobacillus rhamnosus GR-1 appear to be effective at colonizing and protecting the intestine and urogenital tract, respectively, against microbial infection. Treating and preventing urogenital infection by instillating probiotic organisms has great appeal to patients and caregivers. The ability to administer orally L. rhamnosus GR-1 and L. fermentum RC-14, which colonize the intestine and vagina, provides a major step in the right direction for patients as it potentially allows for the self administration of therapy.
Eur Rev Med Pharmacol Sci. 2004 Mar-Apr;8(2):87-95
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