Probiotics and Usage in Urinary Tract Infection

Abstract

Urinary tract infection (UTI) is one of the most common bacterial problems in both young and aging women and it is an infection connecting the kidneys, ureters, bladder, and urethra. In spite of higher incidence of bacteriuria in aging women, most UTI has been conducted in young women. UTI affects millions of women every year. About 40% of women and 12% of men have a UTI at some time in their life. UTI can lead to many complications: inflammation and irritation, dysuria, urination frequency issues, urinary urgency, bad-smelling urine, bloody urine, lower abdominal pain or pelvic pressure, mild fever, and burning with urination. Pregnant women are at increased risk for a UTI.In simple cases, UTIs are simply cured with a short course of antibiotics. In complex cases, longer course antibiotics may be needed. In cases where infections are related to intercourse, taking antibiotics subsequently may be beneficial. The antibiotic of choice is phenazopyridine, which helps the burning and urgency. However, it is not regularly recommended due to safety concerns with its use, specifically an elevated risk of methemoglobinemia.Probiotics have been documented to be beneficial in curing UTI as well as reducing its recurrence and have been administered both orally and vaginally. Vaginal administration introduces the beneficial bacteria directly into the vagina; probiotics consumed orally are believed to ascend to the vaginal tract after they are excreted from the rectum. The mechanisms through which probiotics play a role in bacterial vaginosis treatment include: (1) occupation of specific adhesion sites at the epithelial surface of the urinary tract; (2) maintenance of a low pH and production of antimicrobial substances like acids, hydrogen peroxide, and bacteriocins; (3) degradation of polyamines; and (4) the production of surfactants with antiadhesive properties. This chapter confirms that there are insufficient data to support the routine use of probiotics in urological diseases such as UTI, but probiotics show potential in becoming an alternative or complementary treatment choice for many diseases. As described above, despite definitive clinical evidence on the positive effects of probiotics, study in the field of live microorganisms to gain systematic information on the clinically significant problem of UTI and on the prevention and treatment of infection in general have only recently commenced. é 2016 Elsevier Inc.