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Prevention of Recurrent Urinary Tract Infections in Neurourology.

Authors
  • Pannek, Jürgen1
  • 1 Neuro-Urology, Schweizer Paraplegiker Zentrum, Nottwil, Switzerland; Department of Urology, Inselspital, Bern University Hospital, University of Bern, Switzerland. Electronic address: [email protected] , (Switzerland)
Type
Published Article
Journal
European urology focus
Publication Date
Sep 15, 2020
Volume
6
Issue
5
Pages
817–819
Identifiers
DOI: 10.1016/j.euf.2020.01.015
PMID: 32061538
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Urinary tract infection (UTI) is one of the most common complications of neurogenic lower urinary tract dysfunction (NLUTD). As the underlying neurogenic dysfunction often cannot be resolved, prophylaxis is of utmost importance, as UTIs are associated with significant morbidity and lower quality of life. Prevention is based on a correct diagnosis, as asymptomatic bacteriuria should not be treated. First, bladder management should be optimized and morphologic causes of UTI should be excluded. If UTI persists, medical prophylaxis is advised. Prophylaxis currently involves a trial-and-error approach, including mainly phytotherapy and immune stimulation. Long-term antibiotic prophylaxis should be avoided whenever possible. Among the current experimental techniques, bacteriophage use seems to be the most promising. Although UTIs are a frequent problem in NLUTD, no prophylaxis with evidence-based efficacy has been identified. Therefore, well-designed studies are necessary. PATIENT SUMMARY: In this review, the reasons for urinary tract infection (UTI) in individuals with bladder problems due to a disorder of the nervous system are explained and possible methods for UTI prevention are described. Copyright © 2020 European Association of Urology. Published by Elsevier B.V. All rights reserved.

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