Pathophysiology and potential treatment modalities in women with recurrent urinary tract infection

Urinary tract infection (UTI) of the urinary bladder is a common bacterial infection that predominantly affects women, with many experiencing recurrent episodes. Recurrent UTIs (rUTIs) are associated with significant physical, psychological, and social difficulties. Further, they are closely related...

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Main Authors: Wei-Ju Liao, Yuan-Hong Jiang, Jia-Fong Jhang, Sheng-Fu Chen, Yu Khun Lee, Cheng-Ling Lee, Tien-Lin Chang, Hann-Chorng Kuo
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-04-01
Series:Tzu Chi Medical Journal
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Online Access:https://journals.lww.com/10.4103/tcmj.tcmj_286_24
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author Wei-Ju Liao
Yuan-Hong Jiang
Jia-Fong Jhang
Sheng-Fu Chen
Yu Khun Lee
Cheng-Ling Lee
Tien-Lin Chang
Hann-Chorng Kuo
author_facet Wei-Ju Liao
Yuan-Hong Jiang
Jia-Fong Jhang
Sheng-Fu Chen
Yu Khun Lee
Cheng-Ling Lee
Tien-Lin Chang
Hann-Chorng Kuo
author_sort Wei-Ju Liao
collection DOAJ
description Urinary tract infection (UTI) of the urinary bladder is a common bacterial infection that predominantly affects women, with many experiencing recurrent episodes. Recurrent UTIs (rUTIs) are associated with significant physical, psychological, and social difficulties. Further, they are closely related to lower urinary tract dysfunction (LUTD). LUTD affects bladder function and structure, thereby contributing to urinary urgency, frequency, and incontinence, which, in turn, increases the risk of recurrent infections due to impaired urothelial defense mechanisms. The current study explored the pathophysiology of LUTD in women with rUTIs. Potential treatments for rUTIs include long-term prophylactic antibiotics, probiotics, D-mannose, vaccines, small molecule inhibitors, and stem cell therapy. Moreover, it evaluated the use of platelet-rich plasma (PRP) therapy as a treatment modality for LUTD. PRP has regenerative and anti-inflammatory properties. Hence, it can be a promising option for enhancing urothelial barrier integrity and reducing infection recurrence. Repeated intravesical PRP injections are effective in improving bladder symptoms and decreasing UTI recurrences by enhancing the proliferative ability of the urothelium in patients with rUTIs. Further, this review examined the potential predictors of successful PRP treatment outcomes such as cytokine and urothelial biomarker levels, which provided insights into patient selection and individualized treatment strategies. Identifying the predictive biomarkers of treatment responsiveness is essential for optimizing PRP therapy. Hence, to improve the clinical outcomes and quality of life of patients with rUTIs, future research should focus on refining the use of PRP, exploring combination therapies, and validating biomarkers.
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spelling doaj-art-f4e24ffcd5014c35a317bcbaf5c5f1f92025-08-20T02:14:11ZengWolters Kluwer Medknow PublicationsTzu Chi Medical Journal1016-31902223-89562025-04-0137211712410.4103/tcmj.tcmj_286_24Pathophysiology and potential treatment modalities in women with recurrent urinary tract infectionWei-Ju LiaoYuan-Hong JiangJia-Fong JhangSheng-Fu ChenYu Khun LeeCheng-Ling LeeTien-Lin ChangHann-Chorng KuoUrinary tract infection (UTI) of the urinary bladder is a common bacterial infection that predominantly affects women, with many experiencing recurrent episodes. Recurrent UTIs (rUTIs) are associated with significant physical, psychological, and social difficulties. Further, they are closely related to lower urinary tract dysfunction (LUTD). LUTD affects bladder function and structure, thereby contributing to urinary urgency, frequency, and incontinence, which, in turn, increases the risk of recurrent infections due to impaired urothelial defense mechanisms. The current study explored the pathophysiology of LUTD in women with rUTIs. Potential treatments for rUTIs include long-term prophylactic antibiotics, probiotics, D-mannose, vaccines, small molecule inhibitors, and stem cell therapy. Moreover, it evaluated the use of platelet-rich plasma (PRP) therapy as a treatment modality for LUTD. PRP has regenerative and anti-inflammatory properties. Hence, it can be a promising option for enhancing urothelial barrier integrity and reducing infection recurrence. Repeated intravesical PRP injections are effective in improving bladder symptoms and decreasing UTI recurrences by enhancing the proliferative ability of the urothelium in patients with rUTIs. Further, this review examined the potential predictors of successful PRP treatment outcomes such as cytokine and urothelial biomarker levels, which provided insights into patient selection and individualized treatment strategies. Identifying the predictive biomarkers of treatment responsiveness is essential for optimizing PRP therapy. Hence, to improve the clinical outcomes and quality of life of patients with rUTIs, future research should focus on refining the use of PRP, exploring combination therapies, and validating biomarkers.https://journals.lww.com/10.4103/tcmj.tcmj_286_24biomarkerslower urinary tract dysfunctionplatelet-rich plasmarecurrent urinary tract infectionwomen
spellingShingle Wei-Ju Liao
Yuan-Hong Jiang
Jia-Fong Jhang
Sheng-Fu Chen
Yu Khun Lee
Cheng-Ling Lee
Tien-Lin Chang
Hann-Chorng Kuo
Pathophysiology and potential treatment modalities in women with recurrent urinary tract infection
Tzu Chi Medical Journal
biomarkers
lower urinary tract dysfunction
platelet-rich plasma
recurrent urinary tract infection
women
title Pathophysiology and potential treatment modalities in women with recurrent urinary tract infection
title_full Pathophysiology and potential treatment modalities in women with recurrent urinary tract infection
title_fullStr Pathophysiology and potential treatment modalities in women with recurrent urinary tract infection
title_full_unstemmed Pathophysiology and potential treatment modalities in women with recurrent urinary tract infection
title_short Pathophysiology and potential treatment modalities in women with recurrent urinary tract infection
title_sort pathophysiology and potential treatment modalities in women with recurrent urinary tract infection
topic biomarkers
lower urinary tract dysfunction
platelet-rich plasma
recurrent urinary tract infection
women
url https://journals.lww.com/10.4103/tcmj.tcmj_286_24
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