Probiotics for preventing urinary tract infections in people with bladder dysfunction after a nervous system injury

New
Authors: 
Toh S, Boswell-Ruys CL, Lee BB, Simpson JM, Clezy KR

What is the issue?

Bladder function can be altered after an injury to the nervous system and most often happens in conditions like multiple sclerosis, spinal cord injury or stroke. This type of bladder dysfunction is termed ‘neuropathic bladder’. The bladder dysfunction in people with a nervous system injury increases their risk of frequent bladder infections. Currently, there is no effective way to prevent bladder infections in these people. Long-term use of antibiotics is not encouraged as it results in reduced effectiveness of that antibiotic. Probiotics are bacteria that can have a beneficial effect on the body. Some evidence already exists to suggest that probiotics can prevent bladder infections in post-menopausal women.

What did we do?

This review investigates the evidence for the effectiveness of probiotics on the prevention of bladder infections in people with bladder dysfunction after a nervous system injury.

What did we find?

We conducted a literature review up to March 2017 and three studies were included according to our selection criteria. The three studies reported data on 110 participants. All three studies investigated whether introducing probiotics directly into the bladder to create a non-harmful colony will prevent urinary tract infections in people with bladder dysfunction, predominantly people with spinal cord injury. Two studies reported that this method was generally safe. This review found that generally, the studies were poor quality with high risk of bias. We found the effectiveness of colonisation with probiotics in preventing bladder infection in people with bladder dysfunction is uncertain. Furthermore, the success of colonisation was variable, and the colonisation process is invasive and demands a high level of commitment on the part of the participant.

We did not identify any studies investigating whether other probiotics and other administration routes is effective in preventing urinary tract infections in people with bladder dysfunction.

Conclusions

It is uncertain if probiotics prevent urine infections in people with bladder dysfunction after a nervous system injury. Further robustly designed studies are necessary.

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