Effectiveness of Prophylactic Oral and/or Vaginal Probiotic Supplementation in the Prevention of Recurrent Urinary Tract Infections: A Randomized, Double-Blind, Placebo-Controlled Trial.

This article focuses on a randomized, double-blind, placebo-controlled study evaluating the effectiveness of prophylactic oral and vaginal probiotics in preventing recurrent urinary tract infections (UTIs) in premenopausal women. The study enrolled 174 women with a history of recurrent UTIs and assigned them to four groups: placebo, oral probiotic, vaginal probiotic, and a combination of oral and vaginal probiotics. Results showed that vaginal probiotics alone or combined with oral probiotics significantly reduced the incidence and number of symptomatic UTI recurrences and prolonged the time to first recurrence compared to placebo or oral probiotics alone. Vaginal microbiota analysis revealed increased beneficial lactobacilli and decreased uropathogens in probiotic groups, and no serious adverse events were reported. These findings suggest that vaginal probiotic supplementation, with or without oral probiotics, may be a promising nonantibiotic strategy for managing recurrent UTIs in premenopausal women.