The vaginal microbiome and chronic urinary tract infection
Research type
Research Study
Full title
The vaginal microbiome and non-antibiotic vaginal treatments for recurrent/chronic urinary tract infection in post-menopausal women
IRAS ID
348086
Contact name
R Khasriya
Contact email
Sponsor organisation
University College London
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
Urinary tract infection (UTI) is extremely common, and a significant proportion of people go on to suffer with chronic symptoms with a huge impact on quality of life or potentially serious consequences such as sepsis. This condition, known as recurrent/chronic UTI disproportionately affects women and even more so, menopausal women. Menopausal women are an often-overlooked group when it comes to medical research but are in fact the largest growing workforce group, and interest in conditions more common in such women, such as chronic UTI, are now being highlighted to keep women happy, healthy and in the workforce during this valuable part of their lifespan. Genitourinary syndrome of menopause (GSM) is well recognised and includes urinary symptoms with an overlap with UTI and unsurprisingly has been linked to oestrogen deficiency, an inevitability of menopause. At present, recurrent/chronic UTI treatment is complicated; many healthcare professionals have little knowledge of the condition and there is no consensus on its best management. Specialist treatment is primarily with long courses of antibiotics which often cause side effects and may lead to anti-microbial resistance (AMR).
Research into oestrogen replacement has reliably shown changes to vaginal pH, microbiota and vulvovaginal and urinary symptoms but research into the exact reasons for this benefit is a developing area, although it has been proven that the urinary and vaginal microbiomes show significant overlap. Research specifically into the vaginal microbiome, oestrogen replacement or other vaginal therapies, and its impact on recurrent/chronic UTI is in its infancy and this research would uniquely assess patient-reported clinical outcomes as well as laboratory findings in this patient group. Furthermore, wet-mount microscopy of vaginal fluid is a little-used test that we suggest could yield important information regarding vaginal dysbiosis and be utilised in the same way urine microscopy is routinely to diagnose UTI and monitor treatment response. We hypothesise that there are crucial links to be found between the vaginal pH, vaginal microscopy, the genitourinary microbiome and UTI disease burden and that this could be modulated in menopausal women using vaginal therapies such as oestrogen or medications lowering pH, such as boric acid. We hope that this translational research will provide an evidence-based alternative or adjunct to antibiotics for recurrent/chronic UTI, taking basic science findings bench to bedside.REC name
West Midlands - Solihull Research Ethics Committee
REC reference
24/WM/0254
Date of REC Opinion
18 Dec 2024
REC opinion
Further Information Favourable Opinion