Recurrent cystitis: a vaginal egg containing lactobacilli against recurrences?

Recurrent cystitis a vaginal egg containing lactobacilli against recurrences

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    Dr Odile Bagot (Gynecologist-obstetrician)

    According to the results of a Japanese study, administering lactobacillus to women suffering from recurrent cystitis could prevent the risk of recurrence. The explanations of Dr. Odile Bagot, gynecologist member of the committee of experts of Doctissimo.

    Infection of the urinary tract and bladder, cystitis can be recurrent in some women. During these infections, the vaginal flora changes. Usually harboring more lactobacilli than pathogenic bacteria, such as E.Coli; this ratio tends to be reversed in the event of a urinary tract infection.

    Compare the vaginal microbiota of 4 groups of women

    Previous studies have shown that this modification of the vaginal microbiota can partly explain the development of urinary tract infections. To confirm this hypothesis, particularly in postmenopausal women, a team of Japanese scientists worked on the sequencing of the gene based on ribosomal ribonucleic acid (rRNA) 16S to analyze the bacteria present in the samples taken from the vaginas of four types of women :

    • Healthy postmenopausal women;
    • Women affected by recurrent cystitis;
    • Women affected by uncomplicated cystitis;
    • Women who received vaginal ovules containing Lactobacillus crispatus, to prevent their recurrent cystitis.

    The team also studied the relative abundance of different bacterial species in the vagina, before and after the administration of vaginal ovules containing Lactobacillus crispatus that they developed. The objective is to study the therapeutic effect of this Lactobacillus.

    Very different bacterial colonies according to the groups

    Results: Japanese experts found several things. The bacterial populations of healthy women differed from those with uncomplicated cystitis. In the same way, these two groups also presented a different vaginal microbiota from women affected by recurrent cystitis.

    Indeed, scientists have not found the presence of any lactobacilli in vaginal samples from postmenopausal patients with recurrent cystitis. Instead, the dominant species were various members of the family of Enterobacteriaceaewhich include many uropathogenic bacteria.

    Vaginal Lactobacillus eggs as a prevention?

    Finally, the presence of these lactobacilli in the group of women treated with vaginal ovules was much higher (19%) than in the group of women with recurrent cystitis. For the authors, the administration of lactobacilli could attenuate the differences in vaginal microbiota between women with and without recurrent cystitis.

    We found that the vaginal microbiota in postmenopausal women with recurrent cystitis is substantially different from that of postmenopausal women with uncomplicated cystitis or healthy women.notes Dr. Takanori Sekito from the Department of Urology at Okayama University’s Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.

    Finally, remember that the problem with recurrent cystitis is their treatment. It requires taking antibiotics, which taken repeatedly, can lose their effectiveness. For Dr. Sekito, the vaginal ovules of Lactobacillus therefore have “the potential to be a new preventive method to help the many people suffering from recurrent cystitis, which cannot be adequately cured by taking antibiotics“.

    The point of view of Odile Bagot, gynecologist, member of the Doctissimo expert committee

    The link between the composition of the vaginal microbiota and the risk of cystitis is probable, because the bacteria present in the vaginal flora play a role in the occurrence of cystitis. Probiotic eggs existed over the counter in pharmacies and made it possible to restore this flora, but they are no longer available in France. Pharmaceutical companies have stopped producing them following a disagreement over a European decision, which wanted to give medicinal status to eggs. This regulation was rejected by manufacturers, who no longer produce them. The only egg remaining on the market is precisely a drug because it contains a little estrogen. This is Trophigil, which must be prescribed by prescription by a doctor and has certain contraindications”.

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