Affiliation:
1. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology
Abstract
Recurrent urinary tract infections (RUTI) are one of the most common manifestations of the genitourinary menopausal syndrome and occur in more than 20% of peri- and post-menopausal women. The most common risk factor for RUTI in peri- and post-menopausal women is sex steroid deficiency. The urinary and genital tracts share a common embryonic origin due to the presence of α- and β-estrogen receptors, progesterone and androgen receptors in all structures of the urogenital tract: lower third of the ureters, urinary bladder, vascular plexus, urothelium, pelvic floor muscles, pelvic ligamentous apparatus. Patients with RUTI are treated in two stages: treatment of exacerbations and prevention of relapses. During exacerbations, short courses of antibiotic therapy are administered according to the sensitivity of the bacterial agent. If microbiological testing of urine samples is not possible, antibiotics are selected empirically, taking into account the most common pathogens of a UTI. Vaccine prophylaxis is the leading method of preventing a UTI recurrence. The efficacy and safety of E. coli bacterial extracts have been proven in numerous RCTs. The Uro-Vaxom vaccine reliably reduces the incidence of cystitis recurrence, reduces the need for antibacterial drugs, and therefore improves the quality of life of menopausal women with RUTIs. Vaccine prophylaxis in menopause can be administered as monotherapy or in combination with topical estrogen therapy, which also plays a positive role in the treatment of urinary tract infections.
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