Recurrent urinary tract infections (UTI) are predominantly seen in women. Vaginitis is one of the most common female sex infections. These ailments significantly reduce the quality of a woman’s life, causing unpleasant feelings, pain, shame and numerous difficulties in everyday life.
The main problem is the recurrent nature of the infection, even despite the use of targeted therapy (antibiotic, antifungal, chemotherapy). This state that the most common cause of such problems encompass not one specific pathogenic microorganism (bacteria, fungus and others), but the overall disruption of the vaginal ecosystem.
The vaginal ecosystem, defined as qualitative and quantitative ratios of microorganisms colonizing the vagina, is a key element in maintaining the balance within the urogenital system. However, it should be noted that the vagina microenvironment is very sensitive to internal factors, which is why the clinical course represents huge variability. Disbiotic factors include: drugs (antibiotic and antifungal therapy, hormonal), co-occurring or previously diagnosed diseases (e.g. diabetes, anaemia), the stage of the menstrual cycle and many others.
The microbiological balance within the vagina epithelium, serves as protection against pathogenic microorganisms and subsequent development of infections and inflammations. Almost 95% of the vaginal ecosystem is composed of the Lactobacillus genus. Therefore, in women with recurrent genitourinary system infections, gynaecological probiotics – vaginal and oral should be implemented. Unfortunately, in a large proportion of women, despite the use of gynaecological probiotics, vaginitis is still of recurrent nature. In such situation, it should be assumed that the etiological factor (causative agent) of inflammation of the genitourinary system is the disruption of the intestinal microbiological balance. Nearly 100% of urinary and genital infections are of ascending nature, in which bacteria inhabiting anal area are the causative agents. Restoring the intestinal microflora (also in the anus) is an integral part of the treatment of recurrent vaginal infections. For this reason, it is necessary to evaluate the intestinal microbiota composition and apply correctly matched probiotic and prebiotic therapy.
In case of recurrent infection of the genitourinary system, the following test is recommended: