Neuro-Urology, Schweizer Paraplegiker Zentrum, Nottwil, Switzerland; Department of Urology, Inselspital, Bern University Hospital, University of Bern, Switzerland.
Eur Urol Focus. 2020 Sep 15;6(5):817-819. doi: 10.1016/j.euf.2020.01.015. Epub 2020 Feb 13.
Urinary tract infection (UTI) is one of the most common complications of neurogenic lower urinary tract dysfunction (NLUTD). As the underlying neurogenic dysfunction often cannot be resolved, prophylaxis is of utmost importance, as UTIs are associated with significant morbidity and lower quality of life. Prevention is based on a correct diagnosis, as asymptomatic bacteriuria should not be treated. First, bladder management should be optimized and morphologic causes of UTI should be excluded. If UTI persists, medical prophylaxis is advised. Prophylaxis currently involves a trial-and-error approach, including mainly phytotherapy and immune stimulation. Long-term antibiotic prophylaxis should be avoided whenever possible. Among the current experimental techniques, bacteriophage use seems to be the most promising. Although UTIs are a frequent problem in NLUTD, no prophylaxis with evidence-based efficacy has been identified. Therefore, well-designed studies are necessary. PATIENT SUMMARY: In this review, the reasons for urinary tract infection (UTI) in individuals with bladder problems due to a disorder of the nervous system are explained and possible methods for UTI prevention are described.
尿路感染（UTI）是神经源性下尿路功能障碍（NLUTD）最常见的并发症之一。由于潜在的神经源性功能障碍通常无法解决，因此预防措施至关重要，因为尿路感染会导致严重的发病率和较低的生活质量。预防基于正确的诊断，因为无症状菌尿不应治疗。首先，应优化膀胱管理并排除 UTI 的形态学原因。如果 UTI 持续存在，建议进行医学预防。目前的预防措施包括尝试和错误的方法，主要包括植物疗法和免疫刺激。应尽可能避免长期使用抗生素预防。在目前的实验技术中，噬菌体的使用似乎最有前途。尽管尿路感染是 NLUTD 中的常见问题，但尚未确定具有循证疗效的预防措施。因此，需要进行精心设计的研究。患者总结：在这篇综述中，解释了由于神经系统疾病导致膀胱问题的个体中尿路感染（UTI）的原因，并描述了预防 UTI 的可能方法。
