Role of probiotics in the treatment and prevention of genitourinary infections

Urinary tract infections (UTIs) represent one of the leading causes of gynecological morbidity and their incidence shows no significant downward trend. A characteristic feature concerning the clinical manifestation of inflammatory diseases in recent years has been a predominantly chronic course, frequently accompanied by relapses. While novel antibacterial agents have demonstrated efficacy in the management of acute infections, their efficacy is markedly reduced in cases of chronic UTIs and they are insufficient in preventing relapse. Over the past 10–15 years, there has been a profound shift in research focus toward the study of the female reproductive tract microbiome, with particular attention to vaginal microbiocenosis, given its relevance to the ascending route of infection to the upper genital tract. The adjunctive use of probiotics following antimicrobial therapy is currently regarded as a promising therapeutic strategy. Evidence suggests that, in cases of complicated vulvovaginal candidiasis, the administration of probiotic preparations as a second-line intervention following antimycotic therapy can reduce relapse rates by up to twofold. Moreover, prophylactic probiotic administration in immunocompromised women contributes to the maintenance of normal vaginal microbiocenosis and preservation of the vaginal barrier function. At present, the therapeutic armamentarium includes a novel multifunctional probiotic complex consisting of a unique combination of probiotic strains (Bifidobacterium longum BL21, Lactobacillus crispatus LCr, Lactobacillus gasseri LG08, Lactobacillus jensenii LJe52) and prebiotic components that optimize the environment for microflora normalization, thereby facilitating restoration of sufficient lactobacilli populations during the second phase of vaginal infection therapy. In addition, each capsule of this symbiotic formulation contains D-mannose and cranberry powder, which contributes to the prevention of dysuric symptoms and supports the overall health of the female urinary tract KEYWORDS: vaginal microbiocenosis, bacterial vaginosis, candidal vulvovaginitis, chronic course, relapses, two-stage treatment, lactobacilli, symbiotic FOR CITATION: Selikhova M.S. Role of probiotics in the treatment and prevention of genitourinary infections. Russian Journal of Woman and Child Health. 2025;8(2):124–127 (in Russ.). DOI: 10.32364/2618-8430-2025-8-2-5