SynthesisBJU international2026
Intravesical therapy for recurrent urinary tract infection: a systematic review and meta-analysis.
Synthesis in BJU international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed.
- Urinary Tract Infections: Molecular Determinants of Uropathogenicity and Their Translation into Contemporary Clinical Practice.International journal of molecular sciences · 2026Review
- Catheter-Deliverable Floating Hydrogels for Sustained Intravesical Drug Release.Gels (Basel, Switzerland) · 2026Article
- Proactive Cystoscopic Debris Removal for Reducing Catheter Blockage in Patients with Long-Term Indwelling Catheters: A Prospective Self-Selected Cohort Study with Exploratory Subgroup Analysis on Urinary Tract Infections.Journal of clinical medicine · 2026Article
- Successful treatment of noninfectious hemorrhagic cystitis with intravesical hyaluronic acid in a 5-year-old boy: a case report.Oxford medical case reports · 2026Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo undertake a systematic review and meta-analysis to evaluate the efficacy, safety, and clinical applicability of intravesical instillations for preventing recurrent urinary tract infections (rUTIs).
methodsPubMed/MEDLINE, Embase, Cochrane CENTRAL, Scopus, and Web of Science were searched from January 2000 to April 2025 for randomised and observational studies of intravesical instillations in rUTI treatment. The primary outcome was UTI recurrence, expressed as incidence rate ratio (IRR) or risk ratio (RR). Random-effects meta-analyses were performed for three intervention families: aminoglycosides, hyaluronic acid (HA) monotherapy, and HA with chondroitin sulphate (HA + CS) combined therapy. Subgroup analyses examined population type and antibiotic used; sensitivity analyses included leave-one-out re-estimation. Other agents were narratively synthesised.
resultsTotal of 25 studies were included. Aminoglycoside instillations produced a marked reduction in recurrence (pooled IRR 0.23, 95% confidence interval [CI] 0.15-0.37; P < 0.001), with consistent benefit across neurogenic and non-neurogenic populations and across gentamicin and amikacin. HA monotherapy was also effective (pooled RR 0.15, 95% CI 0.05-0.43; P = 0.011), although heterogeneity was high. HA + CS combined therapy showed favourable results in individual studies but an imprecise pooled effect (RR 0.41, 95% CI 0.04-4.77; P = 0.465). Narrative evidence for heparin, povidone-iodine and fosfomycin suggested potential benefit, but methods and outcome definitions were inconsistent. Serum aminoglycoside levels were undetectable where measured, and adverse events were mild and infrequent.
conclusionIntravesical instillations appear safe and effective for preventing rUTIs in select patients. The strongest evidence supports aminoglycosides while HA offers a non-antibiotic alternative. HA + CS requires further study. Larger, high-quality randomised trials with standardised outcomes are needed to optimise protocols and patient selection.
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