Please select the eligibility criteria that correspond to the clinical trial below.
Title: Nutritional Supplementation for Extending Time Between Recurrent Urinary Tract Infections in Women: a Randomized Double Blind Cross-over Trial
Brief Summary: The study will test the ability of specially formulated nutritional supplement capsules to extend the time between recurrent urinary tract infections in women. This objective will be completed by enrolling women who have suffered from 3-4 uncomplicated UTIs in the past 12 months into a double blind placebo controlled cross-over trial. Cross-over and study completion are triggered by the next two UTI recurrences. The goal of the study is for the supplement to extend the time to the next UTI for study participants as compared to placebo.


Options:
A: Inclusion Criteria:

* Presenting with symptoms of UTI
* Presentation of 3rd or 4th simple cystitis of lower tract in the past 12 months
* Active infection at enrollment, confirmed and documented in medical record
* Cognitive capacity to consent and ability to undergo the consent process in English

Exclusion Criteria:

* Known allergy or intolerance to supplement ingredients
* Pregnant or planning to become pregnant or lactating
* Unwilling to commit to birth control use
* Use of related nutritional supplements
* Unwilling to halt berry extracts, polyphenols, antioxidants, d-mannose, vitamins
* Taken WelTract in past six months
* Unwilling to avoid probiotics, yogurt, apple or cranberry juice, hibiscus tea
* Certain comorbid or physical conditions
* History of febrile UTI
* Bladder catheter or urethral stents
* Use of topical hormones in urogenital areas
* Diabetes (i.e. taking diabetic medications) or glycosuria
* Intestinal diseases with malabsorption (e.g. Crohn's and celiac diseases)
* Severe renal impairment or kidney stones
* Neural problems (spinal cord injury or Multiple Sclerosis)
* Immunocompromised individuals
* Rheumatoid arthritis
* Lupus
* HIV
* Taking steroids or immunobiologic medications
* Prophylactic antibiotic use (e.g. post-coital)
* Other physician judgement
B: Inclusion Criteria:

* Women
* ≥ 3 UTIs within the last 12 months or ≥ 2 UTIs within the last 6 months;
* Laboratory urine culture: \<103 CFUs
* Age \> 18 years

Exclusion Criteria:

* UTIs ≥ 12 within 1 year
* Pregnancy or Lactation
* Immune disease
* Lactose intolerance
* Urinary tract anomaly
* Systemic infection
* Newly started hormone therapy within the last 6 months
* Antibiotic prophylaxis within the last 6 months
* α-D-mannose intake within the last month
* Use of catheters
* Diabetes mellitus
* Participation to other studies
C: Inclusion Criteria:

* Patients 18 years old or older
* 3 or more culture documented urinary tract infections in the preceding 12 months
* Patients who had not taken antimicrobials within 4 weeks and were not pregnant or contemplating pregnancy.

Exclusion Criteria:

* Patients with evidence of upper urinary tract infection, such as temperature higher than 38 °C, flank/lumbar pain or tenderness.
D: Inclusion Criteria:

* Postmenopausal women
* History of recurrent UTI (\>=3 culture proven UTIs in one year or \>=2 in 6 months)
* Recurrent, culture proven UTI while on vaginal estrogen for at least 4 weeks + d-mannose prophylaxis
* English speaker

Exclusion Criteria:

* Not postmenopausal
* Complicated UTIs
* Known renal tract anomaly
* Liver dysfunction
* Neurogenic bladder
* Incomplete bladder emptying (PVR \> 150 cc when voided volume \>150 cc)
* Self-catheterization or use of indwelling catheter
* Contraindication to vaginal estrogen, methenamine hippurate, or d-mannose, including allergic reactions
* History of or current endometrial cancer
* History of estrogen sensitive breast cancer without approval of patient, patient's oncologist, oncologic surgeon, or primary care physician to use vaginal estrogen after counseling
* History of interstitial cystitis/painful bladder syndrome
* Urothelial cancer
* Enrolled in other clinical trials for UTIs other than Washington University study IRB# 201711120
* Currently on daily antibiotic prophylaxis and unwilling to stop this intervention

Answer: A