Overall , lactobacilli were beneficial for the treatment of patients with bacterial vaginosis .
No clear benefit was seen for c and idiasis or urinary tract infection .
In conclusion , the use of certain lactobacillus strains such as L. rhamnosus GR-1 and L. reuteri for prevention and treatment of recurrent urogenital infection is promising , especially for recurrent bacterial vaginosis .
Abstract Probiotics are increasingly being used to treat and prevent urogenital infections .
However , a critical assessment of their efficacy in major urogenital infections is lacking .
We report the results of a systematic review to determine the efficacy of probiotics for prevention or treatment of three major urogenital infections : bacterial vaginosis , vulvovaginal c and idiasis , and urinary tract infection .
A controlled trial of intravaginal estriol in postmenopausal women with recurrent urinary tract infections.
BACKGROUND Recurrent urinary tract infections are a problem for many postmenopausal women .  Estrogen replacement restores atrophic mucosa , lowers vaginal pH , and may prevent urinary tract infections . METHODS We enrolled 93 postmenopausal women with a history of recurrent urinary tract infections in a r and omized , double-blind , placebo-controlled trial of a topically applied intravaginal estriol cream . Midstream urine cultures were obtained at enrollment , monthly for eight months , and whenever urinary symptoms occurred . Vaginal cultures and pH measurements were obtained at entry and after one and eight months . The women were assigned to receive either estriol ( n = 50 ) or placebo ( n = 43 ) , both administered intravaginally ; 36 and 24 , respectively , completed the eight months of follow-up . RESULTS The incidence of urinary tract infection in the group given estriol was significantly reduced as compared with that in the group given placebo ( 0.5 vs. 5.9 episodes per patient-year , P < 0.001 ) . Survival analysis showed that more of the women in the estriol group than in the placebo group remained free of urinary tract infection ( P < 0.001 ) . Lactobacilli were absent in all vaginal cultures before treatment and reappeared after one month in 22 of 36 estriol-treated women ( 61 percent ) but in none of the 24 placebo recipients ( P < 0.001 ) . With estriol the mean vaginal pH declined from 5.5 to 3.8 ( P < 0.001 ) , whereas there was no significant change with placebo . The rate of vaginal colonization with Enterobacteriaceae fell from 67 percent to 31 percent in estriol recipients but was virtually unchanged ( from 67 to 63 percent ) in the placebo recipients ( P < 0.005 ) . Side effects were minor , but caused 10 estriol recipients ( 28 percent ) and 4 placebo recipients ( 17 percent ) to discontinue treatment . CONCLUSIONS The intravaginal administration of estriol prevents recurrent urinary tract infection in postmenopausal women , probably by modifying the vaginal flora
Overall , lactobacilli were beneficial for the treatment of patients with bacterial vaginosis .
No clear benefit was seen for c and idiasis or urinary tract infection .
In conclusion , the use of certain lactobacillus strains such as L. rhamnosus GR-1 and L. reuteri for prevention and treatment of recurrent urogenital infection is promising , especially for recurrent bacterial vaginosis .
Abstract Probiotics are increasingly being used to treat and prevent urogenital infections .
However , a critical assessment of their efficacy in major urogenital infections is lacking .
We report the results of a systematic review to determine the efficacy of probiotics for prevention or treatment of three major urogenital infections : bacterial vaginosis , vulvovaginal c and idiasis , and urinary tract infection .