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Understand the science behind UTIs and related cancers

Understanding UTIs

Urinary tract infection (UTI) is one of the most common infectious diseases and the leading cause of both community-acquired and healthcare-associated infections that develop during medical care. Annually, UTIs affect around 30 million people in the United States, making them the single greatest cause of antibiotic use outside hospital settings [134].

Prevalence and Gender Disparity

Women are disproportionately affected by UTIs, with 60% of women in the U.S. experiencing a UTI in their lifetime, compared to just 14% of men [33]. However, these statistics are likely underestimated, as approximately 50% of UTIs do not come to medical attention.

The increased risk for women is partly due to anatomical factors. The female urethra’s proximity to the vagina and rectum can facilitate the unintentional introduction of pathogenic bacteria, such as Escherichia coli. This bacterium, the most common pathogen associated with acute and recurrent UTIs in women, can migrate from the rectum to the genital area and ascend the urethra to the bladder.

Infections that spread to the kidneys or bloodstream pose more significant health risks and are harder to treat. Lower urinary tract infections often present as cystitis or prostatitis, while upper UTIs can result in pyelonephritis. Among otherwise healthy, sexually active women over 18 years, UTIs tend to occur approximately every other year [34].

The prevalence of UTIs increases with age, often due to functional and anatomical changes [32]. Among men aged 50 to 80, up to 90% experience troublesome lower urinary tract symptoms [83]. A population-based study of 31,000 residents in Calgary found that UTI incidence among women peaks in their twenties (30 per 1,000), decreases slightly during later reproductive years, and then steadily increases, reaching a maximum of 125 per 1,000 among those aged 80 and older [35].

Recurrent UTIs and Antibiotic Resistance

Recurrent UTIs are defined as two or more infections within six months or three or more within 12 months. These differ from single instances, as they are often resistant to one or more antibiotics. People with weakened immune systems or chronic conditions are particularly vulnerable to antibiotic-resistant infections [39, 73].

The overuse of beta-lactam antibiotics (e.g., penicillins, cephalosporins, monobactams, carbapenems) has decreased their efficacy in eradicating vaginal colonization by E. coli. Clinically, these antibiotics are associated with rapid recurrence of UTIs after treatment compared to other agents [68, 69].

Microbiota Disruption and Pathogen Proliferation

The intestinal microbiota is essential in maintaining mucosal protection across various organs. When disrupted, it can lead to UTI pathogenesis and recurrence [41]. Changes in the microbiota increase pathogen colonization of the vagina and urethra, allowing bacteria to ascend to the bladder and kidneys.

Repeated antibiotic use reduces bacterial diversity and disrupts the inflammatory process, enabling pathogens like Proteus, Staphylococcus, Pseudomonas, Providencia, Enterococcus, Enterobacter, Ureaplasma, and Klebsiella to proliferate [24-26]. These pathogens increase proinflammatory protein production (e.g., cytokines) and suppress anti-inflammatory responses [67]. This imbalance interferes with iron homeostasis and oxygen delivery to tissues, fostering an environment where bacteria thrive [77-81].

Some pathogens also deplete citrate, which helps prevent kidney and bladder stones. They produce urease and other enzymes that generate ammonia, carbon dioxide, uric acid, and free radicals, promoting biofilm formation and enhancing survival under adverse conditions, such as antibiotic exposure or nutrient deprivation [29].

Association with Cancer and Other Health Risks

Recurrent UTIs are strongly linked to higher incidences of acute urinary retention and various cancers, including bladder, kidney, male colorectal, prostate, and female liver cancers. Acute urinary retention is characterized by a sudden, painful inability to void and occurs more frequently in men, with a 2.2 to 8.8 per 1,000 incidence rate annually, increasing with age [84-88].

A 2018 Danish study involving 5.8 million residents found that the absolute risk of urinary tract cancer among patients aged 50 and older was 1.3% at three months, 1.8% at one year, and 2.5% at five years following a first diagnosis of acute non-surgical-induced urinary retention. The study reported significantly higher rates of invasive and non-invasive bladder cancers than expected in both men and women [Source].

The use of antibiotics, particularly for more than seven days, is associated with an increased risk of bladder cancer in men. Women with a history of UTI have shown a higher risk of liver cancer, particularly around 30 months after infection [91-93].

Challenges with Current Treatment Approaches

The conventional medical approach to treating UTIs has led to 53% of women with their first UTI experiencing recurrence within 6 to 12 months [94]. Men, though less prone to recurrence, may harbor bacteria within the prostate, making treatment more complex.

Antibiotics as a first-line treatment have become less attractive due to rising resistance and the associated risks of urogenital conditions and cancers [40]. The high rate of antibiotic-resistant UTIs and the associated healthcare costs, which exceeded $2 billion annually in the U.S. as of 2010, present a major public health challenge [36-38].

Furthermore, most major pharmaceutical companies have stopped investing in alternative treatments for UTIs, as the lack of profitability from antibiotic research has deterred innovation in this area.

RISK FACTORS

There are a number of anatomic and mechanical risk factors that increase the likelihood of pathogen colonization and UTIs. They include the following [95]:

  • Chronic dehydration
  • Diet rich in a high concentration of toxins and other non-digestible elements
  • Certain forms of birth control, such as spermicidal foam and diaphragms, contain compounds that may have a toxic effect on the vaginal microbiota [70].
  • Putting off urinating and defecating when you need to
  • Incomplete bladder emptying
  • Chronic constipation
  • Atrophic vulvovaginal changes
  • Lack of urinating after sex
  • Cystocele in females
  • Penetrative anal sex
  • Prostatic hypertrophy

SOLUTIONS

Curogenix is developing simple, low-risk medications that drastically reduce the risk of recurrent UTIs and related cancers. To learn more, please refer to our About page.

There are various complementary therapies with anti-uropathogenic and bactericidal activities that are effective at treating and preventing acute and recurrent UTIs and decreasing antibiotic resistance and other urogenital diseases. They include the following [96]:

  • Urinating after intercourse,
  • Urinating and defecating when the urge arises
  • Wiping from front to back after urination
  • Vaginal estrogen in the postmenopausal woman with atrophic vulvovaginal changes. This is often an adjunctive to a prolonged course of antibiotics of 6 to 12 months [39], where the probability of a recurrent UTI within 3 months is 60% [97-99].
  • Drinking between 0.5-1.0 ounces of water for each pound a person weighs daily is recommended to increase urinary volume and flush pathogenic bacteria out of the urinary tract. For example, weighing 150 pounds would require 75 to 150 ounces of water daily. Men should drink 3.7 liters of water daily, and women should have 2.7 liters. Fluids can also come in food (e.g., soups, steamed or sauteed vegetables, green smoothies, and herbal tea).
  • Waiting 20 to 30 minutes before and after meals, and not during mealtimes, to drink water is recommended to prevent the dilution of digestive juices, increase the metabolism of protein, fats, and carbohydrates, and absorption of vital nutrients. This is essential to boost the immune system and bacterial diversity.
  • A diet containing excess salts, sugar, chemicals, minerals (e.g., phosphorus, calcium, iron), and other toxic substances the body must excrete and interfere with the absorption of minerals (like iron and calcium) [23] in the gut, electrolytes and fluid levels, and red blood cell production. Increased binding of these items’ byproducts with calcium in the urine causes stone formation in the bladder and kidneys. Stones enable pathogens to multiply (24-26, 29], which boosts stone retention, cell injury and inflammation, and acute and recurrent UTIs [27-31, 89-90]. Iron deficiency anemia decreases the oxygen-carrying capacity of tissues [10, 15-16], alters intestinal permeability, damages the mucosa, lowers bacterial diversity, and modulates the inflammatory process. Stimulating a high loss of protein and premature cell death enables the multiplication of pathogens in the GI and GU tracts, which correlates with acute and recurrent infections, various inflammatory chronic conditions, and cancer growth [14, 18-21]. The top insulters include:
    • Animal products (like red meat, dairy products, eggs, poultry, shellfish, and fish)
    • High phosphorus items (like additives, preservatives, and artificial sweeteners – commonly found in canned, frozen, processed, and fast foods; bottled colas, condiments, ultra-sweet fresh and dried fruits such as dates, berries, and grapes
    • Oxalate-rich foods [like spinach, starchy grains (e.g., soybeans, tofu, wheat, and bran cereals), nuts, root vegetables (e.g., potatoes, sweet potatoes, beets, carrots)]
    • Polyphenol-rich items such as ultra-sweet fresh and dried fruits such as berries, grapes, dates, alcohol, coffee, cocoa, nuts, olives, black and green tea, spinach, and artichokes.
Natural antibiotics, such as D-mannose, uva ursi, berberine, stinging nettle, Vitamin C, and other herbs, are effective at treating acute UTIs, supporting healthy kidney and bladder function, and preventing recurrent infections.

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Curogenix medications specifically designed to remedy UTIs, protect from recurrent UTIs and associated cancers, and nurture the microbiota and overall health.

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“I underestimated how easy it was to address UTIs and Recurrent UTIs until I tried Curogenix.”

— OLIVIA R., CUROGENIX CLIENT

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