DiseasesCystitis — an old medicine that works without antibiotics?
Sources: 3 · Article: 9 293 characters
Henryk Różański says that urotropine was used for cystitis, and that its effect depends on acidic urine.
- It works best at pH 5.5 and has no antimicrobial effect at pH 7.
- Urotropine does not work against urease-producing bacteria, and prolonged use may cause blood in the urine.
- It may also irritate the urinary tract and cause a burning sensation; it should not be taken with sulfonamides.
What the authors write
Henryk Różański
Urotropine was once commonly used for cystitis and inflammation of the renal pelvis.
„Formerly commonly used for cystitis and pyelitis, and at 0.5 g as a preventive measure against post-scarlet-fever nephritis (Tappeiner H. 1910, Muszyński J. 1947). Dr. R. Franck (1939) recommended it for cystitis, pyelitis, pyelonephritis, prostatitis, and bacteriuria, and as an adjunct in the treatment of gonorrhea.”Dawniej powszechnie używana przy Cystitis i Pyelitis a 0,5 g zapobiegawczo przeciwko poszkarlatynowemu zapaleniu nerek (Tappeiner H. 1910 r., Muszyński J. 1947 r.). Dr R. Franck (1939 r.) zalecał przy Cystitis, Pyelitis, Pyelonephritis, Prostatitis, Bakteriurie, pomocniczo przy terapii rzeżączki.
Henryk Różański
In acidic urine, urotropine releases formaldehyde, which destroys bacteria and fungi; in alkaline urine, it has no antimicrobial effect.
„From the beginning, it was used to treat urinary tract infections because it releases formaldehyde in acidic urine, which destroys bacteria and fungi. It has no antimicrobial activity in alkaline urine. Pathological urine is often alkaline, so acidifying agents, for example, must be used when administering urotropine.”Od początku był stosowany w leczeniu zakażeń układu moczowego, bowiem w kwaśnym moczu uwalnia formaldehyd, który niszczy bakterie i grzyby. W moczu zasadowym nie wykazuje aktywności przeciwdrobnoustrojowej. Mocz patologiczny często jest zasadowy, dlatego podczas podawania urotropiny konieczne jest zastosowanie zakwaszaczy, np.
Henryk Różański
Urotropine works most effectively when urine pH is 5.5 and has no activity at pH 7.
„Urotropine works most effectively in urine with a pH of 5.5. At pH 7, it has no activity (T. Chruściel 1991).
Urotropine does not work against bacterial spores (J. Modrakowski 1930). Prolonged administration of urotropine may cause blood in the urine, especially in children (Modrakowski 1930).”Urotropina działa najefektywniej w moczu o pH 5,5. Przy pH 7 nie wykazuje aktywności (T. Chruściel 1991 r.).
Urotropina nie działa na zarodniki bakterii (J. Modrakowski 1930 r.). Dłuższe podawanie urotropiny może wywołać krwiomocz, zwłaszcza u dzieci (Modrakowski 1930 r.).
Henryk Różański
Urease-producing bacteria are not sensitive to urotropine.
„Urotropine, in combination with hippuric and mandelic acids, inhibits the growth of many Gram-positive and Gram-negative bacteria, for example Escherichia coli, Pseudomonas aeruginosa, and Klebsiella. Unfortunately, bacteria equipped with the enzyme urease are not sensitive to urotropine. Cinnamic acid (Różański H. 2007) and mandelic acid enhance urotropine’s antibacterial effect.”Urotropina w powiązaniu z kwasem hipurowym i migdałowym hamuje rozwój wielu bakterii Gram+ i Gram-, np. Escherichia coli, Pseudomonas aeruginosa, Klebsiella. Niestety bakterie uzbrojone w enzym ureazę nie są wrażliwe na urotropinę. Kwas cynamonowy /Różański H. 2007 r./, migdałowy – potęgują działanie przeciwbakteryjne urotropiny.
Henryk Różański
Urotropine was listed as a treatment for bacterial and yeast infections of the urinary tract.
„Indications for the use of urotropine: bacteriuria (urine containing excessive amounts of bacteria) without signs of inflammation; bacterial and yeast infections of the urinary tract; bacterial resistance to antibiotics and sulfonamides, and to fluoroquinolones. For external use: excessive sweating, as an alternative to deodorants containing aluminum compounds.”Wskazania do stosowania urotropiny: bakteriuria (mocz zawierający nadmierne ilości bakterii) bez objawów stanu zapalnego; infekcje bakteryjne i drożdżakowe układu moczowego; oporność bakterii na antybiotyki i sulfonamidy, fluorochinolony. Zewnętrznie: nadmierna potliwość, alternatywa dla środków dezodorujących ze związkami glinu.
Henryk Różański
For cystitis associated with sexually transmitted diseases, urotropine was recommended in combination with sandalwood oil.
„For bladder infections occurring as part of sexually transmitted diseases, he recommended sandalwood oil—Oleum Santali (Santalum album), 1 g per dose (in capsules) or 20 drops in milk several times a day, together with urotropine (0.5 g three times a day).
Urotropine sometimes causes bleeding from the urinary tract, and people with sensitive bladders complain of a burning sensation; it may also cause hives and eczema (F.”Przy zakażeniach pęcherza moczowego w przebiegu chorób wenerycznych polecał olejek sandałowy – Oleum Santali (Santalum album) po 1 g (w kaps.) lub 20 kropli w mleku kilka razy dziennie wraz z urotropiną (3 razy dziennie po 0,5 g).
Urotropina wywołuje niekiedy krwawienia z dróg moczowych, a chorzy z wrażliwym pęcherzem narzekają na pieczenie; może wywołać również pokrzywkę i wyprysk (F.
Henryk Różański
Urotropine may irritate the urinary tract, cause a burning sensation, and sometimes cause bleeding.
„Urotropine sometimes causes bleeding from the urinary tract, and people with sensitive bladders complain of a burning sensation; it may also cause hives and eczema (F. Malinowski 1939). To strengthen urotropine’s effect, it was commonly combined with phosphoric and benzoic acids:
Rp.”Urotropina wywołuje niekiedy krwawienia z dróg moczowych, a chorzy z wrażliwym pęcherzem narzekają na pieczenie; może wywołać również pokrzywkę i wyprysk (F. Malinowski 1939 r.). Dla wzmocnienia działania urotropiny popularne było kojarzenie jej z kwasem fosforowym i benzoesowym:
Rp.
Henryk Różański
Prolonged use of urotropine may cause blood in the urine, so the text indicates that it should be used in short courses to treat infections of the genitourinary tract.
„Prolonged administration of urotropine may cause blood in the urine, especially in children (Modrakowski 1930). It is therefore suitable for short-term treatment of infections of the genitourinary tract.
Rp. Sol. Urotropini 5.0/150.0. Directions: 1 tablespoon 3 times a day.
Rp. Urotropini in tablets.”Dłuższe podawanie urotropiny może wywołać krwiomocz, zwłaszcza u dzieci (Modrakowski 1930 r.). Nadaje się więc do krótkotrwałych terapii zakażeń układu moczowo-płciowego.
Rp. Sol. Urotropini 5,0/150,0 D.S. 3 razy dziennie po 1 łyżce stołowej.
Rp. Urotropini in tabl.
Henryk Różański
Urotropine should not be given together with sulfonamides because inactive, insoluble precipitates form.
„This medicine must not be given together with sulfonamides, because inactive precipitates that are insoluble in water form (Janiec W. 2010). Do not combine it with tannin. The maximum concentration of ammonia in the urine occurs 2 hours after urotropine is given. Hydrochloric acid in the stomach hydrolyzes about 30% of the administered dose, so it is important to administer urotropine in an enteric-coated form.”Nie wolno tego leku podawać wraz z sulfonamidami, bowiem powstają nieaktywne strąty, nierozpuszczalne w wodzie /Janiec W. 2010 r./. Nie łączyć z taniną. Maksymalne stężenie amoniaku w moczu występuje po 2 godzinach od podania urotropiny. Kwas solny obecny w żołądku hydrolizuje około 30% podanej dawki leku, dlatego ważne jest, aby podawać urotropinę dojelitowo.
Henryk Różański
Historical preparations combining urotropine with other ingredients and disinfecting the urinary tract were also mentioned.
„Cystopurine (Cystopurinum)—a combination of urotropine and sodium acetate, an excellent diuretic and urinary tract disinfectant; given at 1 g 3 times a day.
3. Amphotropine (Amphotropinum)—a combination of camphor and urotropine, given at 0.5–1 g 3 times a day.”Cystopuryna (Cystopurinum) – połączenie urotropiny z octanem sodu, doskonały środek moczopędny i odkażający drogi moczowe; podawano po 1 g 3 razy dziennie.
3. Amfotropina (Amphotropinum) – połaczenie kamfory z urotropiną, podawano po 0,5-1 g 3 razy dziennie.
Research from PubMed · Europe PMC
We selected 2 studies with the best, positive results. This is a selection, not a full review of all research.
Total number of studies on this topic in PubMed: 14.
The review found that urotropine may help prevent recurrent urinary tract infections, although it does not assess it as a treatment for acute cystitis.
Aim of the study: Antibiotic resistance is an unavoidable consequence of antibiotic use, and rising rates of resistance are an urgent issue. Methenamine is a non-antibiotic alternative used to prevent urinary tract infections (UTIs). This review aims to evaluate recently published research on the effectiveness and safety of methenamine for UTI prevention.
Results: A total of seven studies (three prospective and four retrospective) met the inclusion criteria for review. Two of the three prospective studies found no difference, or no meaningful difference, in clinical effectiveness between methenamine and antibiotic prophylaxis in preventing recurrent UTIs. The third found lower UTI rates with methenamine in patients with short-term indwelling catheters than with cranberry alone. The retrospective studies consistently supported the effectiveness and safety of methenamine for UTI prevention in a range of populations and clinical settings. Reported side effects of methenamine were similar to those of the comparators and included nausea, abdominal pain, and headache. Methenamine was found to be effective for UTI prevention in a variety of settings, without a higher risk of side effects than prophylactic antibiotics. Larger, blinded clinical trials are needed to better define the role of methenamine in UTI prevention.
Money for the studynot stated
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studyreview of many studies
“Not stated” does not mean nobody paid — the database does not always record it.
In a small study of people with recurrent acute cystitis, fewer recurrences occurred while they were taking urotropine than while they were taking a placebo.
Aim of the study: In a randomized, double-blind, long-term crossover study, 1 g of methenamine hippurate twice daily was compared with a placebo for its preventive effect on recurrent episodes of acute cystitis. Methenamine hippurate and placebo were alternated every six months for two years.
Results: Of the 21 patients enrolled, 14 completed the first year and 13 completed both years of treatment, allowing the evaluation of 27 patient-years. There were 52 episodes of acute cystitis caused by reinfection: 41 occurred during placebo treatment and only 11 during the methenamine hippurate regimen (p less than 0.01). Increasing fluid intake did not reduce the incidence of acute cystitis or lessen the effect of methenamine hippurate. Methenamine hippurate is effective in preventing recurrent acute cystitis and has the advantage of not causing cross-resistance to conventional antibiotics.
Money for the studynot stated
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studystudy with random allocation to groups (RCT)
Participants21
“Not stated” does not mean nobody paid — the database does not always record it.
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