Editing AUA & CUA Recurrent UTI (2019) (section)

====== <span style="color:#ff0000">Non-antibiotic prophylaxis (2):</span> ======
# '''<span style="color:#ff0000">Cranberry prophylaxis</span>'''
#* MOA: thought to be related to proanthocyanidins present in cranberries and their ability to prevent the adhesion of bacteria to the urothelium
#* '''<span style="color:#ff0000">Indications</span>'''
#**'''<span style="color:#ff0000">Can be offered for women with rUTIs</span>'''
#*Oral juice and tablet formulations are available
# '''<span style="color:#ff0000">Vaginal estrogen</span>'''
#* '''<span style="color:#ff0000">Indications</span>'''
#**'''<span style="color:#ff0000">Recommended in peri-and post-menopausal women with rUTIs,</span>''' if there is no contraindication to estrogen.
#*** '''Oral or other formulations of systemic estrogen therapy have not been shown to reduce UTI and are associated with different risks and benefits.'''
#*** Given low systemic absorption, risks generally associated with systemic estrogen (cardiovascular disease, thrombosis, breast cancer) are minimal with vaginal estrogen.
#* '''Patients with rUTI and are already on systemic estrogen therapy should still be placed on vaginal estrogen. There is no substantially increased risk of adverse events.'''
#* '''Vaginal estrogen therapy has not been shown to increase risk of cancer recurrence in women undergoing treatment for or with a personal history of breast cancer'''. Therefore, vaginal estrogen therapy should be considered in prevention of UTI women with a personal history of breast cancer in coordination with the patient’s oncologist.
* '''Lactobacillus is not recommended''' as a prophylactic agent for rUTI given the lack of data