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SUFU 2022: Use of Cranberry Supplement, D-Mannose, and other OTC Modalities for Prevention of Recurrent UTI in Women Post-Electrofulguration

(UroToday.com) In women with antibiotic-recalcitrant recurrent urinary tract infections (RUTI), electrofulguration (EF) to destroy of areas of chronic cystitis can provide durable cure or improvement. However, some women will fail while others will experience some UTI recurrences over time and are interested in non-antibiotic therapies to combat these UTI episodes. The aim of this study was to collect data via telephone survey about over-the-counter (OTC) modalities used by women who fail EF and experience rUTIs and how much it helped with reducing their UTI rates.


In this study, women with a history of undergoing EF for rUTI were offered a short, standardized phone survey to collect information about their use of various OTC modalities for RUTI prevention. Data were compared between two cohorts, ≥70 and <70 years old, using Chi-Square (categorical measures) and Student t-tests (continuous measures).

From a database of 324 patients, 163 accepted the interview.

  • 46% (75/163) of the women reported no current use of any OTC modality
  • 17% (28/163) reported current use of cranberry supplements
  • 10% (16/163) D-mannose supplements
  • 42% (69/163) another non-prescription modality for rUTI prevention including turmeric, garlic, apple cider vinegar, cranberry juice, increased daily water intake, and various probiotic pills.
The <70 years old cohort spent an average of $80 less annually on cranberry/D-mannose supplements than the >70 years old cohort (p=0.043) and was more likely to use non-cranberry/D-mannose modalities for the prevention of UTI (52% vs. 30%; p=0.0061). Individuals using D-mannose were also much more likely to purchase their product online compared to those using cranberry supplements (85% vs 56%). Across all modalities, the perceived benefit difference in reducing UTI/year ranged from a median of 0 less UTI/year for Pyridium to 4 less UTI/year for probiotics, with D-mannose and cranberry at 2 less UTI/year, and those increasing daily fluid consumption from their baseline reporting 2.5 less UTI/year.

This study found the continued use of OTC modalities for rUTI prevention was common among women with an EF history but varied based on age group. Women <70 years old were more likely to use any OTC prophylactic treatments for rUTI and spent less annually than the >70 years group.

Presented by: Parker Kenee, Alana Christie, Philippe Zimmern, Department of Urology, University of Texas Southwestern Medical Center