Ces Urol X:X | DOI: 10.48095/cccu2026020

Ialuril^® Prefill and its use in catheter therapy for the prevention of recurrent urinary tract infections

Roman Wasserbauer

Urologická klinika LF MU a FN Brno

Introduction: Recurrent urinary tract infections (rUTIs) represent a significant clinical problem. They are defined as ≥ 2 episodes within 6 months or ≥ 3 within 12 months, most commonly caused by uropathogenic Escherichia coli. The pathogenesis involves ascending spread, the formation of intracellular bacterial communities, and disruption of the protective glycosaminoglycan (GAG) layer of the urothelium, which significantly reduces quality of life.

Methodology: This article summarizes current knowledge and recommendations from the European Association of Urology (EAU), focusing on intravesical instillation therapy to restore the GAG layer using hyaluronic acid (HA) and chondroitin sulfate (CS).

Results: Disruption of the GAG layer is a key factor contributing to bacterial adhesion and invasion. Clinical studies and meta-analyses confirm that intravesical administration of HA, either alone or in combination with CS, significantly reduces the number of recurrences, prolongs the intervals between infections, and improves quality of life. Combination therapy (HA + CS) demonstrates greater efficacy than monotherapy and is supported by EAU Guidelines.

Conclusion: Restoration of the GAG layer represents an effective non-antibiotic strategy in the treatment of rIMC. The intravesical combination of HA and CS effectively breaks the cycle of recurrent infections and reduces antibiotic use, although further studies are needed to confirm long-term efficacy.

Keywords: recurrent urinary tract infections – instillation therapy – glycosaminoglycan layer

Received: June 27, 2026; Revised: June 27, 2026; Accepted: July 10, 2026; Prepublished online: August 20, 2026