Exploring the Efficacy of Methenamine Hippurate Across Different Patient Groups With Recurrent Urinary Tract Infections - Experience From a University Teaching Hospital in South Wales, United Kingdom

Sep 29, 2026

Uploaded by Muffet

Recurrent urinary tract infections (rUTIs) are a major clinical problem often managed with long-term antibiotic prophylaxis, yet rising antimicrobial resistance drives the search for non-antibiotic prevention. This retrospective observational study evaluated methenamine hippurate (MH) for rUTI prophylaxis, focusing on patients with urinary tract structural or functional abnormalities and those requiring catheterization. Among the first 150 MH recipients, 12-week improvement and follow-up outcomes were assessed using radiological, functional, and catheter-use variables. Overall, MH showed effectiveness across diverse groups with no clear long-term differences by these factors.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Abstract

Introduction

Objective

Methods

Results

Conclusions

Introduction

Review began 11/19/2025 Review ended 11/29/2025 Published 12/05/2025 © Copyright 2025 Abolanle et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited. DOI: 10.7759/cureus.98511 Open Access Original Article Exploring the Efficacy of Methenamine Hippurate Across Different Patient Groups With Recurrent Urinary Tract Infections: Experience From a University Teaching Hospital in South Wales, United Kingdom Philip Abolanle 1 , Daniel Akintelure 1 , Maike Eylert 1, Don S. Wijayasuriya 1 , Hasan A. Al-Ibraheem 1 , Coral Seymour 1 , Paulette Hussain 1 1. Urology Department, Royal Gwent Hospital, Aneurin Bevan University Health Board, Newport, GBR Corresponding author: Philip Abolanle, [abolanlephilip@gmail.com](abolanlephilip@gmail.com) Abstract Introduction: Recurrent urinary tract infections (rUTIs) represent a significant clinical challenge, traditionally managed with long-term antibiotic prophylaxis. However, growing concerns regarding antimicrobial resistance have necessitated the exploration of alternative treatment modalities. Methenamine hippurate (MH), a urinary antiseptic with a unique mechanism of action, has emerged as a promising non-antibiotic option for rUTI prevention. Objective: This study aims to examine the effectiveness of MH in the prophylaxis of rUTI, with a specific focus on patients with structural or functional abnormalities of the urinary tract and those requiring catheterization to empty their bladder. Methods: A retrospective observational study was conducted on the first 150 patients prescribed MH in a University Hospital at a Local Health Board in South Wales from April 2020 to July 2022. Patient demographics, radiological findings, functional urological status, catheter use, and treatment outcomes were analyzed. Chi-square statistical tests were used to assess associations between categorical variablesand treatment outcomes. Results: The cohort comprised 132 females (88%) with a median age of 60 years. After 12 weeks of treatment, 100 (66 . 7%) of patients showed improvement, with about half of these (n = 46) experiencing complete resolution of UTIs and a further third (n = 35) reporting reduced frequency or severity at six months follow-up. No statistically significant difference in long-term outcomes was observed based on radiological findings (χ2 = 0 .138, df = 2, p = 0 .933) . Similarly, there was no significant association between functional urological status and treatment outcome (χ2 = 4 .763, df = 2, p = 0 .092), nor between catheter use and outcome (χ2 = 4 .226, df = 2, p = 0 . 121) Conclusions: MH demonstrates effectiveness for long-term management of rUTIs across diverse patient populations, including those with structural or functional urinary tract abnormalities and catheter users. These findings support the broader application of MH as a viable alternative to antibiotic prophylaxis, potentially reducing antimicrobial resistance while maintaining clinical efficacy. Categories: Urology, Infectious Disease Keywords: antibiotic prophylaxis, antimicrobial resistance, methenamine hippurate, recurrent uti, urogynaecology, uti prophylaxis Introduction Recurrent urinary tract infections (rUTIs) are defined as two or more episodes within six months or three or more episodes within one year [1] . This condition predominantly affects women, with an annual incidence of approximately 30 per 1,000 women [2] . The burden of rUTIs extends beyond acute symptoms such as dysuria, urgency, and suprapubic pain, with potential complications including renal damage, sepsis, and reduced quality of life [3] . Traditionally, continuous antibiotic prophylaxis has been the mainstay of rUTI management. However, this modality carries substantial risks, including the development of antimi

FAQs

What clinical problem does the study address?

The study addresses recurrent urinary tract infections (rUTIs), a condition traditionally treated with long-term antibiotic prophylaxis despite concerns about antimicrobial resistance and other risks.

What is the aim of using methenamine hippurate (MH) in this study?

The study aims to evaluate the effectiveness of MH for preventing rUTIs, with emphasis on patients with urinary tract structural or functional abnormalities and those needing catheterization.

What were the main outcomes reported after treatment?

After 12 weeks, two-thirds of patients showed improvement, including complete resolution in about half of improved patients. At around six months, many also reported reduced frequency or severity, and long-term outcomes were not significantly different by radiological findings, functional status, or catheter use.

Sep 29, 2026

Uploaded by Muffet