Gentamicin + Lactobacillus for Neurogenic Bladder

This trial explores a new treatment for neurogenic bladder in individuals with spinal cord injuries or diseases. It tests whether combining gentamicin, an antibiotic, with the probiotic Lactobacillus can help the bladder restore healthy bacteria and determine the duration of this effect. Participants will receive one of two different doses to assess which is more effective and whether responses differ between men and women. Ideal candidates for this trial have had a neurogenic bladder for at least six months and are not currently experiencing a urinary tract infection. As an Early Phase 1 trial, this research aims to understand how the treatment works in people, offering participants the opportunity to be among the first to receive this innovative approach.

The trial requires that you stop taking any antibiotics at least 2 weeks before starting the study. If you are on prophylactic antibiotics, you will need to discontinue them.

Research has shown that using gentamicin in bladder treatments is generally safe for people with neurogenic bladder. One study found that gentamicin can reduce urinary tract infections without causing major side effects. Similarly, Lactobacillus rhamnosus GG, a type of probiotic, is safe and well-tolerated when placed directly in the bladder, helping to maintain a balanced and healthy bacterial environment.

Researchers are excited about the Gentamicin + Lactobacillus treatment for neurogenic bladder because it introduces a new approach using a combination of an antibiotic and a probiotic. Unlike typical treatments that often focus solely on catheterization or anticholinergic medications to manage symptoms, this approach targets bladder infections directly by using gentamicin to combat bacteria and Lactobacillus to restore healthy bladder flora. The two treatment arms, low dose and high dose, offer a unique delivery method where the solution is instilled directly into the bladder, potentially providing more targeted and effective results. This combination could offer a more comprehensive treatment option by not only addressing infection but also promoting a healthier bladder environment.

This trial will evaluate the effects of combining gentamicin and Lactobacillus rhamnosus GG for neurogenic bladder. Research has shown that applying gentamicin directly in the bladder can reduce urinary tract infections (UTIs) in individuals with nerve-related bladder issues, such as those with spinal cord injuries. Studies also indicate that the probiotic Lactobacillus rhamnosus GG can improve urine quality and lessen symptoms. Participants in this trial will receive either a low or high dose of this combination, aiming to restore healthy bacteria in the bladder and decrease infections. Early results suggest this combination could be a promising approach.¹²³⁴⁶