Targeted antibiotic treatment prevents recurrent UTIs

A 56-year-old woman had no further UTIs for more than a year after receiving antibiotics directly through a urostomy, researchers have reported.

The treatment involved delivering the antibiotic gentamicin into a surgically created passage that carries urine from the kidneys to an opening in the abdomen.

The patient had previously experienced 13 urinary tract infections requiring antibiotics and three hospital admissions in a single year. She also had persistent low-level kidney pain.

Researchers at Royal Berkshire Hospital developed the approach for the woman, who had undergone a cystectomy, an operation to remove the bladder.

Following surgery, she had an ileal conduit, a passage made from a short section of bowel that carries urine to an abdominal opening called a urostomy, where it drains into an external bag.

Gentamicin was administered directly into the conduit using a catheter.

According to the clinical team, this is the first documented use of the technique to prevent recurrent UTIs in a patient with an ileal conduit.

The findings were presented by professor Bob Yang at the 46th Congress of the Société Internationale d’Urologie (SIU 2026).

Treatment began with daily doses for four weeks, followed by alternate-day administration for nine weeks and twice-weekly doses for another 12 weeks.

The patient then gradually reduced the frequency and is currently receiving treatment every five days.

Initially administered in an outpatient clinic, the treatment was later carried out by the patient at home after she received training.

During more than a year of follow-up, she experienced no further urinary tract infections and needed no additional oral or intravenous antibiotics.

Her longstanding kidney pain also resolved.

Blood tests during the initial daily treatment phase showed no increase in gentamicin levels in the bloodstream and no changes in kidney or liver function.

The clinical team said the findings confirmed that the antibiotic acted locally without systemic absorption, helping prevent unwanted side effects.

The patient experienced brief discomfort around her kidneys during administration, which indicated that the treatment was reaching both kidneys. The discomfort quickly resolved.

Yang, consultant urological surgeon at The Forbury Clinic and Royal Berkshire Hospital, said: “For people living with a urostomy, recurring urinary infections can mean repeated antibiotic treatment, hospital admissions, and considerable disruption to daily life. More importantly, the open access means any infection can travel straight up into the kidneys rapidly, causing sepsis.”

He said the patient had been able to administer the treatment independently at home, with minimal disruption to her daily life.

Although the results are encouraging, the findings relate to a single patient and further research is needed to establish whether the technique is safe and effective for wider use.

Yang said: “That is encouraging, but this is one patient’s experience. We need longer follow-up and further studies to establish how well the approach works, assess its long-term safety, and understand which patients might benefit.”