Medical Research: What are the main findings of this study?
Dr. Hodges: The main findings of this study were that skin irritants (typically urine) may cause vulvitis in prepubertal girls, which leads to an alteration of their perineal microbiome, with increased colonization by uropathogenic bacteria, increasing the risk of UTI.
Medical Research: Were any of the findings unexpected?
Dr. Hodges: The only unexpected finding was that the link to the alteration of the perineal microbiome was due to an alteration in the skin pH, the typical skin pH is 4.5, but when active vulvitis was present, the pH increased to 7, allowing uropathogenic bacteria to grow.
Medical Research: What should patients and clinicians take away from this report?
Dr. Hodges: Parents and clinicians should make every effort to maintain healthy vulvar skin in prepubertal girls suffering from recurrent urinary tract infections – this includes encouraging them to voids with their legs wide apart, wipe well, use barrier creams and soothing baths as needed to counteract the effects of skin irritants.
Medical Research: What further research do you recommend as a result of this work?
Dr. Hodges: We have developed a brand of astringent wipes, Dr. Soother’s Healthy Wipes (www.mysoothers.com), to prevent and treat vulvitis, we plan to examine their ability to prevent UTIs in girls.
Altered perineal biome is associated with vulvovaginitis and urinary tract infection in preadolescent girls
Ilya Gorbachinsky, Robert Sherertz, Gregory Russell, L. Spencer Krane, and Steve J. Hodges
Therapeutic Advances in Urology 1756287214542097, first published on July 16, 2014 doi:10.1177/1756287214542097