In this episode of the Live UTI Free Podcast, host Melissa Kramer welcomes Dr. Henry Schreiber, instructor at Washington University School of Medicine in St. Louis, to explore the fascinating link between our gut microbiome, bladder health, and urinary tract infections (UTIs). Dr. Schreiber specialises in understanding UTIs as a whole‑body problem (not just a bladder infection), and he shares insights on how the gut may serve as a reservoir for UTI‑causing bacteria, how inflammation and nervous system signalling in the bladder contribute to persistent symptoms, and why we need better diagnostics and treatments. If you have recurrent UTIs (RUTIs) or pelvic/urinary symptoms, want to better understand the science, or are a healthcare professional seeking a research‑grounded discussion, this episode offers information to help you feel more empowered.

Three Key Takeaways:

1. Dr. Schreiber explains how the gut microbiome can influence bladder health, more than just one “bad bug”; it’s about bacterial diversity, immune education, and metabolite production (e.g., butyrate‑producing bacteria being lower in people with recurrent UTIs).
   
   
   
2. He emphasises that UTIs (especially recurrent) often reflect a whole‑body issue, not just a bladder infection: a lowered neuronal threshold in the bladder, immune system dysregulation, and a “reservoir” in the gut (or nearby) may all contribute to repeated episodes.
   
   
   
3. He speaks directly to patients: Yes, the neurological and mood symptoms many people with UTIs experience are real (not “just anxiety”), and while many treatments are under development, self‑advocacy and understanding your own biology matter because “biology is just weird” and there’s no one‑size‑fits‑all.

Want to learn more about urinary health? Visit LiveUTIFree.com for expert articles on the latest research, or check out our YouTube channel for a video format.

Join host Melissa from Live UTI Free as she speaks with Dr. Indira Mysorekar, a pioneer in urinary tract infection research whose lab uncovered how Escherichia coli can hide in reservoirs within the bladder and then re‑emerge to trigger recurrent UTIs. Together, they explore how bladder health differs between people assigned female at birth and those assigned male, how menopause and chronic inflammation increase UTI risk, and what the future of diagnostics and care might look like. Whether you’re battling recurrent UTIs, living with chronic urinary symptoms, or just want to understand the science behind bladder‑health issues, this episode offers insight, support, and actionable ideas grounded in research.

3 Key Takeaways

• Dr. Mysorekar explains that in many recurrent UTI cases, bacteria aren’t simply coming and going; they may persist hidden within bladder tissue in what she calls “quiescent intracellular reservoirs,” then re‑emerge to cause symptoms.
  
  
  
• Chronic bladder inflammation (even in the absence of a classic culture‑positive infection) can damage the bladder’s barrier cells, turning “normal” urine into an irritant and priming the bladder for future infection.
  
  
  
• The “female bladder” (people with female anatomy) is biologically distinct (and under‑researched) compared to the male bladder; menopause and hormone changes significantly raise the risk of recurrent UTIs, so care needs to look beyond “take antibiotics and go home.”

Want to learn more about urinary health? Visit LiveUTIFree.com for expert articles on the latest research, or check out our YouTube channel for a video format.

In this episode of the Live UTI Free Podcast, host Melissa Kramer talks with Professor Chris Harding, Consultant Urological Surgeon at Newcastle upon Tyne Hospitals NHS Foundation Trust and Professor of Urology at Newcastle University.

They explore the VESPER clinical trial, a landmark study for people with recurrent urinary tract infections (RUTIs) who haven’t improved with first-line prevention. Together, they discuss how bladder instillations work at home, why this trial focuses on real-world symptoms rather than lab culture results, who can participate, and how the findings could inform future care guidelines across the UK.

Key Takeaways

• Three prevention options tested side by side. The VESPER trial compares daily oral antibiotics, bladder-administered gentamicin, and GAG-layer replacement therapy, designed to strengthen the bladder’s natural protective coating.
  
  
  
• Targeted treatment results in fewer whole-body side effects. Delivering medicine straight into the bladder keeps it where it’s needed most. In earlier studies, gentamicin wasn’t detected in the bloodstream, suggesting a low risk of systemic side effects.
  
  
  
• Measuring what matters most. Instead of relying on unreliable culture tests, success is defined by symptoms and treatment outcomes, reflecting how people actually experience UTIs in daily life.

If you or someone you support meets the criteria and is in the UK, discuss a referral specifically for the VESPER trial with your GP.

Want to learn more about urinary health? Visit LiveUTIFree.com for expert articles on the latest research, or check out our YouTube channel for a video format.