Could a virus found in your toilet water be the future of UTI treatment? In this episode of the LUF Podcast, host Melissa Kramer, PhD, talks with Esme Brinsden, Project Coordinator at the Phage Collection Project, a citizen science initiative based at the University of Southampton in the UK. Esme breaks down bacteriophage therapy: what phages are, how they target and kill bacteria without harming human cells, and why this century-old treatment is gaining new momentum as an alternative to antibiotics for recurrent and chronic UTIs. The conversation covers how phages break down bladder biofilms, how phage and antibiotic combination therapy works, current access to phage therapy in the UK versus countries like Georgia, and how listeners can get involved in phage research by submitting a water sample. Learn more about the Phage Collection Project at phage-collection.org, and visit liveutifree.com for more UTI research and education.

3 Key Takeaways

1. Phages can break down the biofilms that protect chronic UTI bacteria. Esme explains that phages produce an enzyme that degrades biofilm, which makes the bacteria inside it more vulnerable to both phage therapy and antibiotics, a key reason phage therapy is generating interest for chronic and recurrent UTIs.
   
   
2. Combining phage therapy with antibiotics may work better than either alone. Esme describes it as a “double hit”: bacteria rarely develop resistance to phages and antibiotics at the same time, so pairing the two treatments can clear infections that one approach alone might miss.
   
   
3. Anyone can contribute to phage research, starting with a water sample. Through the Phage Collection Project’s citizen science model, members of the public can request a sampling kit, collect water (yes, even toilet water), and help build a biobank of phages that could one day be used to treat UTIs and other bacterial infections.

Resources Mentioned

• The Phage Collection Project — request a sampling kit or take the willingness questionnaire
• Live UTI Free — educational resources and community research on recurrent and chronic UTIs

The bladder doesn't work in isolation. In this episode of the Live UTI Free podcast, host Melissa Kramer, PhD, talks with Intimate Health Specialist and Nutritional Therapist Kate Waters about the gut-bladder-vagina connection, the role of diet in recurrent and chronic UTIs, and why the nervous system may keep sending pain signals long after an infection has cleared.

Kate explains how inflammation and dysbiosis in one part of the pelvis can affect the others, why a whole-foods diet and cruciferous vegetables support the urinary microbiome, and what the research actually says about probiotics, biofilms, and E. coli overgrowth. The conversation also covers nerve sprouting in chronic bladder pain, practical tools for calming an overactive nervous system, and prevention strategies for UTIs linked to sex, swimming, long shifts, and travel.

Kate Waters is an Intimate Health Specialist, Nutritional Therapist and Behavioural Change Coach based in the UK. She works exclusively with clients living with bladder, vaginal and vulval conditions, taking a whole-body approach that looks at the microbiome, hormones, nervous system and daily habits. Kate is a BANT-registered nutritional therapist trained at the College of Naturopathic Medicine in London.

Key Takeaways

1. The gut, vagina, and bladder are interconnected. They sit close together in the pelvis and share a mucosal environment, so inflammation or dysbiosis in one site can influence the others. That said, gut issues don't automatically mean bladder issues, and vice versa.
2. Biofilms and probiotics are more nuanced than "good vs. bad." Biofilms occur naturally throughout the body, not just the bladder, and they typically break down on their own over time. Probiotics containing Lactobacillus can sometimes trigger a temporary uptick in symptoms as biofilms are disrupted, but that's a different mechanism than the probiotic itself causing infection.
3. Chronic pain doesn't always mean active infection. Ongoing bladder issues can cause nerve fibers to "sprout" into the bladder lining, amplifying pain signals even after bacteria are gone. Calming the nervous system through breathwork, grounding and finding a sense of safety can help reduce that amplification, alongside continuing to rule out infection through medical care.

Links and Resources

• Kate Waters' website: katewaters.co.uk
• Kate Waters on Instagram: @katewatersnutrition
• Kate Waters' 2020 Q&A with Live UTI Free: Read here
• Live UTI Free: liveutifree.com
• Join the Live UTI Free mailing list for educational materials and research opportunities: liveutifree.com

Catheter-associated UTIs (CAUTIs) don't follow the same rules as uncomplicated UTIs, and most patients are never told why. In this episode, host Melissa Kramer, PhD, talks with microbiologist Dr. Ana Flores-Mireles of the University of Notre Dame about how catheterization changes the bladder environment, why the protein fibrinogen becomes a "bed and breakfast" for bacteria and fungi like Candida auris, and how her lab is developing antibiotic-free, slippery catheter coatings to reduce infection and inflammation. She also shares emerging research linking long-term catheterization to bladder cancer markers, and what that could mean for people who rely on catheters long-term. Melissa and Dr. Flores-Mireles cover intermittent vs. indwelling vs. suprapubic catheters, whether D-mannose or probiotics have a role for catheter users, and why comorbidities like clotting disorders may predispose some people to more severe infections.

Key Takeaways

1. Catheterization changes the bladder environment.
Inflammation brings proteins like fibrinogen into the bladder to heal damage, but pathogens exploit them to attach and grow. Dr. Flores-Mireles calls it "a place to stay and a place to eat."

2. Prevention science is still catching up.
CDC guidance recommends changing indwelling catheters every two weeks, but even careful hygiene doesn't guarantee prevention. Firm recommendations aren't possible yet.

3. Antibiotic-free technology is on the horizon.
Dr. Flores-Mireles's lab developed a "slippery" catheter coating that blocks pathogen attachment without antimicrobials, and early data shows it also lowers bladder cancer markers. Clinical trials haven't started yet.

Links & Resources

• Dr. Flores-Mireles's faculty page, University of Notre Dame
• Live UTI Free