We hypothesised that bacterial autovaccine treatment would be associated with a reduction in recurrent symptomatic urinary tract infection (UTI) episodes in adults with chronic spinal cord injury (SCI). The aim of this study was to assess whether bacterial autovaccine treatment was associated with a lower number of recurrent symptomatic UTI episodes in this population.

This was a prospective, longitudinal observational before-and-after study conducted between June 2022 and September 2024, following approval by the local ethics committee. Each participant served as their own historical control, with the number of symptomatic UTI episodes recorded during the year before bacterial autovaccine treatment compared with the number recorded during the year after treatment.

The study included two assessment phases. In the initial phase, epidemiological data, SCI-related variables, and the number of symptomatic UTI episodes during the previous year were recorded. In the final phase, the number of symptomatic UTI episodes during the year after treatment was documented, and participants completed the Spanish version of the BSW questionnaire (Benefit, Satisfaction and Willingness).

Eligible participants were adults aged over 18 years, without cognitive impairment, with chronic SCI of more than 2 years’ duration, and with a history of at least 3 symptomatic UTI episodes in the previous year despite preventive measures. All participants agreed to receive bacterial autovaccine treatment, attended an educational session, and provided written informed consent.

Statistical analysis was performed using Stata version 14.0. Quantitative variables were summarised using mean, standard deviation and median, whereas qualitative variables were presented as frequencies. Comparisons were performed at a 95% confidence level.

A total of 105 patients were enrolled, of whom 93 completed the study. The final cohort comprised 68 men (73%) and 25 women (27%). Median age at inclusion was 50 years (interquartile range [IQR] 36–64), and median SCI duration was 18 years (IQR 6–30). The number of symptomatic UTI episodes decreased from 4.5 (95% CI 3.3–5.7) in the year before treatment to 2.3 (95% CI 0.5–4.1) in the year after treatment. This reduction was statistically significant (p=0.032). The median patient-reported BSW questionnaire score was 6.5 (IQR 3.8–9.2).

In this cohort of adults with chronic SCI and recurrent symptomatic UTI episodes despite preventive measures, bacterial autovaccine treatment was associated with a significant reduction in infection frequency during follow-up compared with the year before treatment, with each participant acting as their own control. The observed decrease in the annual number of symptomatic UTI episodes suggests a potential beneficial effect of this approach in a population with a high infectious burden and limited therapeutic alternatives. Patient-reported benefit and satisfaction, as reflected by the BSW questionnaire, were overall favourable.

In this prospective before-and-after observational study, bacterial autovaccine treatment was associated with a reduction in recurrent symptomatic UTI episodes in adults with chronic SCI. These findings support its potential role as an adjunctive strategy in selected patients with recurrent infections despite standard preventive measures. Further controlled studies are warranted to confirm these findings and better define the place of this approach in clinical practice.

Continence 19S (2026) 102547
DOI: 10.1016/j.cont.2026.102547