Advanced Urology Reports Marked Reduction in Antibiotic Use Among 50 Men Treated Under New Recurrent UTI Protocol

Root-cause-focused program addressing metabolic health, bladder outlet obstruction, and bacterial persistence is breaking the cycle of recurrent infection

SNELLVILLE, GA, UNITED STATES, April 19, 2026 /EINPresswire.com/ -- Advanced Urology, metro Atlanta's most innovative urology practice, today announced outcomes from the first 50 men treated under its comprehensive recurrent urinary tract infection (rUTI) protocol, reporting a marked reduction in antibiotic use, infection frequency, and patient-reported symptom burden. The results reflect what clinical leaders at the practice describe as a fundamentally different approach to a condition in men that is frequently misdiagnosed, undertreated, and managed almost exclusively with repeat courses of antibiotics.

Recurrent UTIs in men are clinically distinct from those in women and demand a different diagnostic approach. In men, recurrent infections are rarely idiopathic — they are almost always a downstream consequence of an underlying anatomic, functional, or metabolic driver. Bladder outlet obstruction, incomplete bladder emptying, prostatic inflammation, indwelling catheters, metabolic dysfunction, and bacterial persistence within the prostate are among the most common root causes. Yet most men with recurrent infections are never evaluated for these drivers. They are simply prescribed another antibiotic, and the cycle continues.

Advanced Urology's protocol rejects that model in favor of a root-cause evaluation that examines why infections keep occurring in the first place. Across the initial 50-patient male cohort, the practice reports:

An over 50 percent reduction in antibiotic prescriptions per patient-year compared with the twelve months prior to enrollment.

60 percent of patients reporting meaningful improvement in UTI-related bother and quality of life.

A Different Premise
"Recurrent UTIs in men are not a mystery — they are a symptom of something structural or metabolic that is not being addressed," said Jitesh Patel, MD, Founder and President of Advanced Urology. "When a man has three or four UTIs in a year, the question is not which antibiotic to use next. The question is why his bladder is not emptying, why his prostate is inflamed, or why his metabolic environment is feeding bacterial growth. Our job is to find that answer and fix it, not to write another prescription and wait for the next infection."

The protocol is built around a coordinated set of interventions, selected and combined based on the specific drivers identified in each patient:
Bladder outlet obstruction evaluation and treatment. For men with recurrent UTIs driven by incomplete emptying due to benign prostatic hyperplasia or other outlet pathology, Advanced Urology offers the full range of modern minimally invasive BPH therapies, including UroLift and Prostate Artery Embolization. By relieving obstruction and restoring normal bladder emptying, these therapies eliminate one of the most common structural drivers of recurrent male UTIs without committing patients to lifelong medication or traditional surgery.

Metabolic optimization. Elevated blood glucose feeds bacterial growth, impairs immune function, and increases bacterial adherence to the bladder wall. Every patient receives a thorough metabolic evaluation, with glucose control addressed as a foundational intervention.

Methenamine hippurate (Hiprex). A urinary antiseptic that converts to bactericidal formaldehyde in acidic urine. Because it is not an antibiotic, bacterial resistance is not a meaningful concern. The 2025 AUA guideline formally includes methenamine hippurate as a prophylaxis option for patients with recurrent UTIs.

Clean intermittent catheterization. For selected patients with functional retention, home-based CIC eliminates the residual urine and bacterial reservoir that sustain the cycle of infection.

Daily bladder irrigation. A home-based sterile saline flush that mechanically reduces bacterial load in the bladder without any antibiotic exposure.

The Antibiotic Stewardship Imperative
The 2025 American Urological Association guideline update on recurrent UTI places new emphasis on antimicrobial stewardship and a microbiome-aware approach to treatment, reflecting a maturing understanding that repeated antibiotic courses disturb microbial communities throughout the body and paradoxically make future infections more likely, more resistant, and harder to treat. This concern is particularly acute in men, where bacterial persistence within the prostate can make simple antibiotic courses inadequate and repeat exposure especially damaging.

"The data is unambiguous: repeated antibiotic courses are not a sustainable solution for recurrent UTIs — and in men, they are often not solving the actual problem at all," said Vahan Kassabian, MD, Chief Physician Officer of Advanced Urology. "When we treat the outlet obstruction, correct the metabolic drivers, and support the bladder mechanically, patients stop cycling. Our 50-patient male experience demonstrates that a coordinated, evidence-based, root-cause-focused protocol can break that cycle — and keep patients off antibiotics rather than putting them back on them."

A Path Forward for Patients
Many of the men treated under the protocol had cycled through antibiotics for years before arriving at Advanced Urology, often without ever being evaluated for the underlying drivers of their infections. Most leave with a clear understanding of why their infections keep occurring and a concrete, individualized plan to stop them.

"If you are a man who has been treated for three, five, or ten UTIs and nobody has checked whether your bladder is emptying, whether your prostate is obstructing your flow, or whether your blood sugar is contributing, you have not yet received a complete evaluation," Dr. Patel said. "You deserve one."

About Advanced Urology
Advanced Urology is metro Atlanta's most innovative urology practice, with 14 clinic locations and 6 ambulatory surgery centers across Georgia. The practice provides comprehensive urologic care for men and women, with specialized programs in recurrent UTI, BPH, overactive bladder, prostate cancer, kidney stones, low testosterone, and erectile dysfunction. To learn more or schedule a recurrent UTI consultation, visit advancedurology.com or call 678 344 8900.

Jitesh Patel
Advanced Urology
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