DOI: 10.3892/br.2022.1552
Fabio Parazzini 1, Elena Ricci 1, Francesco Fedele1, Francesca Chiaffarino 2, Giovanna Esposito 1, Sonia Cipriani 2
1Department of Clinical Sciences and Community Health, University of Milan, School of Medicine and Surgery, I-20122 Milan, Italy. 2Gynecology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, I-20122 Milan, Italy.
Abstract
Several studies, reviews and meta‑analyses have documented that D‑mannose use lowers the risk of recurrent urinary tract infections (UTI), but its role in the treatment of UTI/cystitis‑related symptoms is unclear. In particular, no systematic review has analyzed the role of treatment with D-mannose in acute UTI/cystitis. In this paper, we systematically reviewed the published data on the effect of D‑mannose, alone or in association with other compounds, on the typical symptoms of UTI/cystitis. PubMed/Medline and EMBASE databases were searched, from 1990 to January 2022, using combinations of the following keywords: ‘urinary tract infections’, ‘cystalgia’, ‘recurrent next urinary tract infection’, ‘cystitis’, ‘mannose’, ‘mannoside’, ‘D‑mannose’, ‘bacteriuria’, ‘pyuria’, ‘pyelocystitis’ with the appropriate Boolean modifiers (Limits: Human, English, full article). Studies were selected for the systematic review if they were clinical studies and reported original data, the number of patients using D‑mannose alone or in association with other treatments, and the number of patients with symptoms of UTI/cystitis at trial entry and after the follow‑up period. A total of seven studies were identified. D‑mannose was given alone in two studies, and was associated with cranberry extract, Morinda citrifolia fruit extract, pomegranate extract, fructo‑oligosaccharides, lactobacilli, and N‑acetylcysteine in the others. All studies reported that symptoms decreased after treatment with D‑mannose. Despite the limitations of the studies, the consistent results observed among all studies give support to the general findings that D‑mannose may be useful in the treatment of UTI/cystitis symptoms.