{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T22:00:45Z","timestamp":1784757645697,"version":"3.55.0"},"reference-count":32,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,11,10]],"date-time":"2020-11-10T00:00:00Z","timestamp":1604966400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To test the effectiveness of intravesical <jats:italic>Lactobacillus rhamnosus GG (LGG<\/jats:italic>) to reduce the burden of urinary symptoms for individuals with spinal cord injury and disease (SCI\/D) with neurogenic lower urinary tract dysfunction (NLUTD) who manage their bladders with intermittent catheterization (IC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A three\u2010phase study (6\u00a0months each in baseline, intervention, and washout). Participants self\u2010managed following the Self\u2010Management Protocol using Probiotics (SMP\u2010Pro), completing the online Urinary Symptom Questionnaire for Neurogenic Bladder\u2010IC version (USQNB\u2010IC) weekly.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Nationwide (United States).<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Ninety\u2010six adults and seven children with SCI\/D.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>In response to one or both of the SMP\u2010Pro trigger urinary symptoms, \u201ccloudier\u201d or \u201cfoul smelling\u201d urine, participants self\u2010administered using a clean urinary catheter an <jats:italic>LGG<\/jats:italic>+ Normal Saline instillate once or twice in a 30\u2010hour period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Change in USQNB\u2010IC burden was adjusted individually according to the previous phase for four symptom types. Adjusted changes in burden between the intervention and washout phases were analyzed using one\u2010sample <jats:italic>t<\/jats:italic>\u2010tests. Holm correction was applied for the four types of symptoms: A, clinically actionable; B1, bladder function; B2, urine quality; and C, other.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the intervention phase, participants met SMP\u2010Pro instillation criteria 3.83 times on average (range 1\u201020). An average of 5.6 doses of <jats:italic>LGG<\/jats:italic> were instilled. For those who instilled at least once, burdens of type A and B2 symptoms were significantly improved at washout (both adjusted <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Self\u2010instilled <jats:italic>LGG<\/jats:italic> seemed to improve \u201cclinically actionable\u201d (A) and \u201curine quality\u201d (B2) symptom burden. No changes were observed for those who did not instill. This first\u2010in\u2010human clinical trial supports ongoing research of intravesical <jats:italic>LGG<\/jats:italic>, and the SMP\u2010Pro for urinary symptoms.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pmrj.12470","type":"journal-article","created":{"date-parts":[[2020,8,15]],"date-time":"2020-08-15T07:53:35Z","timestamp":1597478015000},"page":"695-706","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Effects of Intravesical <i>Lactobacillus Rhamnosus GG<\/i> on Urinary Symptom Burden in People with Neurogenic Lower Urinary Tract Dysfunction"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1121-2119","authenticated-orcid":false,"given":"Rochelle E.","family":"Tractenberg","sequence":"first","affiliation":[{"name":"Collaborative for Research on Outcomes and \u2013Metrics  Silver Spring MD USA"},{"name":"Departments of Neurology and Biostatistics, Bioinformatics &amp; Biomathematics Georgetown University Medical Center  Washington DC USA"},{"name":"Department of Rehabilitation Medicine Georgetown University Medical Center  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne L.","family":"Groah","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine Georgetown University Medical Center  Washington DC USA"},{"name":"MedStar National Rehabilitation Hospital  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie K.","family":"Frost","sequence":"additional","affiliation":[{"name":"Collaborative for Research on Outcomes and \u2013Metrics  Silver Spring MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda K.","family":"Rounds","sequence":"additional","affiliation":[{"name":"MedStar National Rehabilitation Hospital  Washington DC USA"},{"name":"MedStar Health Research Health Institute  Hyattsville MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Davis","sequence":"additional","affiliation":[{"name":"MedStar National Rehabilitation Hospital  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inger H.","family":"Ljungberg","sequence":"additional","affiliation":[{"name":"MedStar National Rehabilitation Hospital  Washington DC USA"},{"name":"MedStar Health Research Health Institute  Hyattsville MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manon M.","family":"Schladen","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine Georgetown University Medical Center  Washington DC USA"},{"name":"MedStar National Rehabilitation Hospital  Washington DC USA"},{"name":"MedStar Health Research Health Institute  Hyattsville MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,11,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2011.01.001"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.2340\/16501977-0067"},{"key":"e_1_2_7_4_1","unstructured":"Paralyzed Veterans of America. 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