{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T21:14:05Z","timestamp":1776806045615,"version":"3.51.2"},"reference-count":41,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:00:00Z","timestamp":1745971200000},"content-version":"unspecified","delay-in-days":29,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Imperial Open Access Fund"},{"name":"MRC"},{"name":"RCSEng"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,4,11]]},"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Recurrent urinary tract infections (rUTIs) are typically treated using antibiotics. Given the growing issue of antimicrobial resistance, non-antibiotic management options for rUTIs have faced a recent resurgence in popularity. Methenamine hippurate is a urinary antiseptic used as a non-antibiotic prophylactic measure in those with rUTIs. The results of a recent randomised controlled trial showed methenamine hippurate to perform on par with antibiotic prophylaxis in adult women with rUTIs. However, little is known about the efficacy of methenamine hippurate in vulnerable patient populations, such as children, the elderly, patients with indwelling catheters and those with renal tract abnormalities. Moreover, an up-to-date, comprehensive evaluation of the entirety of the literature surrounding methenamine hippurate has yet to be carried out. As such, key trends within the literature, such as common side effects and specific avenues for future research, are difficult to determine. Therefore, we developed the methodology for a scoping review to map the entirety of the existing evidence base for methenamine hippurate.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and analysis<\/jats:title>\n                  <jats:p>The protocol for this scoping review was developed in accordance with the framework set out by Arksey and O\u2019Malley. We will search MEDLINE, Embase, Scopus, the Cochrane Central Register of Controlled Trials and ProQuest Dissertation and Theses from inception until August 2024, with no language restrictions applied. Studies including patients of any age and sex receiving methenamine hippurate treatment, either as a primary or adjunct treatment for rUTIs, will be eligible for inclusion. Interventional studies, such as randomised controlled trials and their protocols, non-randomised clinical trials, cohort studies, case-control studies and observational studies of any design, will be included. Grey literature, systematic reviews and qualitative studies will also be included. Two independent reviewers blinded to each other\u2019s decisions will assess the eligibility of articles at each stage using the Covidence review platform. After the relevant data from each study has been extracted, we will report the results of our scoping review using descriptive summary statistics and a narrative thematic analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>Due to the nature of the present study, ethical approval was not required for this scoping review. The final manuscript of this scoping review will be published in an international, peer-reviewed journal and the findings of the review presented in relevant national and international conferences.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-100458","type":"journal-article","created":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T21:45:26Z","timestamp":1746049526000},"page":"e100458","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Methenamine hippurate for the management and prophylaxis of recurrent urinary tract infections: a scoping review protocol"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6835-5900","authenticated-orcid":false,"given":"Abhisekh","family":"Chatterjee","sequence":"first","affiliation":[{"name":"Imperial College School of Medicine, Imperial College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iihan","family":"Ali","sequence":"additional","affiliation":[{"name":"Imperial College School of Medicine, Imperial College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franklyn","family":"Wong","sequence":"additional","affiliation":[{"name":"Imperial College School of Medicine, Imperial College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea M","family":"Allen-Tejerina","sequence":"additional","affiliation":[{"name":"Lister Hospital, East and North Hertfordshire NHS Trust, Stevenage, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolaos","family":"Chatzikrachtis","sequence":"additional","affiliation":[{"name":"Department of Urology, West Middlesex University Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katie","family":"McComb","sequence":"additional","affiliation":[{"name":"Department of Urology, West Middlesex University Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Bishara","sequence":"additional","affiliation":[{"name":"Department of Urology, West Middlesex University Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diane","family":"De Caluwe","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery and Urology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolaos","family":"Zavras","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph M","family":"Norris","sequence":"additional","affiliation":[{"name":"UCL Division of Surgery & Interventional Science, University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8427-7223","authenticated-orcid":false,"given":"Panagiotis","family":"Nikolinakos","sequence":"additional","affiliation":[{"name":"Department of Urology, West Middlesex University Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK"},{"name":"Department of Pediatric Surgery, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,4,30]]},"reference":[{"key":"2025101813094788000_15.4.e100458.1","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/j.ogc.2021.05.005","article-title":"Recurrent Urinary Tract Infections: Diagnosis, Treatment, and Prevention","volume":"48","author":"Peck","year":"2021","journal-title":"Obstet Gynecol Clin North Am"},{"key":"2025101813094788000_15.4.e100458.2","unstructured":"Bono MJ , Leslie SW , Reygaert WC . Uncomplicated urinary tract infections. Treasure Island (FL): StatPearls, 2025."},{"key":"2025101813094788000_15.4.e100458.3","unstructured":"Sabih A , Leslie SW . Complicated urinary tract infections. Treasure Island (FL): StatPearls, 2024."},{"key":"2025101813094788000_15.4.e100458.4","doi-asserted-by":"crossref","first-page":"S142","DOI":"10.21037\/tau.2017.06.09","article-title":"Non-surgical management of recurrent urinary tract infections in women","volume":"6","author":"Bergamin","year":"2017","journal-title":"Transl Androl Urol"},{"key":"2025101813094788000_15.4.e100458.5","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1111\/bju.15630","article-title":"Management of uncomplicated recurrent urinary tract infections","volume":"129","author":"Zare","year":"2022","journal-title":"BJU Int"},{"key":"2025101813094788000_15.4.e100458.6","doi-asserted-by":"publisher","DOI":"10.1080\/14737167.2017.1359543"},{"key":"2025101813094788000_15.4.e100458.7","doi-asserted-by":"publisher","DOI":"10.1007\/s00239-019-09914-3"},{"key":"2025101813094788000_15.4.e100458.8","doi-asserted-by":"publisher","DOI":"10.1038\/s41585-018-0106-x"},{"key":"2025101813094788000_15.4.e100458.9","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1097\/MOU.0000000000000821","article-title":"Nonantibiotic treatments for urinary cystitis: an update","volume":"30","author":"Barea","year":"2020","journal-title":"Curr Opin Urol"},{"key":"2025101813094788000_15.4.e100458.10","first-page":"1509","article-title":"Drug therapy reviews: Methenamine mandelate and methenamine hippurate","volume":"36","author":"Gleckman","year":"1979","journal-title":"Am J Hosp Pharm"},{"key":"2025101813094788000_15.4.e100458.11","doi-asserted-by":"publisher","DOI":"10.1586\/14787210.2014.904202"},{"key":"2025101813094788000_15.4.e100458.12","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/bju.15756","article-title":"Guideline of guidelines: management of recurrent urinary tract infections in women","volume":"130 Suppl 3","author":"Kwok","year":"2022","journal-title":"BJU Int"},{"key":"2025101813094788000_15.4.e100458.13","doi-asserted-by":"publisher","DOI":"10.3310\/AAFO2475"},{"key":"2025101813094788000_15.4.e100458.14","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1080\/02813432.2022.2139363","article-title":"Preventive effect of methenamine in women with recurrent urinary tract infections - a case-control study","volume":"40","author":"Rui","year":"2022","journal-title":"Scand J Prim Health Care"},{"key":"2025101813094788000_15.4.e100458.15","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1093\/jac\/dkae078","article-title":"Effect of methenamine hippurate shortage on antibiotic prescribing for urinary tract infections in Norway\u2014an interrupted time series analysis","volume":"79","author":"Heltveit-Olsen","year":"2024","journal-title":"J Antimicrob Chemother"},{"key":"2025101813094788000_15.4.e100458.16","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1097\/MOU.0000000000001108","article-title":"The resurgence of methenamine hippurate in the prevention of recurrent UTIs in women- a systematic review","volume":"33","author":"Kale","year":"2023","journal-title":"Curr Opin Urol"},{"key":"2025101813094788000_15.4.e100458.17","doi-asserted-by":"publisher","DOI":"10.3399\/BJGP.2020.0833"},{"key":"2025101813094788000_15.4.e100458.18","doi-asserted-by":"crossref","first-page":"2709","DOI":"10.1007\/s00345-020-03159-2","article-title":"Treatment of urinary tract infections in the old and fragile","volume":"38","author":"Zeng","year":"2020","journal-title":"World J Urol"},{"key":"2025101813094788000_15.4.e100458.19","doi-asserted-by":"crossref","unstructured":"Rowe TA , Juthani-Mehta M . Urinary tract infection in older adults. Aging health 2013;9. doi:10.2217\/ahe.13.38","DOI":"10.2217\/ahe.13.38"},{"key":"2025101813094788000_15.4.e100458.20","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1016\/j.ucl.2015.07.002","article-title":"Bacteruria and Urinary Tract Infections in the Elderly","volume":"42","author":"Detweiler","year":"2015","journal-title":"Urol Clin North Am"},{"key":"2025101813094788000_15.4.e100458.21","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1016\/j.pcl.2022.07.003","article-title":"Urinary Tract Infection in Children","volume":"69","author":"Brandstr\u00f6m","year":"2022","journal-title":"Pediatr Clin North Am"},{"key":"2025101813094788000_15.4.e100458.22","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1007\/s00431-020-03714-4","article-title":"Swiss consensus recommendations on urinary tract infections in children","volume":"180","author":"Buettcher","year":"2021","journal-title":"Eur J Pediatr"},{"key":"2025101813094788000_15.4.e100458.23","doi-asserted-by":"crossref","first-page":"72","DOI":"10.12968\/bjcn.2011.16.4.168","article-title":"Preventing infection with long-term indwelling urinary catheters","volume":"16","author":"Slater","year":"2011","journal-title":"Br J Community Nurs"},{"key":"2025101813094788000_15.4.e100458.24","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1186\/s12879-023-08475-7","article-title":"Indwelling catheter vs intermittent catheterization: is there a difference in UTI susceptibility?","volume":"23","author":"Neumeier","year":"2023","journal-title":"BMC Infect Dis"},{"key":"2025101813094788000_15.4.e100458.25","article-title":"Methenamine hippurate for preventing urinary tract infections","volume":"10","author":"Lee","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"2025101813094788000_15.4.e100458.26","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1002\/phar.2895","article-title":"Methenamine for urinary tract infection prophylaxis: A systematic review","volume":"44","author":"Li","year":"2024","journal-title":"Pharmacotherapy"},{"key":"2025101813094788000_15.4.e100458.27","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1007\/s00192-024-05726-2","article-title":"Use of Methenamine for Urinary Tract Infection Prophylaxis: Systematic Review of Recent Evidence","volume":"35","author":"Davidson","year":"2024","journal-title":"Int Urogynecol J"},{"key":"2025101813094788000_15.4.e100458.28","doi-asserted-by":"publisher","DOI":"10.1080\/1364557032000119616"},{"key":"2025101813094788000_15.4.e100458.29","doi-asserted-by":"publisher","DOI":"10.1097\/XEB.0000000000000277"},{"key":"2025101813094788000_15.4.e100458.30","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2021-049084","article-title":"Scoping review protocol to understand the conceptualisation, implementation and practices of health promotion within the context of primary healthcare in Africa","volume":"11","author":"Nkangu","year":"2021","journal-title":"BMJ Open"},{"key":"2025101813094788000_15.4.e100458.31","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2023-081153","article-title":"Exploring the landscape of oesophageal discontinuity procedures and creation of cervical oesophagostomy in the modern era: a scoping review protocol","volume":"14","author":"Bondzi-Simpson","year":"2024","journal-title":"BMJ Open"},{"key":"2025101813094788000_15.4.e100458.32","doi-asserted-by":"publisher","DOI":"10.1159\/000530608"},{"key":"2025101813094788000_15.4.e100458.33","doi-asserted-by":"crossref","first-page":"251","DOI":"10.3390\/jpm11040251","article-title":"Is Metformin a Possible Beneficial Treatment for Psoriasis? A Scoping Review","volume":"11","author":"Stanescu","year":"2021","journal-title":"JPM"},{"key":"2025101813094788000_15.4.e100458.34","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-018-0611-x"},{"key":"2025101813094788000_15.4.e100458.35","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-5-69"},{"key":"2025101813094788000_15.4.e100458.36","doi-asserted-by":"publisher","DOI":"10.7326\/M18-0850"},{"key":"2025101813094788000_15.4.e100458.37","unstructured":"Covidence . Covidence systematic review software, veritas health innovation, melbourne, australia. Available: https:\/\/www.covidence.org\/ [Accessed 21 Apr 2025]."},{"key":"2025101813094788000_15.4.e100458.38","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"2025101813094788000_15.4.e100458.39","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.i4919","article-title":"ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"Sterne","year":"2016","journal-title":"BMJ"},{"key":"2025101813094788000_15.4.e100458.40","unstructured":"Team RC . R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria; 2016. Available: http:\/\/wwwR-projectorg"},{"key":"2025101813094788000_15.4.e100458.41","doi-asserted-by":"crossref","DOI":"10.1186\/s13643-023-02309-y","article-title":"Data visualisation in scoping reviews and evidence maps on health topics: a cross-sectional analysis","volume":"12","author":"South","year":"2023","journal-title":"Syst Rev"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-100458","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T20:09:57Z","timestamp":1760818197000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-100458"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":41,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4,30]]},"published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1136\/bmjopen-2025-100458"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-100458","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]}}}