A potpourri of pediatric urology

This is my second Pot Pourri article in lock-down. Since my last effort, leggings have replaced Louboutins, and webinars have become the highlight of my social calendar. They started off being educational and scientific, a much-felt need to see familiar faces and chat to colleagues I would normally catch up with in conferences (remember them? When we dressed up and left home, even travelled afar, to meet people in a crowded hotel to stare at a screen and drink weak instant coffee?). They then veered into any topics that would fill that mid-week, mid-winter, mid-lockdown evening slump: wine-tasting/genomics/pensions/olympic weight-lifting. One such webinar introduced me to the concept of UTI vaccines. I was elated by the possible effect this could have on reducing the number of stressed-parent e-mails I receive. Yang and Foley explained how a sublingual spray vaccine (Uromune (Syner-Med Pharmaceutical Products Ltd)) acts by activating the mammalian lymphoid organ system (MALT), a broad-spectrum mucosal and systemic immune response. The spray is composed of a suspension of equal amounts of Escherichia coli; Klebsiella pneumoniae; Proteus vulgaris; and Enterococcus faecalis (can't imagine how tasty it must be). Sublingual stimulation results in a persistent and effective response at the site of the bladder mucosa. A UK study in 75 women, asked to use the sublingual spray daily for 3 months, showed promising results, with 78% reporting no subsequent UTIs during both the treatment and in the subsequent year.