Beyond the Symptoms | An Expert Interview Series by LUF | Live UTI Free

LUF | Live UTI Free
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Beyond the Symptoms is an interview series by Live UTI Free (LUF) that explores the science, solutions, and stories behind pelvic health, UTIs, and chronic urinary infections.  Host Melissa Kramer engages in deep conversations with leading medical experts, researchers, and healthcare innovators who share breakthrough insights beyond conventional diagnoses and treatments.  Each episode uncovers cutting-edge research on biofilms, embedded infections, antibiotic resistance, and innovative diagnostic approaches while examining how these conditions impact quality of life. Whether you're a patient navigating recurrent UTIs, interstitial cystitis, or chronic pelvic pain, a healthcare practitioner seeking evidence-based approaches, or a curious mind interested in women's health advocacy, this podcast provides actionable information about complex pelvic health conditions.  Episodes feature world-renowned urologists, urogynecologists, researchers, and patient advocates sharing clinical insights and practical strategies.  Explore our comprehensive resources at liveutifree.com, find additional studies at linktr.ee/liveutifree, watch video interviews on YouTube (@LiveUTIFree), and join our supportive community on Instagram (@liveutifree). 

  1. Why Standard UTI Tests Fail & What Immunotherapy Could Change | Dr. Malcolm Starkey with Live UTI Free

    16 Jun

    Why Standard UTI Tests Fail & What Immunotherapy Could Change | Dr. Malcolm Starkey with Live UTI Free

    Standard urine cultures have dominated UTI diagnosis for over 70 years, yet they were never designed for this purpose. In this episode, Melissa speaks with Dr. Malcolm Starkey, a scientist at Monash University who leads the Urinary Tract Disease Research Group, about why current testing misses infections, how the urinary microbiome connects to your gut and vagina, and why immunotherapy, not just antibiotics, may be the future of chronic UTI treatment. Dr. Starkey explains the science behind diagnostic gaps, the role of Type 2 immunity in bladder health, and what personalized medicine could look like for recurrent infection. If you’ve received a negative test despite clear symptoms, this episode explains why that happens and what researchers are doing to change it. The gap between what patients experience and what standard tests detect reflects a fundamental limitation in how UTIs are diagnosed. Research is moving toward understanding the immune response, not just the bacteria, and that shift could change everything. What You’ll Learn Why standard urine cultures fail to detect many infections: The 100,000 CFU threshold came from a 1950s pregnancy study, not UTI diagnosis. Bacteria hide inside bladder cells. Labs exclude samples with epithelial cells, treating a sign of infection as contamination.How your gut, vagina, and bladder microbiomes connect: Uropathogenic E. coli bloom in your gut, then colonize your urethra. Protective Lactobacilli in your vagina help, but what matters most is how your immune system responds to these bacteria.Why immunotherapy could work when antibiotics alone don’t: Antibiotics kill bacteria. Immunotherapy restores immune balance. Your bladder prioritizes repair over immune memory, unlike your kidneys. Type 2 immunity, stronger in women, may be dysregulated in chronic UTI. Existing asthma treatments could be repurposed to address this. Resources & Links Monash University Urinary Tract Disease Research GroupBladder and Kidney Health Discovery Program Chronic UTI Australia (provides clinician information for Australian residents)

    54 min
  2. EAT-UP Trial: Extended Antibiotic Treatment for Chronic UTI | Dr. Kiren Gill and Dr. Harry Horsley with Live UTI Free (LUF)

    2 Jun

    EAT-UP Trial: Extended Antibiotic Treatment for Chronic UTI | Dr. Kiren Gill and Dr. Harry Horsley with Live UTI Free (LUF)

    A clinical trial that defines chronic UTI and tests a treatment protocol designed around it has been a long time coming. In this episode of the Live UTI Free podcast, host Dr. Melissa Kramer sits down with Dr. Kiran Gill and Dr. Harry Horsley to talk through the EAT-UP trial, a new UK-based phase 2 randomised controlled trial investigating extended full-dose antibiotics combined with methenamine hippurate (Hiprex) for chronic UTI. Dr. Kiran Gill is a consultant urogynaecologist at the Whittington Hospital and a clinical academic at University College London, and co-chief investigator on EAT-UP alongside Professor Rajvinder Khasriya. Dr. Harry Horsley is principal investigator and scientific lead, and co-leads the Bladder Infection and Immunity Group (BIIG) at UCL, where he has been researching recurrent and chronic UTI for over 15 years. Together, Melissa, Kiran, and Harry walk through how recurrent UTI and chronic UTI are defined, and why the lack of NHS guidelines for chronic UTI leaves patients misdiagnosed with conditions such as painful bladder syndrome (interstitial cystitis), overactive bladder, or the genitourinary syndrome of menopause. The conversation also covers the two trial arms: extended full-dose antibiotics plus methenamine hippurate compared to the current NICE-recommended low-dose prophylaxis informed by the ALTAR study. They explain why fresh urine microscopy is being used as the primary endpoint instead of standard MSU culture alone, the perineal swab approach to tracking antimicrobial resistance, who is eligible for the trial, and how to access screening at the five UK trial sites (Whittington, UCLH, Guy’s and St Thomas’, Manchester St Mary’s, and Newcastle). Recruitment closes August 2027, with first results expected in early 2028. Key Takeaways EAT-UP is the first RCT built around a clinical definition of chronic UTI. It defines the condition as continuous daily urinary symptoms lasting more than three months, with acute flares in between.The trial looks at the host response, not just the bacteria. Fresh urine microscopy checks for white blood cells as a sign of an immune response, giving same-day results instead of a two- to three-day wait for culture.The design reflects what patients actually need. Clinicians choose the antibiotic based on tolerability and history. D-mannose, cranberry, and vaginal oestrogen are allowed, flares are managed with rescue therapy, and travel is reimbursed up to £45. Links and Resources Mentioned Learn more about EAT-UP Trial: https://www.isrctn.com/ISRCTN17592593Get in touch with the research team: whh-tr.researchanddevelopment@nhs.net Watch our previous interview with Dr. Harry Horsley: https://www.youtube.com/watch?v=pq1K1zBt7HoMore on the science behind chronic urinary tract infection: https://liveutifree.com/chronic-urinary-tract-infection/

    24 min
  3. Chronic UTI Prevention, Bladder Tea, & D-Mannose | Julia Anditsch with Live UTI Free (LUF)

    11 May

    Chronic UTI Prevention, Bladder Tea, & D-Mannose | Julia Anditsch with Live UTI Free (LUF)

    What if your bladder isn’t working against you, but trying to tell you something? In this episode of the Live UTI Free podcast, host Melissa Kramer sits down with Julia Anditsch, founder of Die Blase (German for “The Bladder”), an international bladder health platform based in Germany and Austria, and creator of Die Blase To Go, the first ready-to-drink bottled bladder tea. Together, Julia and Melissa get into the tools, tests, and daily habits that patients in their communities are actually using to manage recurrent and chronic UTI. They cover D-mannose; lactic acid bacteria probiotics for the gut and vagina; bladder teas made with nettle, goldenrod, birch leaf, ginger, and mint; Hiprex (methenamine hippurate); and the UK ULTA study; UTI vaccines like Uromune, Uro-Vaxom, and Strovac; the importance of testing for STIs and ureaplasma alongside UTI; and the emerging research connecting the urogenital microbiome to fertility and pregnancy. Whether you’re newly diagnosed or years into a chronic UTI journey, this conversation offers real patient experience, science, and a reminder that you’re not alone. What You’ll Learn Why standard urine dipsticks and cultures can miss infections, and what tests like vaginal swabs, PCR, and STI panels may pick up. Plus, why looking at bladder, gut, and vaginal health together can offer a more complete picture.What alternatives and add-ons to antibiotics are being explored in the community. This includes D-mannose, probiotics, bladder teas, Hiprex (methenamine hippurate), and vaccines like Uromune, Uro-Vaxom, and Strovac. Also covered: what’s known, what’s still being researched, and how access varies by country.Which everyday factors often come up as possible UTI triggers, including heat, cold feet, dehydration, stress, and sex. Plus, simple daily habits some people find helpful alongside their treatment plan.Resources and Links Learn more and access related articles: liveutifree.comSubscribe to the LUF YouTube channel for video format

    39 min
  4. Why UTI Tests Keep Failing You And What Science Is Doing About It | Prof. Jenny Roan with Live UTI Free

    6 Apr

    Why UTI Tests Keep Failing You And What Science Is Doing About It | Prof. Jenny Roan with Live UTI Free

    If you’ve ever been told your urine test came back negative but you know something is wrong, this episode is for you. Host Melissa Kramer speaks with Professor Jenny Roan, Head of the Centre for Urological Biology at University College London (UCL), to get into the science that most people living with recurrent or chronic UTI desperately want to understand. From why the dipstick test misses so many real infections, to what’s actually happening inside the bladder wall when antibiotics stop working, Professor Roan breaks it all down in plain language, without dismissal. Professor Roan also shares details of a novel treatment her team at UCL has developed, CapFuran, a microencapsulated nitrofurantoin designed to deliver the antibiotic directly into the bladder wall to target embedded bacteria and biofilms that standard antibiotics simply can’t reach. With a potential clinical trial horizon of 2026–2027, this is the research the chronic UTI community has been waiting for. 3 Key Takeaways Your negative test result doesn’t necessarily mean there’s no infection. Dilution, the wrong type of bacteria, mixed growth being discarded… There are multiple scientific reasons a real UTI can be missed. The research highlighting these inadequacies has existed for decades.Chronic UTI may involve bacteria that are literally hiding inside your bladder wall. These intracellular bacteria and biofilms are dormant and largely unreachable by standard short-course antibiotics, which is why a three-day course of nitrofurantoin often isn’t enough.Research into new treatments is moving forward and the patient community is part of the push. From the uro-immune vaccine to a novel encapsulated antibiotic therapy targeting embedded infection, there are promising options in development. The more patients ask questions and advocate for themselves, the harder it becomes to ignore this area of health.​​Resources and Links Learn more and access related articles: liveutifree.comSubscribe to the LUF YouTube channel for video formatConnect with Professor Jenny Roan via UCL or LinkedIn

    40 min
  5. Why Chronic UTI Symptoms Can Worsen With Stress | Dr. Aparna Taylor with Live UTI Free

    24 Mar

    Why Chronic UTI Symptoms Can Worsen With Stress | Dr. Aparna Taylor with Live UTI Free

    Can stress really trigger chronic UTI symptoms? In this episode of the Live UTI Free Podcast, host Melissa Kramer speaks with Dr. Aparna Taylor about the connection between stress, the nervous system, inflammation, gut health, and chronic UTI symptoms. Dr. Taylor explains why stress is not just about feeling “stressed out,” but about the body perceiving a threat to survival. She breaks down how being stuck in fight, flight, or freeze can affect immune function, sleep, digestion, and healing, and why that matters so much for people living with chronic bladder symptoms. The conversation also explores why symptoms can flare during stressful moments; whether stress reduction alone can resolve an infection; how movement, mindfulness, and calming routines may support healing; and why diet and gut health can be important pieces of the bigger picture. Throughout the episode, Dr. Taylor emphasizes an individualized, sustainable approach that looks beyond the bladder alone. If you’ve ever wondered why your symptoms seem to spike when life feels overwhelming, or why one-size-fits-all advice has not worked for you, this episode offers a grounded and compassionate perspective on chronic UTI recovery. 3 takeaways Why chronic UTI symptoms may flare during stressful moments, and how pain, inflammation, poor sleep, and nervous system overload can all add up. How gut health, food sensitivities, and inflammation may play a role in chronic illness, and why dietary changes often need to be individualized. Why recovery is often about finding a sustainable, realistic, whole-person approach rather than chasing one perfect treatment or “silver bullet.”Want to learn more about urinary health? Visit LiveUTIFree.com for expert articles on the latest research, or check out our YouTube channel for a video format.

    53 min
  6. Mold Toxicity & Chronic Bladder Symptoms | Dr. Pamela Cipriano with Live UTI Free (LUF)

    3 Mar

    Mold Toxicity & Chronic Bladder Symptoms | Dr. Pamela Cipriano with Live UTI Free (LUF)

    Could hidden mold exposure or fungal overgrowth be aggravating your chronic UTI symptoms, even when standard urine cultures come back “negative”? In this episode of the Live UTI Free Podcast, host Melissa (CEO of Live UTI Free) speaks with Dr. Pamela Cipriano, a doctorally-prepared nurse practitioner in Connecticut who practices internal and functional medicine and works with patients experiencing chronic urinary tract infections, chronic bladder pain, mold toxicity, Candida overgrowth, and tick-borne illnesses. Dr. Cipriano explains why the terms mold and fungi are essentially interchangeable, how mold can affect the immune system and irritate the bladder, and why some people can live in the same environment yet one person gets very sick, and the other feels fine. You’ll also hear her approach to testing when symptoms persist, including why she uses MicroGenDX to look beyond a standard culture for what may be embedded in the bladder wall, plus how she thinks about biofilms as a “hiding place for bacteria, mold, fungus.” 3 things you’ll learn in this episode: Why mold and fungi are often used interchangeably, and what “mold toxicity” / mycotoxin illness can look like, from sinus issues to “Candida outbreaks” to urinary symptoms. How Dr. Cipriano approaches chronic UTI cases when symptoms persist: MicroGenDX DNA-based testing, plus what she looks for when she suspects bladder wall infection and fungal involvement. What might make urinary symptoms flare during treatment, including inflammatory reactions, and why Dr. Cipriano puts so much weight on hydration and anti-inflammatory nutrition. Want to learn more about urinary health? Visit LiveUTIFree.com for expert articles on the latest research, or check out our YouTube channel for a video format.

    54 min
  7. Misdiagnosed UTIs, Vulvar Pain & Hormonal Imbalance | Dr. Maria Uloko with Live UTI Free (LUF)

    10 Feb

    Misdiagnosed UTIs, Vulvar Pain & Hormonal Imbalance | Dr. Maria Uloko with Live UTI Free (LUF)

    Join host Melissa from Live UTI Free as she speaks with Dr. Maria Uloko, a board-certified urologist and founder of VUVLAi. about how misdiagnosis and knowledge gaps in medicine are impacting people with chronic UTI symptoms and vulvar pain. Dr. Uloko shares groundbreaking insights from her research, including how 88% of patients she saw for chronic UTIs were actually suffering from hormone-related inflammation. Together, they unpack the myths surrounding post-sex UTIs, explore the overlooked role of testosterone in vulvar health, and discuss why education and advocacy are the keys to transforming outcomes. 3 Key Takeaways: Your UTI might not be a UTI – Dr. Uloko suggests that most “chronic UTIs” are actually lower urinary tract symptoms caused by hormonal or vulvar inflammation, something many clinicians don’t even evaluate. Post-sex UTIs are not inevitable – Pain or UTI-like symptoms after sex are often due to vestibulodynia (inflammation of the vestibule) and pelvic floor dysfunction, not infection. These conditions are treatable. Hormones matter more than you’ve been told – Estrogen and testosterone are essential to vulvar and bladder health. Many medications (like oral contraceptives) unintentionally disrupt this balance and may lead to misdiagnosed symptoms. Want to learn more about urinary health? Visit LiveUTIFree.com for expert articles on the latest research, or check out our YouTube channel for a video format.

    57 min
  8. The Gut–Bladder Connection in Chronic UTI | Dr. Henry Schreiber with LUF

    02/12/2025

    The Gut–Bladder Connection in Chronic UTI | Dr. Henry Schreiber with LUF

    In this episode of the Live UTI Free Podcast, host Melissa Kramer welcomes Dr. Henry Schreiber, instructor at Washington University School of Medicine in St. Louis, to explore the fascinating link between our gut microbiome, bladder health, and urinary tract infections (UTIs). Dr. Schreiber specialises in understanding UTIs as a whole‑body problem (not just a bladder infection), and he shares insights on how the gut may serve as a reservoir for UTI‑causing bacteria, how inflammation and nervous system signalling in the bladder contribute to persistent symptoms, and why we need better diagnostics and treatments. If you have recurrent UTIs (RUTIs) or pelvic/urinary symptoms, want to better understand the science, or are a healthcare professional seeking a research‑grounded discussion, this episode offers information to help you feel more empowered.  Three Key Takeaways: Dr. Schreiber explains how the gut microbiome can influence bladder health, more than just one “bad bug”; it’s about bacterial diversity, immune education, and metabolite production (e.g., butyrate‑producing bacteria being lower in people with recurrent UTIs). He emphasises that UTIs (especially recurrent) often reflect a whole‑body issue, not just a bladder infection: a lowered neuronal threshold in the bladder, immune system dysregulation, and a “reservoir” in the gut (or nearby) may all contribute to repeated episodes. He speaks directly to patients: Yes, the neurological and mood symptoms many people with UTIs experience are real (not “just anxiety”), and while many treatments are under development, self‑advocacy and understanding your own biology matter because “biology is just weird” and there’s no one‑size‑fits‑all.Want to learn more about urinary health? Visit LiveUTIFree.com for expert articles on the latest research, or check out our YouTube channel for a video format.

    54 min
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About

Beyond the Symptoms is an interview series by Live UTI Free (LUF) that explores the science, solutions, and stories behind pelvic health, UTIs, and chronic urinary infections.  Host Melissa Kramer engages in deep conversations with leading medical experts, researchers, and healthcare innovators who share breakthrough insights beyond conventional diagnoses and treatments.  Each episode uncovers cutting-edge research on biofilms, embedded infections, antibiotic resistance, and innovative diagnostic approaches while examining how these conditions impact quality of life. Whether you're a patient navigating recurrent UTIs, interstitial cystitis, or chronic pelvic pain, a healthcare practitioner seeking evidence-based approaches, or a curious mind interested in women's health advocacy, this podcast provides actionable information about complex pelvic health conditions.  Episodes feature world-renowned urologists, urogynecologists, researchers, and patient advocates sharing clinical insights and practical strategies.  Explore our comprehensive resources at liveutifree.com, find additional studies at linktr.ee/liveutifree, watch video interviews on YouTube (@LiveUTIFree), and join our supportive community on Instagram (@liveutifree). 

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