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Lactobacillus rhamnosus GG (LGG) is an investigational live biotherapeutic product being developed by MedStar Health Research Institute for the treatment of neurogenic bladder. [1, 4] This therapy involves the direct instillation of the probiotic into the bladder (intravesical administration) and is intended for patients with spinal cord injury, spina bifida, and other causes of neurogenic lower urinary tract dysfunction (NLUTD). [1, 7] The treatment, which uses the commercially available probiotic Culturelle formulated with normal saline, aims to alter the composition of the urinary microbiome to reduce urinary symptoms like cloudy or foul-smelling urine. [1, 9] It is designed as a patient-initiated, self-administered therapy via a urinary catheter in response to symptoms. [1, 4] Clinical trials, including a Phase 1 safety trial and ongoing Phase 2 studies, have shown that intravesical LGG is safe, well-tolerated, and appears to improve clinically actionable symptoms and urine quality. [1, 2, 7, 12]
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