Archivio Italiano di Urologia e Andrologia 2017; 89, 2 134 ORIGINAL PAPER The role of an herbal agent in treatment for Escherichia coli induced bacterial cyctitis in rats Murat Tuken 1 , Mustafa Zafer Temiz 1 , Emrah Yuruk 1 , Asuman Orcun Kaptanagasi 2 , Kayhan Basak 3 , Fehmi Narter 4 , Ahmet Yaser Muslumanoglu 1 , Kemal Sarica 4 1 Bagcilar Training & Research Hospital, Dept. of Urology, Istanbul, Turkey; 2 Kartal Lütfi Kirdar Training & Research Hospital, Dept. of Biochemistry, Istanbul, Turkey; 3 Kartal Lütfi Kirdar Training & Research Hospital, Dept. of Pathology, Istanbul, Turkey; 4 Kartal Lütfi Kirdar Training & Research Hospital, Dept. of Urology, Istanbul, Turkey. Objectives: The aim of this study is to evalu- ate the effects of the herbal agent in the pre- vention and treatment of bacterial cystitis in a rat model. Material and Methods: A total of twenty-eight male Sprague- Dawley rats were divided into four groups. Group-1 constituted the control group (operated and normal saline injected into the bladder, received only drinking water for 7 days); Group-2 con- stituted the no-treatment group (operated, E.coli J96 strain injected into the bladder, received only drinking water for 7 days); Group-3 constituted the short-term treatment (operated, E.coli J96 strain injected into the bladder, received the herbal agent added into drinking water for 7 days) and Group-4 con- stituted the long-term treatment (operated, E. coli J96 strain injected into the bladder, received herbal agent added into drinking water for 14 days). At the end of the pre-defined treat- ment periods of duration, the rats were sacrificed, urine sam- ples collected from the bladder for culture and bladders were harvested for histopathological evaluation. Urine culture results and histopathological findings were comparatively evaluated between the groups. Results: Urine cultures were positive for implanted E. coli strains in 0%, 85.7%, 42.8% and 0% of rats in Group 1, Group 2, Group 3 and Group 4, respectively (p = 0.001). Although histopathological evaluation revealed increased vascular dila- tion in the bladder specimens obtained from Group 2 and Group 3 (p = 0.028) no significant difference was noticed in level of inflammation (p = 0.610), edema (p = 0.754) and thick- ness of uroepithelium (p = 0.138). Conclusion: While long term (14 days) treatment with an herbal agent added into the drinking water resulted in complete clearance of urine from E. coli; shorter application of the agent revealed partial clearance. Further clinical studies are needed to support our results. KEY WORDS: Antibiotics; Bacterial cystitis; Herbal agent. Submitted 3 February 2017; Accepted 3 April 2017 Summary No conflict of interest declared. use, related antimicrobial resistance and the spread of bacterial resistant strains make the problem more serious than ever. Like other infectious diseases, the early and proper treatment of cystitis decreases the incidence of disease related morbidity and this situation necessitates the initiation of an empirical antimicrobial treatment in the majority of cases (2). On the other hand, with this approach, the antimicrobial resistance patterns of the hospital and the country are generally ignored by the responsible physicians. Administration of an inappropri- ate empirical antimicrobial therapy may eventually result in the accelerated rates of antimicrobial resistance (3). Moreover, these agents are also being used for the antimicrobial prophylaxis in the prevention of urinary tract infections particularly in patients with anatomical abnormalities or increased tendency for serious urinary tract infections. However, the long term prophylactic use of antimicrobial agents has the potential risk of not only the drug resistance but also the development of drug related adverse events. Taking all these facts and difficulties in antimicrobial treatment of infections into account, natural remedies composed of herbal agents have been used as an alterna- tive treatment to antimicrobial medications in an attempt to maintain similar efficacy and lower the side effects. Studies with such agents did show that some of these herbal remedies may treat UTI by several favorable effects. Furthermore, some of them may also be helpful in the prevention of future recurrent attacks (4). In present study we aimed to evaluate the potential pro- tective effects of ‘Tutukon’ application in the management of bacterial cystitis in rat model. MATERIAL AND METHODS Study design After approval by the Local Ethical Committee of Bagcilar Training and Research Hospital, twenty-eight male Sprague-Dawley rats weighting approximately 300-350 g were randomly divided into 4 groups. A 12/12-hour day&night cycle animal housing cage and ad libitum access to food and water were maintained to all rats DOI: 10.4081/aiua.2017.2.134 INTRODUCTION Being responsible for 95% of all symptomatic urinary tract infections (UTI), uncomplicated cystitis is the most common type of UTI (1). Although it can be treated in an effective manner with proper antibiotic selection, cys- titis is now accepted as a major public health issue due to its high prevalence. Moreover, the antimicrobial mis-