Male Bladder Microbiome Relates to Lower Urinary Tract Symptoms

Area of Science:

• Urology
• Microbiology
• Genitourinary Health

Background:

• Compelling evidence links lower urinary tract microbiota (LUTM) to lower urinary tract symptoms (LUTS) in women.
• A similar association in men, particularly those with benign prostate enlargement (BPE), is not well-established.

Purpose of the Study:

• To investigate the association between LUTM and LUTS in men.
• To determine if the severity of LUTS in men correlates with the presence of bacteria in the lower urinary tract.

Main Methods:

• Forty-nine male volunteers (aged 40-85) were recruited, including patients undergoing BPE/LUTS surgery and non-BPE/LUTS surgery.
• Paired voided and catheterized urine specimens were collected and analyzed using expanded quantitative urine culture (EQUC) and 16S ribosomal RNA gene sequencing.
• International Prostate Symptom Score (IPSS) was used to stratify symptom severity.

Main Results:

• LUTM was detected in 39% of catheterized urine specimens and 98% of voided specimens, with significant differences between the two collection methods.
• The prevalence of LUTM in catheterized urine increased with LUTS severity: 22.2% (mild), 30.0% (moderate), and 57.1% (severe).
• Higher IPSS scores were significantly associated with a greater likelihood of detectable bacteria in catheterized urine (OR: 2.21).

Conclusions:

• Voided urine is not a reliable method for characterizing the male bladder microbiome.
• Catheterized urine analysis indicates that LUTS severity in men is associated with the presence of detectable bacteria in the bladder.
• Further research is required to identify specific bacterial taxa linked to LUTS in men.