The Response of the Urinary Microbiome to Botox

Area of Science:

• Urology
• Microbiology
• Immunology

Background:

• Overactive bladder (OAB) is a common condition affecting quality of life.
• Botulinum toxin (Botox) injections are an established treatment for OAB.
• The role of the urinary microbiome in OAB and its response to treatment is not well understood.

Purpose of the Study:

• To investigate if Botox alters the urinary microbiome in OAB patients.
• To determine if urinary microbiome alterations predict treatment response to Botox.

Main Methods:

• Multicenter prospective cohort study of 68 OAB patients undergoing Botox treatment.
• Urine samples collected pre-treatment (S1) and 4 weeks post-treatment (S2).
• 16S rRNA sequencing used for microbiome analysis; clinical data analyzed for treatment response.

Main Results:

• Responders showed increased abundance of Beauveria bassiana, Xerocomus chrysenteron, Crinipellis zonata, and Micrococcus luteus post-Botox.
• Non-responders showed decreased abundance of Pseudomonas fragi post-Botox.
• Pre-treatment urinary microbiome composition differed between responders and non-responders, and between those who developed post-treatment UTIs and those who did not.

Conclusions:

• Botox treatment appears to induce longitudinal changes in the urinary microbiome of OAB patients.
• Distinct urinary microbiome profiles may differentiate Botox responders from non-responders.