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The effect of mindfulness-based stress reduction on the urinary microbiome in interstitial cystitis

Abstract

Introduction and hypothesis

The objective was to investigate the impact of mindfulness-based stress reduction therapy on the urinary microbiome of patients with interstitial cystitis/bladder pain syndrome.

Methods

In this Institutional Review Board-approved prospective cohort study, patients with interstitial cystitis/bladder pain syndrome were recruited to attend an 8-week mindfulness-based stress reduction course involving yoga and meditation. Eligible participants were English-speaking women aged 18 or older with interstitial cystitis/bladder pain syndrome. All participants had a negative urinalysis within 2 months of enrollment and were currently undergoing first- or second-line treatment at the time of recruitment. The mindfulness-based stress reduction course met weekly for 1 h. A straight-catheter urine sample was obtained prior to and following the mindfulness-based stress reduction series. DNA from urine samples underwent bacterial 16S ribosomal gene sequencing at Johns Hopkins University Laboratories followed by taxonomic abundance and diversity analysis by Resphera Biosciences Laboratory. Participants completed validated symptom questionnaires pre- and post-intervention.

Results

A total of 12 participants completed the 8-week course and were included in the analysis. The average age was 59 and the majority identified as white. Patient symptoms, measured by the Urogenital Distress Inventory Short Form and Interstitial Cystitis Symptom and Pain Indices, improved significantly (all p < 0.05). Overall composition of the urinary microbiome changed significantly (p < 0.01) and demonstrated an increase in diversity following the intervention.

Conclusions

Mindfulness-based stress reduction therapy improves patient symptoms and was associated with significant changes in the urinary microbiome in patients with interstitial cystitis/bladder pain syndrome.

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Acknowledgements

The authors thank the TriHealth Hatton Institute Medical Education Research Fund for funding this work. The authors thank Eunsun Yook, Clinical Research Specialist, for statistical analysis and data interpretation; Christine Popa, licensed yoga instructor, for mindfulness-based stress reduction course development and leadership; Vivian Ghodsi, clinical research coordinator, for study coordination and data collection.

Funding

This study was funded by the TriHealth Hatton Institute Medical Education Research Fund, Cincinnati, OH, USA.

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A. Shatkin-Margolis: project development, data collection, manuscript writing; J. White: project development, data collection, manuscript writing/editing; A. Jedlicka: project development, data collection, manuscript writing/editing; T. Tam: project development, data collection, manuscript editing; A. Hill: project development, data collection, manuscript editing; J. Yeung: project development, manuscript editing; C. Crisp: project development, manuscript editing; R. Pauls: project development, manuscript writing/editing.

Corresponding author

Correspondence to Abigail Shatkin-Margolis.

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Shatkin-Margolis, A., White, J., Jedlicka, A.E. et al. The effect of mindfulness-based stress reduction on the urinary microbiome in interstitial cystitis. Int Urogynecol J (2021). https://doi.org/10.1007/s00192-021-04812-z

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Keywords

  • Bladder pain syndrome
  • Interstitial cystitis
  • Mindfulness-based stress reduction
  • Urinary microbiome