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The emerging role of the urinary microbiome in benign noninfectious urological conditions: an up-to-date systematic review

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Abstract

Purpose

The goal of this systematic review was to examine the current literature on the urinary microbiome and its associations with noninfectious, nonmalignant, urologic diseases. Secondarily, we aimed to describe the most common bioinformatics used to analyze the urinary microbiome.

Methods

A comprehensive literature search of Ovid MEDLINE using the keywords “microbiota” AND “prostatic hyperplasia,” “microbiota” AND “urinary bladder, overactive,” “microbiota” AND “pelvic pain,” and “microbiota” AND “urolithiasis” OR “nephrolithiasis” OR “urinary calculi” AND “calcium oxalate” was performed to identify relevant clinical microbiome studies associated with noninfectious benign urological conditions published from 2010 to 2022. We included human studies that evaluated the urinary, stone, or semen microbiota, or any combination of the above-mentioned locations.

Results

A total of 25 human studies met the inclusion criteria: 4 on benign prostatic hyperplasia (BPH), 9 on overactive bladder (OAB), 8 on calcium oxalate stones, and 4 on chronic pelvic pain syndrome (CPPS). Specific taxonomic profiles in the urine microbiome were associated with each pathology, and evaluation of alpha- and beta-diversity and relative abundance was accounted for most of the studies. Symptom prevalence and severity were also analyzed and showed associations with specific microbes.

Conclusion

The study of the urogenital microbiome is rapidly expanding in urology. Noninfectious benign urogenital diseases, such as BPH, calcium oxalate stones, CPPS, and OAB were found to be associated with specific microbial taxonomies. Further research with larger study populations is necessary to solidify the knowledge of the urine microbiome in these conditions and to facilitate the creation of microbiome-based diagnostic and therapeutic approaches.

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Authors and Affiliations

  1. Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA

    Maria Camila Suarez Arbelaez, Joshua Monshine, Joao G. Porto, Khushi Shah, Katherine Amin, Robert Marcovich & Hemendra N. Shah

  2. Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA

    Praveen K. Singh & Sabita Roy

  3. Switzerland Urology Spitial Thurgau AG (STGAG), Frauenfeld, Switzerland

    Thomas R. W. Herrmann

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Contributions

Dr HNS had full access to all the data in the study and took responsibility for the integrity of the data and the accuracy of the data analysis. Protocol/project development: SA, JM, KS, RM, TRWH, KA. Data collection or management: SA, JM, JGP, PKS, KS, SR. Data analysis: PKS, SR. Manuscript writing/editing: SA, JM, JGP, PKS, SR, KS, RM, TRWH, KA, HNS.

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Correspondence to Hemendra N. Shah.

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Conflict of interest

Dr Hemendra Shah received $1000 from Lumenis for mentoring urologists for HoLEP in 2019, and he has been sponsored by Boston Scientific and Applaud. No funding from these companies was received for the study. All other authors have nothing to disclose.

Ethical approval

This systematic review was conducted retrospectively from deidentified data obtained from previously published articles only performed in humans. We consulted extensively with the IRB of the University of Miami who determined that our study did not need ethical approval in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Suarez Arbelaez, M.C., Monshine, J., Porto, J.G. et al. The emerging role of the urinary microbiome in benign noninfectious urological conditions: an up-to-date systematic review. World J Urol 41, 2933–2948 (2023). https://doi.org/10.1007/s00345-023-04588-5

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