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Hiergeist A, Gessner A. Clinical implications of the microbiome in urinary tract diseases. Curr Opin Urol. 2016 Nov 24. [Epub ahead of print]

This educational review outlines some of the key research to date into the potential impact of the microbiome on conditions such as interstitial cystitis/bladder pain syndrome (IC/BPS). The microbiome, which refers to the complex communities of microbes that inhabit and colonize the human body, is currently an areas of increasing interest among researchers. This is in part due to advances in microbe detection, which revealed a diverse community of bacteria throughout the urinary tract. The authors of this review highlight some of the most important investigations into the role of the microbiome in urinary tract diseases, including a recent, comprehensive analysis of biomarkers found in stool that one day could be targets for treatment of IC/BPS. They also point to specific findings from other studies, such as the finding that an increase in Lactobacillus in the urine is associated with IC/BPS. In another study, women with urgency urinary incontinence (UUI) were found to have a different microbiome in the urinary tract compared with control subjects; more recently, investigators have found that women with more severe UUI symptoms have a loss of microbiome diversity compared with women who have less severe symptoms. While these and other findings detailed in this article are compelling, further studies will be needed to understand the true significance of the microbiome in urinary tract diseases.