Is the microbiome influencing patient care in lower urinary tract dysfunction? Report from the ICI-RS 2017.

AIMS: This report sets out to consider the role of the microbiome within the bladder to provide clinicians with knowledge on this specific area of research and recommend potential topics for further studies. METHODS: This is a report from the Plenary 6: Is the microbiome influencing patient care in lower urinary tract dysfunction (LUTD)? RESULTS: There appear to be complex associations between microbial presence in the bladder and lower urinary tract symptoms. There appears to be a greater role of bacteria in the development of overactive bladder symptoms than previously thought with bacteria such as Gardnerella highlighted to be more prevalent in women with urgency urinary incontinence. Some species of Lactobacillus have also been found to play a protective role in both overactive bladder syndrome and bladder pain syndrome. CONCLUSIONS: The bladder is a reservoir for bacterial colonization and what was previously thought to be a sterile environment now seems to be a complex interaction of both multiple protective and pathogenic bacterial species than can give rise to lower urinary tract symptoms. While most clinicians use antibacterial agents as part of treatment regimens, and evidence does suggest a role of antibacterial therapies in treatment of LUTS, this remains a far from an ideal solution.