The Bladder is Not Sterile: an Update on the Urinary Microbiome

  • A. Lenore Ackerman
  • Toby C. ChaiEmail author
Overactive Bladder (U Lee and S Adelstein, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Overactive Bladder


Purpose of Review

The article discusses (1) techniques used to study bacterial urinary microbiota; (2) existence of non-bacterial urinary microbiota; (3) associations between changes in urinary microbiota and various benign lower urinary tract disorders.

Recent Findings

Urine harbors a diverse microbial community that resides within it. A multitude of studies have identified differences in these communities associated with urologic conditions, suggesting that microbial communities may maintain normal bladder homeostasis. Technological advances in analytic approaches have improved our understanding of the urinary microbiome. The choice of urine sampling method (voided, catheterized, or aspirated) will significantly influence microbiome findings. Sex and age highly influence urinary microbiota; in addition to rigorous inclusion criteria, microbial studies must be sufficiently powered to overcome the substantial interindividual variability of urinary microbiota. Regardless of these complicating factors, studies have identified microbial patterns correlating with both urologic diagnoses and treatment responses.


Without a clear understanding of the variability of and exogenous influences on the urinary microbiota in the absence of disease, it has been challenging to reveal the microbial patterns responsible for disease pathophysiology. Host mechanisms in response to the urinary microbiome are also poorly understood. Additional research can address whether the manipulation of urinary microbiota will benefit lower urinary tract health.


Urinary microbiome Benign lower urinary tract disorders 


Compliance with Ethical Standards

Conflict of Interest

A. Lenore Ackerman has no conflict of interest. Toby C. Chai has no conflict of interest.

Human and Animal Rights and Informed Consent

The authors did not perform any studies with human or animal subjects in this review article.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Cedars-Sinai Medical CenterBeverly HillsUSA
  2. 2.Boston Medical CenterBoston University School of MedicineBostonUSA

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