The recent finding that urine is not sterile raises a lot of questions: first and foremost, what microorganisms are present, and are these microorganisms correlated with clinical urinary symptoms? Recent work on the female urinary microbiota (FUM) found that the communities of microorganisms differ between women with no lower urinary tract symptoms (LUTS) and those with Urgency Urinary Incontinence (UUI) a form of over-active bladder syndrome. Specifically, a diverse or dysbiotic urinary microbiota was found to be associated with symptomatic women. This suggests the possibility that the FUM can be contributing to urinary symptoms. Conversely, it could also suggest that the FUM is simply a result of the physical environment of the urogenital tract and plays no active role in health. I hypothesize that the FUM is influencing LUTS, both as causative and preventative agents towards the clinical urinary symptoms. To test this, I first looked at the FUM of women with other urinary disorders: Stress Urinary Incontinence (SUI) and women with urinary tract infection (UTI)-like symptoms. Since many common urinary disorders share significant symptom overlap, I also assessed how the FUM correlates to individual symptoms. These data support the hypothesis that these microorganisms are able to influence LUTS. One specific organisms of the FUM, Lactobacillus crispatus, is able to exert a beneficial effect on LUTS, by inhibiting the growth and colonization of Uropathogenic Escherichia coli (UPEC), the most common cause of UTIs. The next step is to assess these potential interactions in an in vivo setting. With that collective knowledge, LUTS and UTI’s can be clinically treated with better effectiveness
