Urgency urinary incontinence (UUI) is involuntary leakage accompanied by or immediately preceded by urgency. While UUI appears to involve the neural pathways that control micturition, the etiology is incompletely understood. On the basis of our groundbreaking findings that clearly show that female human bladders are not sterile despite negative urine culture status, we propose the novel hypothesis that bacterial colonization of the lower urinary tract influences UUI symptoms and outline experiments to test this hypothesis. If our findings support our hypothesis, we will have provided novel insights into UUI etiology. If bacterial community structure correlates with UUI, then treatments could be targeted to modify this bacterial community. Such studies would have immediate clinical impacts and would be well suited for NIH- sponsored clinical trials networks.
The healthy female urinary system is assumed to be free of microbes. Our documentation of urinary bacteria in women without clinical infection argues against that assumption and permits us to propose the novel hypothesis that bacterial colonization of the lower urinary tract plays a role in certain common and poorly understood female urinary tract disorders. Successful completion of the proposed studies is likely to fundamentally change the current dogma regarding the female urinary tract, have immediate clinical impacts, be well suited for NIH-sponsored clinical trials networks, and ultimately exert a broad and significant impact on human health and the associated economic costs.
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