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.

Public Health Relevance

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.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Exploratory/Developmental Grants (R21)
Project #
5R21DK097435-02
Application #
8735131
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Mullins, Christopher V
Project Start
2013-09-15
Project End
2015-08-31
Budget Start
2014-09-01
Budget End
2015-08-31
Support Year
2
Fiscal Year
2014
Total Cost
Indirect Cost
Name
Loyola University Chicago
Department
Microbiology/Immun/Virology
Type
Schools of Medicine
DUNS #
City
Maywood
State
IL
Country
United States
Zip Code
60153
Brubaker, Linda; Wolfe, Alan J (2017) The female urinary microbiota, urinary health and common urinary disorders. Ann Transl Med 5:34
Dune, Tanaka J; Price, Travis K; Hilt, Evann E et al. (2017) Urinary Symptoms and Their Associations With Urinary Tract Infections in Urogynecologic Patients. Obstet Gynecol 130:718-725
Brubaker, Linda; Wolfe, Alan J (2017) The Female Urinary Microbiota/Microbiome: Clinical and Research Implications. Rambam Maimonides Med J 8:
Brubaker, Linda; Wolfe, Alan J (2017) Microbiota in 2016: Associating infection and incontinence with the female urinary microbiota. Nat Rev Urol 14:72-74
Mueller, Elizabeth R; Wolfe, Alan J; Brubaker, Linda (2017) Female urinary microbiota. Curr Opin Urol 27:282-286
Thomas-White, Krystal J; Kliethermes, Stephanie; Rickey, Leslie et al. (2017) Evaluation of the urinary microbiota of women with uncomplicated stress urinary incontinence. Am J Obstet Gynecol 216:55.e1-55.e16
Thomas-White, Krystal J; Hilt, Evann E; Fok, Cynthia et al. (2016) Incontinence medication response relates to the female urinary microbiota. Int Urogynecol J 27:723-33
Thomas-White, Krystal; Brady, Megan; Wolfe, Alan J et al. (2016) The bladder is not sterile: History and current discoveries on the urinary microbiome. Curr Bladder Dysfunct Rep 11:18-24
Brubaker, Linda; Wolfe, Alan (2016) The urinary microbiota: a paradigm shift for bladder disorders? Curr Opin Obstet Gynecol 28:407-12
Price, Travis K; Dune, Tanaka; Hilt, Evann E et al. (2016) The Clinical Urine Culture: Enhanced Techniques Improve Detection of Clinically Relevant Microorganisms. J Clin Microbiol 54:1216-22

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