Emerging evidence shows that the bladder is not sterile as previously thought. This evidence also shows that the resident bacterial community, the female urinary microbiome (FUM), may impact multiple urinary disorders, including urgency urinary incontinence, urinary tract infections and possibly urologic pain syndromes. The origins of urinary bacteria in healthy women may provide important insights into the bacterial cause of or contribution to urinary disorders. We anticipate major clinical implications as we advance knowledge concerning FUM dysbioses that can be quantified, predicted, prevented and/or modified. To advance that knowledge, we request funds to test the overarching hypothesis that the FUM is influenced by adjacent pelvic microbiomes (i.e., vaginal and perineal) and that FUM compositions are strongly associated with urinary symptoms and outcomes. We propose to characterize a pre-existing repository of urine samples and vaginal and perineal swabs obtained from >300 well-characterized adult women. Using 16S rRNA sequence analysis and innovative bioinformatics analysis, we will characterize the bacterial communities in these samples to investigate relationships between the FUM and the microbiomes of adjacent pelvic niches (Aim 1), and between each of these microbiomes and clinical findings (Aim 2). This information will be promptly shared with the wider urological research community via a dedicated web-based database (Aim 3), facilitating further study of diverse clinical conditions, and generating future hypotheses.
