The efficacy of drugs used to treat urinary incontinence may be dependent on the urinary tract microbiome

A very common issue among older women is urinary urgency incontinence (UUI), often referred to as an overactive or uncontrollable bladder. This is characterized by the sudden, intense need to urinate, followed by the loss of bladder control. Treatment for this problem includes solifenacin, an anticholinergic medication. Sequencing of urine bacteria has shown that UUI-affected women have different bacterial compositions than do non-UUI-affected women. This has prompted researchers at Loyola University Chicago to examine the relationship between solifenacin use and the microbiome of UUI patients. The hopes of this study was to begin understanding UUI-patients’ microbiome, in hopes of one day determining whether treatment of the microbiome would be at all beneficial to UUI patients.

Two groups of women were participants in this study: 74 UUI-affected women and 60 controls. The average age of the UUI-affected women group was 61.5 years, while that of the control group was 49 years. Urine samples were collected via transurethreal catheter. At baseline, similar amounts of bacterial DNA were detected in urine samples of both study groups; however, UUI-affected women had more cultivatable bacteria and significantly more bacterial diversity.

After testing symptom improvement following certain dosages of solifenacin, the researchers were able to conclude that certain microbiota characteristics are associated with treatment. It seems as though bacterial diversity could be used to predict treatment response, as women with higher microbial diversity responded better to treatment. It is important to remember that certain bacteria could be associated with bladder health, so the aim is not to eliminate bacteria altogether, but to identify whether bacteria could be targeted as a means of improving symptoms. The results of this study are exciting in that not only are we discovering more about the microbiome, but it could be used to treat yet another malady.

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