The human microbiome is made up of 100 trillion microbial cells. While we're most familiar with the gut microbiome, these tiny little microorganisms can be anywhere on and in us—including within the urinary tract. It can sound a bit weird to think about, but microscopic cells can make a big impact on our health and disease prevalence during our lifetime. To help you better understand some lesser-known aspects of the microbiome, we'll look at the relationship between the urinary tract microbiome and urological health in general.
What is the Human Urinary Microbiome?
The microbiome is a blanket term that refers to microorganisms (bacteria, fungi, viruses, and all of their genetic material) living within the body. The urinary microbiome tends to be made up of any microorganisms that live within the urinary bladder and urethra.
Historically, the idea has been that urine is sterile and no microorganisms live within the urinary tract. When any organism does enter the urinary tract (e.g., via the urethra), it results in infections and subsequent problems. But new advanced detection methods have found that this isn't true. The opposite is true. Microorganisms are present (albeit at lower levels than other microbiome profiles) and may play a role in urological diseases. For example, it's been found that Lactobacillus is the most common species in the female urinary microbiome.
Studies have also found that alterations in the urinary microbiome may occur with age, gender, antibiotic use, underlying health conditions, and even sexual activity. When you have a healthy urinary microbiome, it's thought that the microorganisms can help protect your urinary tract and prevent infections. On the contrary, an unbalanced urinary microbiome could increase the risk of infection or certain urological conditions.
The Relationship Between the Microbiome and Urological Health
So, how does the microbiome of the urinary tract influence various conditions? It's believed that several conditions can occur when the balance of your microbiome is disrupted. This is evident in multiple microbiomes in the body, such as in the vaginal microbiome and the microbiome in your gastrointestinal tract. Here are some current relationships being explored regarding the role of the urinary microbiome and urological health.
The Urinary Microbiome and Urinary Incontinence
Urinary incontinence, or the involuntary loss of bladder control, is a common condition that affects millions, particularly as they age. While it is often attributed to factors like muscle weakness, nerve damage, or hormonal changes, recent studies suggest that the urinary microbiome may also play a significant role.
One study found that women who experienced urinary incontinence had different urinary microbiomes. Not only was the type of bacteria different, but the diversity of species also changed. When explored further, the female urinary microbiomes differed based on whether they were experiencing stress urinary incontinence or urge urinary incontinence. Although this might not sound too surprising since both types of urinary incontinence have different underlying causes, it creates a question of whether the microbiome is influencing the condition or the condition is influencing the microbiome (or a bit of both). More research is needed to understand the connection fully.
Overactive Bladder and Urinary Microbiomes
Overactive bladder (OAB) is marked by the frequent urge to urinate, often accompanied by nocturia or leakage. Researchers have found that the urinary microbiome may play a role in OAB, though the connection is still being investigated.
A study discovered that patients with OAB often have lower levels of Lactobacillus, a bacterium commonly associated with urinary tract health. Furthermore, certain bacteria appear more frequently in individuals with OAB than those without it. This disruption could contribute to OAB symptoms, but again, more research is needed to understand the connection.
Urinary Tract Infections and the Urinary Microbiome
Urinary tract infections (UTIs) are among the most common issues associated with the urinary microbiome. Typically, "bad" bacteria (Escherichia coli) are responsible for UTIs, especially in women. However, "good" bacteria within a healthy urinary microbiome may provide some form of defense against UTI-causing intruders.
For example, certain strains of Lactobacillus produce lactic acid, which lowers the pH of the urinary tract, making it less hospitable to harmful bacteria. So, if you have a lower amount of these protective bacteria, you may experience an increased risk of UTIs or recurrent UTIs. More studies are being done regarding the potential for "probiotic" therapies to help maintain a healthier urinary microbiome and reduce UTI susceptibility.
Male Infertility and the Seminal Microbiome
The male urinary and reproductive tracts are interconnected, and the microbiome in these regions can influence reproductive health. Because of this, alterations in the seminal microbiome, specifically, may be linked with male infertility.
Studies show that certain microorganisms like Mycoplasma and Ureaplasma have been associated with reduced sperm quality and motility. Other microbial profiles that show an imbalance in beneficial versus harmful bacteria may lead to inflammation and oxidative stress, affecting sperm health. With that said, it's worth taking proactive steps to promote a healthy seminal and urinary microbiome in men trying to have children.
The Microbiomes Influence on Certain Cancers
There is also evidence of a relationship between disrupted microbiomes and an increased rate of prostate cancer and bladder cancer. You can read more about these findings here.
Tips to Maintain a Healthy Urinary Microbiome
Although more research is needed to understand the relationship between the microbiome and urological health fully, these early findings are worth considering. To help you maintain a healthy bacterial environment in your urinary tract, consider the following tips:
1. Stay Hydrated
Drinking enough water helps flush out harmful bacteria from the urinary tract, which can prevent infections. Proper hydration also promotes a balanced urinary environment, reducing the risk of microbial imbalances that could disrupt the microbiome.
2. Practice Good Hygiene
Hygienic practices play a significant role in maintaining a healthy urinary microbiome. Simple measures such as wiping from front to back, wearing breathable cotton underwear, and changing wet clothing after swimming can help prevent bacterial entry and imbalance. You should also try to avoid overly harsh soaps or scented hygiene products in the genital area (especially if you have female anatomy) to preserve beneficial bacteria.
3. Consider Probiotics
Certain probiotics may support a balanced urinary microbiome, especially strains like Lactobacillus, which have been linked to urological health. Probiotic-rich foods like yogurt, kefir, and fermented vegetables or supplements can also help introduce beneficial bacteria that may benefit the urinary tract and other microbiomes in the body.
4. Limit Unnecessary Antibiotics
While antibiotics are sometimes essential for treating infections, they can also disrupt the natural balance of bacteria in the body. Only take antibiotics if they're prescribed by your doctor, and make sure to follow the treatment plan accordingly.
5. Maintain a Balanced Diet
A diet rich in fiber, fruits, vegetables, and whole grains can support a healthy microbiome. Foods high in fiber help nourish beneficial bacteria, while fruits and vegetables provide antioxidants that can reduce inflammation and create a favorable environment for microbial diversity.
6. Urinate Regularly
Holding in urine for extended periods can create an environment where harmful bacteria are more likely to multiply. Regular urination helps flush out unwanted bacteria and maintain the balance of microorganisms within the urinary tract.
7. Avoid Irritants
Certain foods and beverages—such as caffeine, alcohol, spicy foods, and artificial sweeteners—can irritate the urinary tract, potentially disrupting the microbiome’s balance. Try to limit your intake of these to help preserve a healthy microbial environment.
How Does Information on the Urinary Microbiome Play a Role in Treatment and Prevention?
Some people swear by probiotics, while others feel like they don't do anything. While supplements may not be the best option, several foods rich in probiotics are known to help create a healthy microbiome throughout the human body. The new research profiling the urinary microbiome studies may provide insight into new preventative or treatment options focused on probiotics for conditions like urinary incontinence and recurrent urinary tract infections. However, the research on the bladder microbiome has only just begun, so it's still important to follow your doctor's treatment plans and always discuss taking any new supplements ahead of time.
Byram Healthcare carries a wide selection of high-quality urologic supplies to help you manage symptoms. Browse our urology product catalog today or contact us today to learn more about living with urinary incontinence.
