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Int Neurourol J > Volume 25(1); 2021 > Article
Cho: The Microbiome and Urology
Research on the microbiome is currently in the spotlight, and researchers are actively exploring the role of the microbiome in a wide variety of urological diseases. The complex microbial communities colonizing the human body have been recognized as major factors with a very close relationship to the pathogenesis of various diseases [1]. In the past, healthy human urine was originally considered to be a sterile body fluid based on routine urine culture techniques. With the advent of modern DNA sequencing technology, such as 16S ribosomal RNA (rRNA) gene or whole-metagenome sequencing, slowly or fastidiously growing bacteria were detected as unique commensal flora in the urinary tract.
In 2012, Wolfe et al. [2] first proved the existence of a urinary microbiome through 16S rRNA gene sequencing, including conventional urine culture tests, using urine obtained from adult women without urinary tract infections. After the first discovery of the microbiome in the urinary tract, researchers have proposed various hypotheses and reported research findings indicating that the microbiome plays an essential role in various urological diseases, including overactive bladder, urolithiasis, and bladder cancer.
The discovery that the microbiome is related to urological diseases other than infectious diseases is a very interesting finding. We should take a keen interest in the conclusions that research in this field will reach in the future. I would cautiously predict that these studies will have a significant impact on the understanding and/or treatment of various urological diseases. The International Neurourology Journal (INJ) has also published some studies and letters related to the microbiome [3,4].
In the present issue of INJ, Kim and Jung [5] highlight a recent study that expands our understanding of the urinary tract microbiota in men with lower urinary tract symptoms. In particular, Kim and Jung [5] review many excellent studies in detail, showing a correlation between benign prostate hyperplasia or chronic prostatitis and the microbiome. This review article will be of great help to the readers of INJ in their research and will strengthen their understanding of the microbiome.
Of course, the biggest question that remains unanswered despite these studies is whether changes in the microbiome are the cause of various diseases or are the result of diseases.
Undoubtedly, the microbiome is linked to urological diseases. The extent of this relationship remains unclear, but the possibilities are endless. Over the next few years, establishing the influence of the microbiome on urological homeostasis will play a key role in our understanding of urological diseases.


Conflict of Interest
No potential conflict of interest relevant to this article was reported.


1. Hiergeist A, Gessner A. Clinical implications of the microbiome in urinary tract diseases. Curr Opin Urol 2017;27:93-8. PMID: 27898455
crossref pmid
2. Wolfe AJ, Toh E, Shibata N, Rong R, Kenton K, Fitzgerald M, et al. Evidence of uncultivated bacteria in the adult female bladder. J Clin Microbiol 2012;50:1376-83. PMID: 22278835
crossref pmid pmc
3. Lee SJ. Commentary on “The urine microbiome of healthy men and women differs by urine collection method”. Int Neurourol J 2020;24:182-4. PMID: 32615682
crossref pmid pmc
4. Pohl HG, Groah SL, Pérez-Losada M, Ljungberg I, Sprague BM, Chandal N, et al. The urine microbiome of healthy men and women differs by urine collection method. Int Neurourol J 2020;24:41-51. PMID: 32252185
crossref pmid pmc
5. Kim MS, Jung SI. The urinary tract microbiome in male genitourinary diseases: focusing on benign prostate hyperplasia and lower urinary tract symptoms. Int Neurourol J 2021;25:3-11. crossref
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