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The concluding statement of this short review states, “the study of the urinary microbiome and its impact on urological disease, including IC/BPS, is in its infancy.” A lot has been said on this subject in recent years, but this, in essence, sums it up. The authors seek to ask three main questions: a) is it associated with presentation and symptom severity; b) will it aid diagnosis; c) can it help guide effective management? Six published studied comparing female interstitial cystitis / bladder pain syndrome (IC/BPS) patients to asymptomatic controls were identified. Modern detection techniques were employed such as expanded quantitative urine culture (EQUC) and 16S ribosomal (r) RNA technology employing polymerase chain reaction (PCR) primers. These are important studies but had differences in detection techniques, sampling methods and study design. The key conclusions from this review are i) there are large inter-individual variations in female IC/BPS microbiome profiles; ii) there is currently no compelling evidence for a clinically significant difference in diversity or species composition between female IC/BPS and control groups; iii) Lactobacillus is the most common predominant genus among both female IC/BPS and control samples; iv) No candidate putative organism, urotype or microbiome pattern has been identified specific to female IC/BPS. The authors conclude that despite this broad agreement between studies, the findings indicating no differences or associations within or between IC/BPS and controls are actually inconclusive.

The urinary microbiome in interstitial cystitis/bladder pain syndrome? A critical look at the evidence.
Walton I, Nickel JC. 
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Jay Khastgir

Princess of Wales Hospital, Bridgend & Swansea University School of Medicine.

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