American Journal of Obstetrics and Gynecology
ResearchGynecologyThe female urinary microbiome in urgency urinary incontinence
Section snippets
Subjects and specimen acquisition
The full methods of the trial and the primary outcome of the ABC trial have been published.1, 5 Briefly, the trial randomly assigned women without neurologic disease with moderate-to-severe UUI, which was defined as having ≥5 episodes of UUI per 3-day period. Participants were anticholinergic drug naïve or previously had used ≤2 anticholinergic medications other than the study drugs. Exclusion criteria included a postvoid residual volume ≥150 mL or previous therapy with oral study medications
Results
Approximately one-half of the urine samples (51.1%, 93/182) were sequence-positive. Table 1 displays demographics and baseline characteristics of participants relative to sequence status; the mean age was 58.5 years, and most participants were white (77%). Sequence-positive subjects were younger (55.8 ± 12.2 vs 61.3 ± 9.0 years; P = .0007), had a higher body mass index (33.7 ± 7.3 vs 30.1 ± 6.6 kg/m2; P = .0009), and had a higher mean number of baseline UUIE (5.7 ± 2.5 vs 4.2 ± 2.1 per day; P <
Principal findings of the study
In adult women with UUI, the composition of the urinary microbiota is identifiable, variable, and related to certain clinical variables of potential importance. Because the female urinary microbiota has been detected only recently,3, 4, 6, 7, 13, 14, 15 an expanded perspective is warranted. The current study demonstrates that the status of the female urinary microbiota (sequence-positive or sequence-negative) can be used to subclassify women with UUI and that sequence-positive women can be
Acknowledgments
We thank the Loyola University Chicago Health Sciences Division’s Office of Informatics and Systems Development (which was developed through grant funds awarded by the Department of Health and Human Services as award number 1G20RR030939-0 1) for their expertise and for the computational resources used in support of this research.
References (18)
- et al.
Anticholinergic versus botulinum toxin A comparison trial for the treatment of bothersome urge urinary incontinence: ABC trial
Contemp Clin Trials
(2012) - et al.
Anticholinergic therapy vs onabotulinumtoxinA for urgency urinary incontinence
N Engl J Med
(2012) - et al.
The new world of the urinary microbiome in women
Am J Obset Gynecol
(2015) - et al.
Urinary bacteria in adult women with urgency urinary incontinence
Int Urogynecol J
(2014) - et al.
Evidence of uncultivated bacteria in the adult female bladder
J Clin Microbiol
(2012) - et al.
Urine is not sterile: Use of enhanced urine culture techniques to detect resident bacterial flora in the adult female bladder
J Clin Microbiol
(2014) - et al.
The female urinary microbiome: a comparison of women with and without urgency urinary incontinence
MBio
(2014) - et al.
Evaluation of methods for the extraction and purification of DNA from the human microbiome
PLoS One
(2012) - et al.
Introducing mothur: Open-source, platform-independent, community-supported software for describing and comparing microbial communities
Appl Environ Microbiol
(2009)
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Drs Pearce and Ziiliox contributed equally as first authors.
Supported by grants from the Eunice Kennedy ShriverNational Institute of Child Health and Human Development and the National Institutes of Health Office of Research on Women’s Health (Duke: 2-U10-HD04267-12, Loyola: U10-HD054136, UAB: 2-U10-HD041261-11, Utah: U10-HD041250, Cleveland Clinic: 2-U10-HD054215-06, UCSD: 2-U10-HD054214-06, Magee: 1-U10-HD069006-01, UTSW: 2-U10-HD054241-06, Univ. of Michigan: U10-HD41249, Brown University/Womens and Infants Hospital: U10 HD069013, New Mexico: U10 HD069025, Pennsylvania: U10 HD069010, RTI International: U01 HD069031RT: 1-U01-HD069010-01 and the NIH Office of Research on Women’s Health.
The authors report no conflict of interest.
Cite this article as: Pearce MM, Zilliox MJ, Rosenfeld AB, et al. The female urinary microbiome in urgency urinary incontinence. Am J Obstet Gynecol 2015;213:347.e1-11.