The lower urinary tract comprises the bladder and the urethra and is supported by muscles and ligaments. The urethra contains both smooth and striated muscles. The inner lining of the bladder is called the urothelium, which also has a barrier function.
According to the International Continence Society (ICS), Lower Urinary Tract Symptoms (LUTS) can be divided into storage symptoms, voiding symptoms and post-micturition symptoms. LUTS in male patients is usually attributed to benign prostatic enlargement and bladder outlet obstruction and in female patients predominantly to the over active bladder syndrome (OAB). [1-3] The definition of OAB includes symptoms of urinary urgency, with or without urinary incontinence, usually accompanied by increased urinary frequency and nocturia. [1-3]
Urinary urgency is defined as a sudden and compelling desire to void, which in case of patients with OAB, cannot be postponed. In contrast, detrusor underactivity (DU) is associated with a reduced ability to void and is accompanied with voiding and post micturition symptoms and can predispose to UTI and acute urinary retention. The aetiology of detrusor underactivity is influenced by multiple factors, including ageing, bladder outlet obstruction, neurological disease, and autonomic denervation.
Until recently, urine of healthy individuals has been considered to be sterile, however new bacteria detection techniques have proven this assumption to be wrong. Urine of asymptomatic, healthy individuals contains a certain microbiome.
‘‘Microbiota’’ refers to the assemblage of living microorganisms present in a defined environment. This is a crucial part of the ‘‘microbiome’’, which can be used to refer to the entire habitat, including the microorganisms (bacteria, archaea, lower and higher eukaryotes, and viruses), their genomes, and the surrounding environmental conditions.
The Human Microbiome Project (HMP) has been investigating these microbiome communities in body. However, the focus mainly has been on organs like the skin, the mouth, the genital tract, the eye, the gut and the blood.
In this study, we give an overview on all the available published literature on the relationship between the urinary microbiota and functional disorders of the genitourinary tract, including bladder pain syndrome, prostatitis, stone disease and bladder cancer. [Table 1].