The Urinary Microbiome: Silent Revolutions in Understanding Urological Disorders

Abstract

For decades, urinary tract was traditionally it considered a sterile environment in healthy individuals. Still, recent advancements in next-generation sequencing and culture-independent microbiological techniques have revolutionized this long-standing belief. Emerging evidence supports the existence of a distinct and dynamic Microbial community of the urinary tract that could play a crucial function in both health and pathology of the urinary tract. The following review aims to provide a comprehensive overview of current knowledge regarding the urinary microbiome as well as its implications for urological disorders. We summarize key findings on the constitution and diversity of the urinary normal flora in healthy populations, highlighting differences based on age, sex, and hormonal status. We then explore the associations between urinary dysbiosis and a range of urological conditions, including recurrent urinary tract infections, extracellular cystitis/bladder pain syndrome, overactive bladder, urinary incontinence, and nephric malignancies. Furthermore, we discuss the impact of urological interventions, such as catheterization, antibiotics, and surgical procedures, on microbial balance within the urinary tract. The review also highlights potential diagnostic and therapeutic applications, including microbiome-based biomarkers, probiotics, and targeted microbiome modulation strategies. Despite promising insights, challenges remain in standardizing sampling methods, defining healthy microbiomes, and establishing causative relationships. By synthesizing the latest research, this article underscores the transformative potential of urinary microbiome science in reshaping our understanding of urological diseases. Identifying the urinary microbiome as a key biological player begins new avenues for precision medicine, individualized urological care, and novel therapeutic interventions.