Urinary microbiome: Norm and pathology

The history of urinary microbiome research goes back approximately 150 years, and the urinary system in healthy individuals was originally believed to be absolutely sterile. Only in recent decades, the scientific community’s opinion on this issue underwent a 180-degree turn. Advances in microbiology research have enabled the use of extended culture-based and up-to-date molecular genetic techniques to detect and identify microorganisms that inhabit the urinary tract. Finally, the well-established dogma about the urine sterility in healthy individuals was destroyed. Not only bacteria, but also viruses and fungi were found in the urine. The concept of urobiome has emerged. Today, there is no single idea of what should be considered a normal urinary microbiome composition. However, accumulated research evidence brings us to the conclusion that changes in the microbiome composition affect the development of various urologic diseases not only in a negative, but also in a positive way, although many of the pathogenetic mechanisms of these effects are not yet fully understood. It should be noted that the urobiome composition can affect the development of not only inflammatory diseases such as urinary tract infections, but also non-inflammatory ones such as benign prostatic hyperplasia, interstitial cystitis/painful bladder syndrome, urolithiasis, overactive bladder and urinary incontinence, and bladder cancer. This paper summarizes techniques and issues of urinary microbiome research, and presents characteristics of the urobiome in health and disease.

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