Urinary symptoms are associated with certain urinary microbes in urogynecologic surgical patients

Cynthia S. Fok, Xiang Gao, Huaiying Lin, Krystal J. Thomas-White, Elizabeth R. Mueller, Alan J. Wolfe, Qunfeng Dong, Linda Brubaker

Research output: Contribution to journalArticlepeer-review

52 Scopus citations


Introduction and hypothesis: Persistent and de novo symptoms decrease satisfaction after urogynecologic surgery. We investigated whether the preoperative bladder microbiome is associated with urinary symptoms prior to and after urogynecologic surgery. Methods: One hundred twenty-six participants contributed responses to the validated OABq symptom questionnaire. Catheterized (bladder) urine samples and vaginal and perineal swabs were collected immediately preoperatively. Bacterial DNA in the urine samples and swabs was sequenced and classified. Results: Preoperative symptom severity was significantly worse in sequence-positive patients. Higher OABq Symptom Severity (OABqSS) scores (more symptomatic) were associated with higher abundance in bladder urine of two bacterial species: Atopobium vaginae and Finegoldia magna. The presence of Atopobium vaginae in bladder urine also was correlated with its presence in either the vagina or perineum. Conclusions: Two specific bacterial species detected in bladder urine, Atopobium vaginae and Finegoldia magna, are associated with preoperative urinary symptom severity in women undergoing POP/SUI surgery. The reservoir for Atopobium vaginae may be adjacent pelvic floor niches. This observation should be validated in a larger cohort to determine whether there is a microbiologic etiology for certain preoperative urinary symptoms.

Original languageEnglish (US)
Pages (from-to)1765-1771
Number of pages7
JournalInternational Urogynecology Journal
Issue number12
StatePublished - Dec 1 2018

Bibliographical note

Funding Information:
Funding This study was supported by NIH grants R21 DK097435 and P20 DK108268, a Falk Foundation grant (LU#202567), and financial support from the Society of Women in Urology.

Publisher Copyright:
© 2018, The International Urogynecological Association.


  • Bladder
  • Microbiome
  • Urinary incontinence
  • Urinary symptoms


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