The Effect of the Urinary and Fecal Microbiota on Lower Urinary Tract Symptoms Measured by the International Prostate Symptom Score: Analysis Utilizing Next-Generation Sequencing.

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BJU international


INTRODUCTION AND OBJECTIVES: There is accumulating evidence that variations in the human microbiota may promote different benign disease conditions. Our goal was to examine the correlation between urinary and fecal microbial profiles and the different aspect of lower urinary tract symptoms (LUTS) in adult males.

MATERIALS AND METHODS: We extracted total DNA from urine and fecal samples from a group of adult males through institutional review board. At the same time, International Prostate Symptom Score (I-PSS) data was collected. We then amplified the extracted DNA and sequenced it using bacterial 16S rRNA gene high-throughput next-generation sequencing platform, and analyzed microbial profiles for taxonomy to examine the correlation between the different operational taxonomy units (OTUs) and LUTS represented by the overall all I-PSS score, the different symptom levels of I-PSS (mild, moderate, and severe), and its subcomponents of storage, nocturia, voiding, and bother.

RESULTS: We included 30 patients in our analysis (60 samples, one urine, and one fecal per patient). Forty-eight fecal OTUs showed significant correlation with one or more of the I-PSS components; 27 with nocturia, 19 with bother, 16 with storage symptoms, and 9 with voiding complaints. The most substantial negative (protective) correlation was between Lachnospiraceae Blautia, a bacteria that increase the availability of gut anxiolytic and antidepressant short chain fatty acids, and bother (correlation coefficient - 0.702, p-value 0.001). The abundance of Lachnospiraceae Blautia continued to have protective correlation against LUTS when looking at the different levels of I-PSS severity (moderate and severe vs. mild, correlation coefficient - 0.6132, p-value 0.002). Ten unique urinary OTUs showed significant correlation with LUTS; 8 with nocturia, 1 with bother, 3 with storage, and 1 with void, but no fecal OUT had more than low correlation with the outcomes of interest in this study.

CONCLUSIONS: Our prospective work finds a plausible correlation between Lachnospiraceae Blautia and LUTS. Additional studies are needed to determine if the correlations found in this research are applicable to the general population of patients affected by LUTS.

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ePub ahead of print