Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Nov;43(8):1938-1947.
doi: 10.1002/nau.25530. Epub 2024 Jun 27.

The urinary and prostatic microbiome in non-neurogenic male LUTS/BPH: A systematic review

Teresa Pina-Vaz  1   2 , Alberto C Silva  1   2 , Carlos Silva  1   2 , Isabel Miranda  3   4 , Francisco Cruz  1   2   5 , João A Silva  1   2
Affiliations

The urinary and prostatic microbiome in non-neurogenic male LUTS/BPH: A systematic review

Teresa Pina-Vaz et al. Neurourol Urodyn. 2024 Nov.

Abstract

Introduction: Despite advancements in the treatment of benign prostatic hyperplasia (BPH), the mechanisms underlying BPH development and progression remain elusive and lacks a one-size-fits-all therapeutic solution. Prostatic inflammation contributes to BPH and lower urinary tract symptoms (LUTS), but the initial trigger remains unknown. Current research suggests dysbiosis of the urinary microbiome as a potential culprit. This systematic review explores the emerging field of the male urinary and prostatic microbiome and its relationship with BPH/LUTS.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. A systematic search in the Pubmed and Scopus databases was performed using specific terms. Inclusion criteria considered male non-neurogenic patients with LUTS due to BPH with analyses of urinary microbiome, concerning evaluation of English-language publications with relevance.

Results: Among seven articles involving 542 patients, there was an association between male LUTS/BPH and the urinary microbiome. Findings indicate a correlation between urinary microbiome dysbiosis and LUTS severity, with specific bacterial genera such as Streptococcus and Haemophilus linked to higher International Prostate Symptom Score (IPSS) scores and PSA levels. The fecal microbiome may be associated with LUTS, although contradictory findings are reported. The review also highlights methodological inconsistencies, small sample sizes, few negative controls and a lack of comprehensive clinical data as major limitations.

Conclusions: While there is an undeniable correlation between the microbiome and LUTS/BPH, future research should aim to standardize sampling techniques and expand the score to include functional microbiome characterization, potentially leading to novel, microbiome-targeted therapeutic strategies for BPH.

Keywords: benign prostatic enlargement; benign prostatic hyperplasia; lower urinary tract dysfunction; lower urinary tract symptoms; microbiome; microbiota.

PubMed Disclaimer

References

REFERENCES

    1. Speakman M, Kirby R, Doyle S, Ioannou C. Burden of male lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) ‐ focus on the UK. BJU Int. 2015;115(4):508‐519.
    1. Abrams P. LUTS, BPH, BPE, BPO: a plea for the logical use of correct terms. Rev Urol. 1999;1(2):65.
    1. Nickel JC, Roehrborn CG, O'Leary MP, Bostwick DG, Rittmaster RS, Somerville MC. The relationship between prostate inflammation and lower urinary tract symptoms: examination of baseline data from the REDUCE trial. Eur Urol. 2008;54(1379‐84):1379‐1384.
    1. Roehrborn CG, Kaplan SA, Noble WD, et al. The impact of acute or chronic inflammation in baseline biopsy on the risk of clinical progression of BPH: results fromthe MTOPS study. J Urol. 2005;173(4S):346.
    1. De Nunzio C, Kramer G, Marberger M, et al. The controversial relationship between benign prostatic hyperplasia and prostate cancer: the role of inflammation. Eur Urol. 2011;60(1):106‐117.

Publication types

MeSH terms

LinkOut - more resources