Bladder Microbiome in Women with Interstitial Cystitis/Bladder Pain Syndrome

Thursday, October 24, 2024

12:40 PM – 12:44 PM EDT

Location: Independence Ballroom E-H (Meeting Level 4)

Objectives: Bladder microbiome may differ between women with IC/BPS and unaffected controls. Our study aims to 1) compare the microbiome of transurethral catheterized urine specimen and bladder irrigation fluid of women with IC/BPS to unaffected controls and 2) to correlate IC/BPS symptom severity with microbial composition.

Methods: Women with a diagnosis of IC/BPS who presented to urology or urogynecology services for either bladder instillation or bladder hydrodistension were approached for participation in the study (IC/BPS subjects). Women who did not have symptoms or diagnosis of IC/BPS were eligible as control subjects. Demographics were collected from all participants. We administered the O’Leary-Sant interstitial cystitis symptom and problem indices (ICSI/ICPI) and the pelvic pain and the urgency/frequency patient symptom scale (PUF) for all the IC/BPS subjects. A transurethral catheterized urine sample followed by a sample of bladder irrigation fluid was collected from all participants. DNA was extracted from these samples and microbial profiling was done by 16S rRNA gene sequencing. Raw sequences were processed with QIIME2. Diversity metrics and different microbial determination were evaluated.

Results: A total of 40 participants were included in the study, 19 subjects in the IC/BPS group and 21 subjects in the control group. There were no differences in the demographics between the two groups except for parity. Women in the IC/BPS group were more likely to be nulliparous compared to the control group (P < 0.05). There was no difference in alpha diversity between IC/BPS and control groups in transurethral catheterized urine specimen. There was a slight increase in the proportion of individual species (Shannon diversity) in the bladder irrigation fluid samples of the IC/BPS group compared to the controls (P < 0.05). There was no significant microbial composition difference between the two cohorts in either bladder irrigation fluid or transurethral catheterized urine samples. Post-menopausal status and having a diagnosis of IC/BPS for more than 10 years independently increased the heterogeneity of microbial composition in the bladder irrigation fluid samples of the IC/BPS group. An increase in Clostridia was noted in the bladder irrigation fluid samples of women with IC/BPS who were post-menopausal, and an increase in Streptococcus was associated with having a diagnosis of IC/BPS for more than 10 years. Additionally, the total scores of ICSI/ICPI and PUF were not associated with the microbial composition in the bladder irrigation fluid or transurethral catheterized urine specimen of the IC/BPS group.

Conclusions: There were no microbial composition differences between IC/BPS and unaffected control groups in the bladder irrigation fluid or transurethral catheterized urine specimen. The severity of IC/BPS symptom scores did not alter the microbial composition. Menopausal status and years diagnosed with IC/BPS may have a greater impact on the bladder microbiome of women with IC/BPS than symptom severity.

Disclosure(s):

Xibei Jia, MD: No financial relationships to disclose

Ana Maldonado-Contreras, PhD: No financial relationships to disclose

Paula B. Bellin, MD: No financial relationships to disclose

Cristóbal Hernández-Álvarez: No financial relationships to disclose

Daniela Vargas-Robles, n/a: No financial relationships to disclose

Deepali Maheshwari, DO, MPH: No financial relationships to disclose

Abhilasha Tangada, MD: No financial relationships to disclose

Katherine Leung, MPH: No financial relationships to disclose

Emily Wu, MD: No financial relationships to disclose

Michael Flynn, MD: No financial relationships to disclose

Cynthia D. Hall, Associate Professor: No financial relationships to disclose

Presenting Author(s)

XJ

Xibei Jia, MD

Urogynecologist
Urology Associates of Cape Cod
Hyannis, Massachusetts, United States

Disclosure(s): No financial relationships to disclose

Co-Author(s)

AM

Ana Maldonado-Contreras, PhD

Assistant Professor
UMASS Chan Medical School
Worcester, Massachusetts, United States

Disclosure(s): No financial relationships to disclose
PB

Paula B. Bellin, MD (she/her/hers)

Urology
UMassMemorial Chan Medical
Worcester, Massachusetts, United States

Disclosure(s): No financial relationships to disclose
CH

Cristóbal Hernández-Álvarez

PostDoc
University of Massachusetts
Mexico City, Massachusetts, United States

Disclosure(s): No financial relationships to disclose
DV

Daniela Vargas-Robles, n/a

PostDoc
University of Massachusetts
Worcester, Massachusetts, United States

Disclosure(s): No financial relationships to disclose
DM

Deepali Maheshwari, DO, MPH

Urogynecologist
Baystate Medical Center
Springfield, Massachusetts, United States

Disclosure(s): No financial relationships to disclose
AT

Abhilasha Tangada, MD

Urogynecologist
Carle Foundation Hospital
Champaign, Illinois, United States

Disclosure(s): No financial relationships to disclose
KL

Katherine Leung, MPH

Biostatistician
UMass Chan Medical School
Worcester, Massachusetts, United States

Disclosure(s): No financial relationships to disclose
EW

Emily Wu, MD

Assistant Professor
University of Massachusetts Memorial Medical Center
Worcester, Massachusetts, United States

Disclosure(s): No financial relationships to disclose
MF

Michael Flynn, MD

Professor Ob/Gyn
University of Massachusetts
worcester, Massachusetts, United States

Disclosure(s): No financial relationships to disclose
CH

Cynthia D. Hall, Associate Professor (she/her/hers)

Associate Professor
Umass Chan medical School
Worcester, Massachusetts, United States

Disclosure(s): No financial relationships to disclose