It is common knowledge that the human bacterial microbiome plays a crucial role in health and disease. The urinary microbiome however, especially its viral component, remains largely unexplored. Emerging evidence suggests that the urinary microbiome might play a significant role in the development of overactive bladder syndrome. This study aims to address this gap in knowledge by investigating the potential link between the urinary virome, and female overactive bladder syndrome.

Prospective pilot study including 15 patients with overactive bladder syndrome and five controls. International Review Board approval was obtained and all participants consented to study participation by written informed consent (2160/2019). Current urinary tract infection and antibiotic therapy within the last two months were ruled out. Urethral swabs (Copan eSwab® urethra) were taken from each participant at one single time point. Subsequent viral isolation, purification, and enrichment were conducted using the ViPEP method. Next-generation sequencing was performed on pooled samples, followed by bioinformatic analysis to identify and classify viral contigs. Phylogenetic analysis was conducted to assess genetic relationships among identified viral sequences.

Patient characteristics are summarized in Table 1. We identified a higher abundance of viruses and phages in patients with overactive bladder syndrome as compared to controls (Table 2). Both bacterial and human viruses were identified in the urine samples. The most common human virus identified was Human papillomavirus type 53 (HPV 53), which was found in one pooled sample from the OAB group. The most common bacterial viruses were Siphoviruses, which infect a variety of bacterial strains and which were found in OAB samples only.

Our study reveals a distinction in the urethral virome between patients diagnosed with overactive bladder syndrome and controls. Notably, overactive bladder patients exhibited a higher abundance of viruses compared to controls. These findings parallel previous research demonstrating a similar trend in bacterial abundance and diversity within urine samples of individuals with overactive bladder syndrome.

In conclusion, our study represents a pioneering effort in characterizing the urethral virome and its potential association with overactive bladder syndrome. By comparing patients diagnosed with overactive bladder syndrome to controls, we have initiated an exploration into the viral component of the microbiome in this disorder. However, further research is imperative for a better understanding of the dynamic interplay between bacterial and viral microbiomes in overactive bladder syndrome. Such endeavors hold promise for advancing our understanding of the pathogenesis of this condition and may ultimately lead to more targeted and effective therapeutic strategies.

Continence 12S (2024) 101561
DOI: 10.1016/j.cont.2024.101561