膀胱過動症的定義為須排除正在進行中的尿路感染，依照通用的醫學說明，尿液中發生尿路感染的定義可為每毫升尿液中存在10萬個生菌數，或者常規尿液中檢出數量不等的白血球數目。然而，近年來的研究，學者們發現女性的膀胱中在不引起醫學上活動性尿路感染的情況下，仍然有菌叢居住於女性的膀胱中，這些菌叢對於膀胱過動症或者急迫性尿失禁的發生與治療，是否具有關聯性呢？

於是學者們就召集一些接受急迫性尿失禁治療的女性患者與相對應的對照組，進行膀胱尿液中菌叢種類的分析。實驗中是以PCR的方式檢測尿液中的16SrRNA作為菌叢分類的依據。並以PGSC score 作為排尿症狀的評估。

研究的結果顯示，在接受solifenacin治療的急迫性尿失禁病患中，其尿液中的細菌數與菌叢種類較正常對照組多且複雜。而治療組中， 以solifenacin治療較為有效的病患比起治療效果不張的病患，其尿液中的細菌數較少而且菌叢的種類較為單純。

這一個研究結果暗示我們，女性罹患急迫性尿失禁的情形，與治療結果，可能與其膀胱尿液中原生的細菌數目與菌叢種類有相關。

Introduction—Many adult women have resident urinary bacteria (urinary microbiome/ microbiota). In adult women affected by urinary urgency incontinence (UUI), the etiologic and/or therapeutic role of the urinary microbiome/microbiota remains unknown.

Hypothesis—Microbiome/microbiota characteristics will relate to clinically relevant treatment response to oral UUI medication.

Methods—Adult women initiating oral medication treatment for UUI and a comparator group of unaffected women were recruited in a tertiary care health care system. All participants provided baseline clinical data and urine. Women with UUI were given 5mg solifenacin with potential dose escalation to 10mg for inadequate UUI symptoms control at 4 weeks. Additional data and urine samples were collected from women with UUI at 4 and 12 weeks. The samples were assessed by 16S rRNA gene sequencing and enhanced quantitative urine culturing. The primary outcome was treatment response as measured by the validated Patient Global Symptom Control (PGSC) questionnaire. Clinically relevant UUI symptom control was defined as a 4 or 5 score on the PGSC.

Results—The diversity and composition of the urinary microbiome/microbiota of women with and without UUI differed at baseline. Women with UUI had more bacteria and a more diverse microbiome/microbiota. The clinical response to solifenacin in UUI participants was related to baseline microbiome/microbiota, with responders more likely to have fewer bacteria and a less diverse community at baseline. Non-responders had a more diverse community that often included bacteria not typically found in responders.

Conclusions—Knowledge of an individual’s urinary microbiome/microbiota may help refine UUI treatment. Complementary tools, DNA sequencing and expanded urine culture, provide information about bacteria that appear related to UUI incontinence status and UUI treatment response in this population of adult women.

Brief Summary

Adult womens’ individual urinary microbiome/microbiota differ based on presence of UUI. The microbiota relate to UUI treatment response in women treated with oral UUI medication.