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Gary Bellman, M.D., F.R.C.S.
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Could Bacteria in Urine Contribute to Overactive Bladder?

By: Dr. Gary Bellman on July 7, 2014, 4:41 pm

If you are one of those affected by the ‘gotta go’ feeling--  the sudden urge to urinate that you cannot control, it may be because of the bacteria in urine, a recent study showed.
 
Approximately 15% of women suffer from overactive bladder (OAB) and an estimated 40%-50% of affected women do not respond to conventional treatments.  One possible explanation for the lack of treatment response may be the bacteria present in these women.  For the study, researchers evaluated urine specimens of 90 women with and without OAB using a new technique known as expanded quantitative urine culture (EQUC).
 
EQUC was able to find bacteria that were not identified by the standard urine culture techniques typically used to diagnose urinary tract infections.  Using EQUC, the researchers discovered that the bladder bacteria in healthy women differ significantly from those in women affected by OAB, suggesting that certain bladder bacteria may play a role in OAB.  
 
The EQUC method applies larger volumes of urine and incubates plates for longer and under more varied conditions before identifying microorganisms by sequencing ribosomal RNA.
 
The researchers presented their findings, which build on earlier work, at the American Society for Microbiology meeting.  One outcome of their research program is what the authors consider a ‘debunking’ of the idea that urine is medically sterile (free from microorganisms).
 
If bacteria are always present in a healthy bladder, this raises questions for clinicians about when it is appropriate to treat bacteria in urine as an infection.  Further research is needed to determine which types of bacteria are neutral or helpful at excluding the bacteria contributing to infection and symptoms of incontinence.



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