Urgency Urinary Incontinence (UUI): experiencing a strong sensation of
an urgent need to pee, followed by immediate leakage of a large volume
of urine. It can severely adversely affect someone's life, contributing
to anxiety, depression and social isolation.
Almost one in five women over the age of 44 suffer from what is known as
Urgency Urinary Incontinence (UUI).
‘The variety and type of bacteria that are present in the urinary tract may have a role in conditions like urgent urinary incontinence.’
In spite of its impact, the causes of the complaint are still
relatively unknown. The condition is often attributed to abnormal
signalling prompting the bladder muscles to contract involuntarily, but
this seems to account for only about three fifths of cases. Scientists
are searching for other possible causes of the condition. Some think
that understanding the bacteria that live within us may hold the key.
The urinary tract has long been thought to be a sterile environment: a place where no bacteria can grow. A new study from Oregon Health and Science University that was published in Frontiers in Cellular and Infection Microbiology
suggests that this assumption might be far from the truth. Furthermore,
their research suggests that the variety and type of bacteria that are
present in the tract may have a role in general health and conditions
like urgent urinary incontinence.
The main reason why the urinary tract has been assumed to be
inhospitable for bacteria is that scientists have been unable to grow
bacteria from urine samples in the laboratory and so believed that there
was nothing living within those samples. However, the Oregon team has
taken a different approach, looking for the tell-tale signs of bacterial
DNA within urine.
Nearly every woman from whom they collected urine, regardless of
whether or not she suffered from urinary incontinence, had a wide
variety of bacteria present, though the women with UUI seemed to have
fewer different types of bacteria. Rahel Nardos, one of the scientists
behind the study, hopes that "the scientific community can learn to
understand how these bacteria behave under normal and diseased
In some cases, the bacteria present in the urine of women suffering
from UUI are the same kinds that cause urinary tract infections. This
suggests that a persistent low grade infection by bacteria that are not
commonly detected by routine cultures could potentially be responsible
for the irritative symptoms of UUI, at least for some individuals.
Rahel hopes "that future work in this area of research will lead to more
accurate diagnoses and better targets for treatments."
Furthermore, it seems that the fewer different kinds of bacteria
that are present in the urinary tract, the more severe are the symptoms
experienced by the patient. Dr Lisa Karstens, one of the scientists in
this project thinks that "much larger studies will need to be completed
in order to understand the variability of these bacterial communities in
healthy individuals and to determine if there are specific patterns
that emerge from this variability that indicate normal and abnormal
Medicine is increasingly acknowledging that our bodies are host to
an entire ecosystem of bacteria and other microbes that hitchhike upon
us and that the health of that network can affect our wellbeing.
Decreased microbial diversity of other body sites has also been
associated with a variety of clinical conditions such as obesity,
irritable bowel syndrome and inflammatory bowel disease.
As Rahel says,
"It turns out, diversity is a good thing to have in all aspects of
life." Understanding the complexities of bacteria in the urinary tract
could lead to valuable progress in this area.