Cystitis Lab Checks

Do You Know Your Enemies?

The crucial question when it comes to recurring bladder infections:

"What is the pathogen?"

The answer to the question is often quite simple: E. coli. Sometimes, however, it is other pathogens. And sometimes the pathogens are difficult to detect, causing you a lot of trouble.

Once the enemy is identified, a targeted therapy can be started. If no pathogen can be found, other causes must be investigated (weak or hypertonic pelvic floor, overactive bladder, interstitial cystitis, endometriosis, bladder cancer, etc.).

Do You Know Your Friends?

In the fight against the enemies, all friends who help us are welcome.

Friends are the healthy microbiome in the gut, vagina, and bladder (urobiome). Changes to the microbiome due to hormonal imbalances or external factors (e.g. antibiotics, excessive intimate hygiene) often lead to an imbalance in the bacteria in the mucous membranes and a reduction of their protective function. This promotes the colonisation and subsequent infections by pathogenic bacteria.

Microbiome & Mucous Membranes

We now know that we are colonised by 100 trillion microbes, mainly bacteria. All the microbes in our body contain around 3 million genes, this is our microbiome. The term microbiota refers to the totality of all microorganisms. They often settle in communities of various single-celled organisms in the form of biofilms.

The digestive tract is the leader in microbial diversity with over 1000 different species. In the urogenital tract, there are about 150 species.

The protective function of bacterial colonisation by symbiotic bacteria depends on the composition and diversity of these bacteria. In general, high diversity is considered beneficial. The exception here is the vagina, which ideally has low biodiversity.

Disruptions to the gut microbiota can promote or even cause chronic diseases. The influence of bacteria extends far beyond the gut, as they affect our metabolism and the mucosa-associated immune system - the central hub of immune defense.

There is a lot of evidence for a connection between disruptions in the gut, vagina, and bladder. The challenge lies in determining whether there is a causal relationship between different variants of the microbiome and various symptoms and diseases. We are still at the beginning here. All current studies raise more questions than they can answer.

What we can say for sure so far:

• Urine from healthy people is not sterile and contains various microbes.
• The microbiome of the bladder (urobiome) likely has a protective function.
• In the future, we will hopefully destroy pathogenic bacteria less with antibiotics, but instead restore a balance with healthy bacteria or probiotics (eubiosis).