The Vaginal Microbiome: Unlocking Its Role in Post-Surgical UTI Prevention

Urinary tract infections (UTIs) affect nearly half of all women during their lifetime, with post-surgical UTIs being a common complication following female pelvic surgeries. While often viewed as an unavoidable risk, emerging research highlights the vaginal microbiome's critical role in predicting and potentially mitigating UTI risk.

What We Know:

• UTIs occur when virulent bacteria, known as uropathogens, infiltrate the urinary system. Traditionally, the gastrointestinal (GI) tract has been regarded as the main source of these bacteria. However, mounting evidence shows that the vaginal microbiome plays an equally significant role, particularly in recurrent UTIs (Naji et al., 2024).

• A study of 435 urine cultures found two-thirds of bacteria shared with the gut microbiome and one-third with the vaginal microbiome, demonstrating their interconnectedness. Vaginal bacteria predominantly influence lower urinary tract infections, while gut bacteria contribute to infections higher up in the urinary system (Dubourg et al., 2020).

• When the vaginal microbiome is disrupted - through douching, sexual activity or hormonal changes - the risk of UTIs increases. Pathogens such as Gardnerella vaginalis and Group B Streptococcus can transiently invade the bladder, triggering immune responses and increasing susceptibility to uropathogens like E. coli. Dysbiosis, particularly a reduction in protective Lactobacillus species, has been strongly linked to recurrent UTIs (Naji et al., 2024). 

Industry Impact and Potential:

• Preoperative analysis of the vaginal microbiome has the potential to revolutionise UTI risk management. In a study of postmenopausal women undergoing pelvic surgery, low levels of Lactobacillus and a higher presence of pathogens like Gardnerella vaginalis were predictive of postoperative UTIs. This highlights the potential for microbiome screening to inform targeted interventions and pre-surgical counselling (Occhino et al., 2024).

• Beyond diagnostics, microbiome-based therapeutics hold promise. For example, Lactobacillus crispatus probiotics have shown efficacy in reducing recurrent UTIs by inhibiting pathogen colonisation and biofilm formation. These findings emphasise the need for further research into therapies that strengthen the vaginal microbiome to lower UTI risks (Naji et al., 2024). 

Our Solution:

At Sequential, we are committed to advancing women’s health through innovative microbiome solutions. Alongside vulvar microbiome analysis, we offer expertise in assessing skin, scalp and oral microbiomes. Our team collaborates with clients to develop cutting-edge products and research that preserve microbiome integrity and promote health. Let us partner with you to create innovative solutions that maintain the vaginal microbiome, reduce UTI risks and empower women’s health.

References:

Dubourg, G., Morand, A., Mekhalif, F., Godefroy, R., Corthier, A., Yacouba, A., Diakite, A., Cornu, F., Cresci, M., Brahimi, S., Caputo, A., Lechevallier, E., Tsimaratos, M., Moal, V., Lagier, J.-C. & Raoult, D. (2020) Deciphering the Urinary Microbiota Repertoire by Culturomics Reveals Mostly Anaerobic Bacteria From the Gut. Frontiers in Microbiology. 11, 513305. doi:10.3389/fmicb.2020.513305.

Naji, A., Siskin, D., Woodworth, M.H., Lee, J.R., Kraft, C.S. & Mehta, N. (2024) The Role of the Gut, Urine, and Vaginal Microbiomes in the Pathogenesis of Urinary Tract Infection in Women and Consideration of Microbiome Therapeutics. Open Forum Infectious Diseases. 11 (9), ofae471. doi:10.1093/ofid/ofae471.

Occhino, J.A., Byrnes, J.N., Wu, P.-Y., Chen, J. & Walther-Antonio, M.R. (2024) Preoperative vaginal microbiome as a predictor of postoperative urinary tract infection. Scientific Reports. 14 (1), 28990. doi:10.1038/s41598-024-78809-1.