Dysbiosis of Urinary Microbiome (Urobiome) in Male Children With Nocturnal Enuresis

Purpose: To determine the characteristics of the urobiome in boys with nocturnal enuresis. Materials and Methods: We enrolled 25 boys aged 5 to 12 years with untreated nocturnal enuresis (nocturnal enuresis group; median age, 7.4 years) and 17 boys aged 5 to 12 years without nocturnal enuresis (healthy control group; median age, 9.3 years). Among the 25 children with nocturnal enuresis, 15 had monosymptomatic nocturnal enuresis, and 10 had non-monosymptomatic nocturnal enuresis. First morning mid-stream urine samples were collected for deoxyribonucleic acid extraction and 16S ribosomal ribonucleic acid gene sequencing. The diversity and bacterial abundance of the urobiome were compared between the groups and between the monosymptomatic and non-monosymptomatic nocturnal enuresis groups. Results: Regarding alpha diversity, Shannon and Simpson indices were significantly lower in the nocturnal enuresis group. Beta diversity differed significantly on the permutational multivariate analysis of variance test. The relative abundance of Ezakiella was significantly greater in the nocturnal enuresis group than the healthy control group; however, in the nocturnal enuresis group, the relative abundance of Peptoniphilus was significantly lower, and predictive functional analyses revealed a greater proportion of bacteria involved in the synthesis of aromatic amino acids. Comparison of the monosymptomatic and non-monosymptomatic groups revealed no significant differences in diversity indices or relative abundance of bacterial taxa at the phylum or genus levels. Conclusions: The urobiome differed between the nocturnal enuresis and healthy control groups, with the nocturnal enuresis group exhibiting dysbiosis characterized by decreased microbial diversity, increased abundance of Ezakiella , and decreased abundance of Peptoniphilus .