Dextrose Prolotherapy's Impact on the Urinary Microbiome in Interstitial Cystitis/Bladder Pain Syndrome

<b>Background</b>: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a debilitating chronic condition affecting millions globally. Dextrose prolotherapy, a minimally invasive and safe treatment, has emerged as a potential way to promote tissue healing in these patients. This study investigates how dextrose prolotherapy impacts the urinary microbiome, aiming to uncover the underlying mechanisms involved in its effectiveness. <b>Methods:</b> Midstream urine samples from healthy controls and IC/BPS patients were collected before and after administering intravesical 10% dextrose injections. Microbiome profiling was conducted using 16S rRNA gene sequencing to analyze bacterial composition. <b>Results:</b> Significant differences in urinary microbiome diversity were observed between healthy controls and IC/BPS patients. Proteobacteria, Firmicutes, and Bacteroidota were more abundant in IC/BPS patients. Importantly, dextrose prolotherapy led to a decrease in harmful bacteria (Subgroup_22, <i>Chryseolinea, and Ureaplasma</i>) while enriching beneficial species such as <i>Luteolibacter</i>, <i>Lactococcus</i>, and <i>L. lactis</i>, correlating with improved clinical symptoms. <b>Conclusions:</b> Dextrose prolotherapy (DP) not only reduces the presence of harmful bacteria but also fosters the growth of beneficial microbes in IC/BPS patients. These findings suggest that the modulation of the urinary microbiome may be a key factor in its therapeutic success.