Altered microbial colonization of the urogenital tract in female overactive bladder syndrome

Women with overactive bladder seem to have a distinct multisite dysbiosis, most pronounced in the urogenital tract, characterized by the loss of Lactobacillus and enrichment of selected taxa across urethra, urine, vagina, and oral cavity. The observed microbial overlap across urogenital sites, compared with stool, is consistent with predominant urogenital microbial relatedness in this cross-sectional cohort. These findings provide insight into microbiome alterations in overactive bladder and highlight the need for longitudinal studies to clarify mechanisms and evaluate potential microbiome-targeted strategies. Given the cross-sectional design, these findings describe associations and cannot establish causality or the directionality of microbial transmission between compartments.