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Peer-reviewedCC BY 4.0International Urogynecology Journal

Urobiome Analysis in Interstitial Cystitis/Bladder Pain Syndrome Reveals Nuanced Differences Associated with Localized Pain

  • Seth A. Reasoner1
  • Jamisha Francis1
  • Mollie Gidney1
  • Afia Amponsah2
  • Brendan Frainey3
  • Andrew Schrepf4
  • A. Grace Kelly2
  • Anna M. Ryden2
  • Leslie J. Crofford1,5
  • Roger R. Dmochowski3
  • Maria Hadjifrangiskou1,3
  • Lindsey C. McKernan3,2
5 affiliations
  1. 1Division of Molecular Pathogenesis, Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, TN USA
  2. 2Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN USA
  3. 3Department of Urology, Vanderbilt University Medical Center, Nashville, TN USA
  4. 4Department of Anesthesiology, University of Michigan, Ann Arbor, MI USA
  5. 5Department of Medicine, Vanderbilt University Medical Center, Nashville, TN USA
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Abstract

Introduction and Hypothesis: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a prevalent chronic pain syndrome associated with functional urinary disorders. IC/BPS symptoms can be localized to the pelvic-region or have co-occurring widespread pain. Importantly, response to treatment depends on pain localization phenotype. The etiology of IC/BPS remains elusive, and whether bacteria contribute to IC/BPS pathophysiology remains uncertain. We hypothesized that the urobiome does not differentiate phenotypic presentations of IC/BPS.

Methods: We used urine samples collected from a longitudinal randomized controlled trial of psychotherapy for individuals with IC/BPS to study the association of the urobiome and IC/BPS symptoms over time. Individuals provided urine samples at baseline, posttreatment, and at 5 months. We performed a secondary analysis on urine samples applying 16S rRNA sequencing and assigned bacterial taxonomy to amplicon sequence variants (ASVs) to characterize the urobiome. We compared urobiome diversity and stability over time, their associations with IC/BPS symptoms, and relationships with pain localization.

Results: As validation of this dataset, we noted a strong influence of menopausal status and recent urinary tract infection on the composition of the urobiome. We did not detect widespread differences in the urobiome that correlated with an individuals’ pain localization or severity. Instead, we observed specific bacterial sequences that were altered in abundance in relation to symptomatology, such as reduced abundance of a Dialister ASV in persons with localized pelvic pain.

Conclusions: Together, this dataset advances our understanding of the urobiome in IC/BPS and sets the stage for future studies on the urobiome and IC/BPS symptoms.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00192-026-06716-2.

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Cite

BibTeXRIS
BibTeX
@article{reasoner2026urobiome,
  title = {{Urobiome Analysis in Interstitial Cystitis/Bladder Pain Syndrome Reveals Nuanced Differences Associated with Localized Pain}},
  author = {Seth A. Reasoner and Jamisha Francis and Mollie Gidney and Afia Amponsah and Brendan Frainey and Andrew Schrepf and A. Grace Kelly and Anna M. Ryden and Leslie J. Crofford and Roger R. Dmochowski and Maria Hadjifrangiskou and Lindsey C. McKernan},
  journal = {International Urogynecology Journal},
  year = {2026},
  month = jun,
  doi = {10.1007/s00192-026-06716-2},
  url = {https://doi.org/10.1007/s00192-026-06716-2},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Urobiome Analysis in Interstitial Cystitis/Bladder Pain Syndrome Reveals Nuanced Differences Associated with Localized Pain
AU  - Seth A. Reasoner
AU  - Jamisha Francis
AU  - Mollie Gidney
AU  - Afia Amponsah
AU  - Brendan Frainey
AU  - Andrew Schrepf
AU  - A. Grace Kelly
AU  - Anna M. Ryden
AU  - Leslie J. Crofford
AU  - Roger R. Dmochowski
AU  - Maria Hadjifrangiskou
AU  - Lindsey C. McKernan
PY  - 2026
DA  - 2026/06/20
JO  - International Urogynecology Journal
DO  - 10.1007/s00192-026-06716-2
UR  - https://doi.org/10.1007/s00192-026-06716-2
AB  - Introduction and Hypothesis: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a prevalent chronic pain syndrome associated with functional urinary disorders. IC/BPS symptoms can be localized to the pelvic-region or have co-occurring widespread pain. Importantly, response to treatment depends on pain localization phenotype. The etiology of IC/BPS remains elusive, and whether bacteria contribute to IC/BPS pathophysiology remains uncertain. We hypothesized that the urobiome does not differentiate phenotypic presentations of IC/BPS.  Methods: We used urine samples collected from a longitudinal randomized controlled trial of psychotherapy for individuals with IC/BPS to study the association of the urobiome and IC/BPS symptoms over time. Individuals provided urine samples at baseline, posttreatment, and at 5 months. We performed a secondary analysis on urine samples applying 16S rRNA sequencing and assigned bacterial taxonomy to amplicon sequence variants (ASVs) to characterize the urobiome. We compared urobiome diversity and stability over time, their associations with IC/BPS symptoms, and relationships with pain localization.  Results: As validation of this dataset, we noted a strong influence of menopausal status and recent urinary tract infection on the composition of the urobiome. We did not detect widespread differences in the urobiome that correlated with an individuals’ pain localization or severity. Instead, we observed specific bacterial sequences that were altered in abundance in relation to symptomatology, such as reduced abundance of a Dialister ASV in persons with localized pelvic pain.  Conclusions: Together, this dataset advances our understanding of the urobiome in IC/BPS and sets the stage for future studies on the urobiome and IC/BPS symptoms.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00192-026-06716-2.
SN  - 0937-3462
SN  - 1433-3023
ER  -