Synchronous genitourinary lichen sclerosus signals a distinct urinary microbiome profile in men with urethral stricture disease

Abstract

Purpose Alterations in the urinary microbiome have been associated with urological diseases. The microbiome of patients with urethral stricture disease (USD) remains unknown. Our objective is to examine the microbiome of USD with a focus on inflammatory USD caused by lichen sclerosus (LS). Methods We collected mid-stream urine samples from men with LS-USD (cases; n = 22) and non-LS USD (controls; n = 76). DNA extraction, PCR amplification of the V4 hypervariable region of the 16S rRNA gene, and sequencing was done on the samples. Operational taxonomic units (OTUs) were defined using a > 97% sequence similarity threshold. Alpha diversity measurements of diversity, including microbiome richness (number of different OTUs) and evenness (distribution of OTUs) were calculated and compared. Microbiome beta diversity (difference between microbial communities) relationships with cases and controls were also assessed. Results Fifty specimens (13 cases and 37 controls) produced a 16S rRNA amplicon. Mean sample richness was 25.9 vs. 16.8 (p = 0.076) for LS-USD vs. non-LS USD, respectively. LS-USD had a unique profile of bacteria by taxonomic order including Bacillales, Bacteroidales and Pasteurellales enriched urine. The beta variation of observed bacterial communities was best explained by the richness. Conclusions Men with LS-USD may have a unique microbiologic richness, specifically inclusive of Bacillales, Bacteroidales and Pasteurellales enriched urine compared to those with non-LS USD. Further work will be required to elucidate the clinical relevance of these variations in the urinary microbiome.

Lichen sclerosus following genital piercing

“…12 Differences in urinary microbiota composition between MGLSc patients and healthy controls have also in a separate study. 13 While our case demonstrates similarities with that reported by De Giorgi et al, no urethrocutaneous fistulation was reported in their case. It has been suggested that clitoral piercing induces changes in the periurethral microflora.…”

“…12 Differences in urinary microbiota composition between MGLSc patients and healthy controls have also in a separate study. 13…”

Balanopreputial sac and urine microbiota in patients with male genital lichen sclerosus

“…While this study represents the only study to date of both the balanopreputial microbiota and urinary microbiota, Cohen et al . investigated the urinary microbiota of men with urethral MGLSc and demonstrated a unique microbiota profile in MGLSc compared with controls, with enrichment of the orders Bacillales , Bacteroidales , and Pasteurellales 51 . They did not report any differences in the relative abundance of the order Fusobacteriales .…”

The Human Vulvar Microbiome: A Systematic Review

“…In penile cancer, Onywera et al have described a higher a greater relative abundance of Prevotella, Peptinophilus and Dialister and lower relative abundance of Corynebacterium in hrHPV-infected men [67]. Cohen et al found that the urine bacteriome of male LS patients with showed enrichment of Bacillales, Bacteriodales and Pasteurellales [68]. Increased incidence of Epstein-Barr virus (EBV) in LS biopsy tissue has been described in both female (26.5%) and male (37-38.3%) LS patients [69][70][71].…”