Urinary tract microbiota in patients with multiple sclerosis and neurogenic pelvic dysfunction

Abstract

Multiple sclerosis (MS) is a chronic progressive disease of the central nervous system common among young people. Neurogenic bladder often is a common symptom of the disease. Young people with MS often have to make treatment and family planning decisions at the same time. The possibility of realizing reproductive plans is closely related to urological complications of the disease, high risk of urinary tract infections, and sexual dysfunction. In addition, disease modifying therapies for MS play a significant role in increasing the likelihood of infectious complications. Therefore, the issue of infection prevention in MS is critical. Effective personalized prevention of urogenital infections is possible with a clear understanding of the microbiota composition. DNA sequencing methods have changed the conventional idea that normal urine is sterile and gave rise to the concepts of asymptomatic bacteriuria in healthy people. Moreover, data on the genitourobiome of patients with neurological diseases have recently emerged. Extended knowledge about the microbiology in the genitourinary system of neurological patients is necessary to unleash the capacity of health-preserving technologies. The aim of the review was to integrate currently available data concerning the microbiocenosis of the lower urinary tract and vagina with underlying neurogenic pelvic dysfunction, including MS, as well as to present data on the association between closely located biotopes and the effect of MS therapy on the risks of developing genitourinary infections.