Traditionally, the healthy urinary bladder has been considered to be sterile. Several teams have used metagenomic (DNA-dependent) and metaculturomic (culture-dependent) methods to debunk this longstanding dogma. In fact, resident microbial communities (urobiome) have been detected in both adult females and males. Although the field is young, several observations have been made. For example, the urobiome differs between men and women, likely due to anatomical and hormonal differences. Importantly, the urobiome has been associated with a variety of lower urinary tract disorders, including overactive bladder and post-operative urinary tract infection, raising the possibility that clinicians might one day treat symptoms by modifying the urobiome instead of killing the suspected uropathogen. Little is known concerning the relationship between the urobiome and host genetics; so far, only a single paper has reported such a study. However, major efforts have gone into understanding the genomics of the urobiome itself, a process facilitated by the fact that many urobiome studies have used metaculturomic methods to detect and identify microbes. In this narrative review, we will introduce the urobiome with separate sections on the female and male urobiomes, discuss challenges specific to the urobiome, describe newly discovered associations between the urobiome and lower urinary tract symptoms, and highlight the one study that has attempted to relate host genetics and the urobiome. We will finish with a section on how metagenomic surveys and whole genome sequencing of bacterial isolates are improving our understanding of the urobiome and its relationship to lower urinary tract health and disorders.

传统上，健康的膀胱被认为是无菌的。几个团队已经使用宏基因组（DNA 依赖）和元培养（文化依赖）方法来揭穿这个长期存在的教条。事实上，在成年女性和男性中都检测到了常驻微生物群落（urobiome）。尽管该领域还很年轻，但已经进行了一些观察。例如，男性和女性的尿路生物群系不同，可能是由于解剖和荷尔蒙的差异。重要的是，尿路生物群与多种下尿路疾病有关，包括膀胱过度活动症和术后尿路感染，这增加了临床医生有朝一日可能通过改变尿路生物群而不是杀死可疑的尿路病原体来治疗症状的可能性。关于尿路生物群与宿主遗传学之间的关系知之甚少；到目前为止，只有一篇论文报道了这样的研究。然而，人们在理解泌尿生物组本身的基因组学方面做出了重大努力，这一过程得益于许多泌尿生物组研究使用元培养方法来检测和识别微生物。在这篇叙述性综述中，我们将分别介绍女性和男性泌尿生物群的部分，讨论泌尿生物群特有的挑战，描述新发现的泌尿生物群与下尿路症状之间的关联，并强调一项试图将其联系起来的研究宿主遗传学和泌尿生物群。