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Komesu YM, Richter HE, Dinwiddie DL, Siddiqui NY, Sung VW, Lukacz ES, Ridgeway B, Arya LA, Zyczynski HM, Rogers RG, Gantz M. Methodology for a vaginal and urinary microbiome study in women with mixed urinary incontinence. Int Urogynecol J 2017; 28:711-720. [PMID: 27738739 PMCID: PMC5391306 DOI: 10.1007/s00192-016-3165-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 09/19/2016] [Indexed: 12/11/2022]
Abstract
INTRODUCTION AND HYPOTHESIS We describe the rationale and methods of a study designed to compare vaginal and urinary microbiomes in women with mixed urinary incontinence (MUI) and similarly aged, asymptomatic controls. METHODS This paper delineates the methodology of a supplementary microbiome study nested in an ongoing randomized controlled trial comparing a standardized perioperative behavioral/pelvic floor exercise intervention plus midurethral sling versus midurethral sling alone for MUI. Women in the parent study had at least "moderate bother" from urgency and stress urinary incontinence symptoms (SUI) on validated questionnaire and confirmed MUI on bladder diary. Controls had no incontinence symptoms. All participants underwent vaginal and urine collection for DNA analysis and conventional urine culture. Standardized protocols were designed, and a central lab received samples for subsequent polymerase chain reaction (PCR) amplification and sequencing of the bacterial16S ribosomal RNA (rRNA) gene. The composition of bacterial communities will be determined by dual amplicon sequencing of variable regions 1-3 and 4-6 from vaginal and urine specimens to compare the microbiome of patients with controls. Sample-size estimates determined that 126 MUI and 84 control participants were sufficient to detect a 20 % difference in predominant urinary genera, with 80 % power and 0.05 significance level. RESULTS Specimen collection commenced January 2015 and finished April 2016. DNA was extracted and stored for subsequent evaluation. CONCLUSIONS Methods papers sharing information regarding development of genitourinary microbiome studies, particularly with control populations, are few. We describe the rigorous methodology developed for a novel urogenital microbiome study in women with MUI.
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Affiliation(s)
- Yuko M Komesu
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology MSC10-5580, University of New Mexico Health Sciences Center, Albuquerque, NM, 87131-0001, USA.
| | - Holly E Richter
- Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Darrell L Dinwiddie
- Clinical Translational Sciences Center and Department of Pediatrics, University of New Mexico of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Nazema Y Siddiqui
- Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA
| | - Vivian W Sung
- Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, RI, USA
| | - Emily S Lukacz
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Reproductive Medicine, UC San Diego Health System, San Diego, CA, USA
| | - Beri Ridgeway
- Center for Urogynecology and Reconstructive Pelvic Surgery, Obstetrics and Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Lily A Arya
- Division of Urogynecology and Reconstructive Pelvic Surgery, Hospital of University of Pennsylvania, Philadelphia, PA, USA
| | - Halina M Zyczynski
- Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Rebecca G Rogers
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology MSC10-5580, University of New Mexico Health Sciences Center, Albuquerque, NM, 87131-0001, USA
| | - Marie Gantz
- Social, Statistical and Environmental Sciences, RTI International, Research Triangle Park, Durham, NC, USA
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