Gevelinger Matthew M, Khemmani Mark, Joyce Cara, John Jerrin, Sohail Sidra, Nasse Anisa, Fontes Noronha Melline, Acevedo-Alvarez Marian, Pham Thythy, Wolfe Alan J, Mueller Elizabeth R
From the Division of Female Pelvic Medicine and Reconstructive Surgery, Departments of Urology and Obstetrics/Gynecology, Loyola University Medical Center.
Departments of Microbiology and Immunology.
Urogynecology (Phila). 2025 Jul 1;31(7):650-659. doi: 10.1097/SPV.0000000000001526.
Little is known about the resilience of the urogenital microbiota in response to urogynecologic surgery.
The aim of this study was to determine if the urogenital microbiota are disrupted after surgery and if the postoperative composition returns to a preoperative baseline. We also sought to determine if the process of recovery differs in premenopausal women versus postmenopausal women.
Women undergoing surgery for pelvic floor disorders were invited to participate in this longitudinal descriptive study. Catheterized urine specimens and vaginal swabs were obtained at 4 timepoints: (1) day of surgery prior to antibiotic administration and surgical preparation; (2) immediately postoperatively; (3) 3-week postoperative visit; and (4) 12-week postoperative visit. Bacterial DNA was extracted, sequenced by 16S rRNA gene sequencing and classified taxonomically. Longitudinal data analyses were performed using linear mixed-effects models evaluating Jensen-Shannon divergence and α diversity measures.
Forty women, 50% of whom were postmenopausal, were included. There were significant alterations in α diversity over time (P time ≤0.05 for all comparisons), except richness in the bladder. There was perturbation immediately postoperatively, with a return to preoperative baseline at 3 and 12 weeks postoperatively. At each timepoint, premenopausal participant microbiota were not diverse, whereas postmenopausal women had diverse compositions. Jensen-Shannon divergence indices were stable in both the bladder (P = 0.95) and vagina (P = 0.88) over time in premenopausal women but showed divergence from the preoperative vagina for postmenopausal women (P = 0.004).
The urogenital microbiome is altered after urogynecologic surgery. In premenopausal versus postmenopausal women, the composition, stability, and process of recovery differ.
关于泌尿生殖系统微生物群对泌尿妇科手术的恢复力知之甚少。
本研究的目的是确定泌尿生殖系统微生物群在手术后是否受到破坏，以及术后组成是否恢复到术前基线。我们还试图确定绝经前女性与绝经后女性的恢复过程是否不同。
邀请接受盆底疾病手术的女性参加这项纵向描述性研究。在4个时间点采集导尿尿液标本和阴道拭子：（1）手术当天，在使用抗生素和进行手术准备之前；（2）术后立即；（3）术后3周随访时；（4）术后12周随访时。提取细菌DNA，通过16S rRNA基因测序进行测序并进行分类学分类。使用评估Jensen-Shannon散度和α多样性指标的线性混合效应模型进行纵向数据分析。
纳入了40名女性，其中50%为绝经后女性。除膀胱中的丰富度外，α多样性随时间有显著变化（所有比较中P时间≤0.05）。术后立即出现扰动，术后3周和12周恢复到术前基线。在每个时间点，绝经前参与者的微生物群种类不多，而绝经后女性的组成则多种多样。绝经前女性膀胱（P = 0.95）和阴道（P = 0.88）中的Jensen-Shannon散度指数随时间稳定，但绝经后女性的阴道与术前相比出现了差异（P = 0.004）。
泌尿妇科手术后泌尿生殖微生物群会发生改变。绝经前女性与绝经后女性在组成、稳定性和恢复过程方面存在差异。
