Dextrose Prolotherapy's Impact on the Urinary Microbiome in Interstitial Cystitis/Bladder Pain Syndrome.

Background: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a debilitating chronic condition affecting millions globally. Dextrose prolotherapy, a minimally invasive and safe treatment, has emerged as a potential way to promote tissue healing in these patients. This study investigates how dextrose prolotherapy impacts the urinary microbiome, aiming to uncover the underlying mechanisms involved in its effectiveness. Methods: Midstream urine samples from healthy controls and IC/BPS patients were collected before and after administering intravesical 10% dextrose injections. Microbiome profiling was conducted using 16S rRNA gene sequencing to analyze bacterial composition. Results: Significant differences in urinary microbiome diversity were observed between healthy controls and IC/BPS patients. Proteobacteria, Firmicutes, and Bacteroidota were more abundant in IC/BPS patients. Importantly, dextrose prolotherapy led to a decrease in harmful bacteria (Subgroup_22, Chryseolinea, and Ureaplasma) while enriching beneficial species such as Luteolibacter, Lactococcus, and L. lactis, correlating with improved clinical symptoms. Conclusions: Dextrose prolotherapy (DP) not only reduces the presence of harmful bacteria but also fosters the growth of beneficial microbes in IC/BPS patients. These findings suggest that the modulation of the urinary microbiome may be a key factor in its therapeutic success.