Beyond Sterility: the Urinary Microbiome in Bladder Cancer Carcinogenesis and Treatment.

PURPOSE OF REVIEW: Emerging evidence has challenged the paradigm of bladder sterility, opening new opportunities for understanding bladder cancer biology.

RECENT FINDINGS: Disruption of commensal intravesical bacterial communities appears to increase risk of carcinogenesis, while the presence of specific bacterial strains has been linked to differential treatment responses. However, the interplay between urinary microbiome and bladder cancer remains incompletely defined. This review summarizes the current literature regarding the role of urinary microbiome in the pathogenesis and treatment outcomes, highlights limitations of existing studies, and outlines future directions for incorporating microbiome profiling into personalized management strategies.