Links between vaginal microbiota and urinary incontinence?
Common strategies to deal with stress urinary incontinence include exercises (to build up a weak perineum) and urinary pads (to absorb leaks). Perhaps one day probiotics may also play a role.
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About this article
Often considered taboo, urinary stress incontinence affects somewhere between 1 in 5 or 1 in 3 women, depending on the study. Motherhood and age increase the risk of these uncontrolled leaks, which can occur when lifting a full shopping bag, coughing, jumping, sneezing, or even laughing. Two mechanisms have traditionally been implicated: a weakening of the perineum (the muscular “hammock” which holds back the urogenital organs), particularly during pregnancy, and a weak urinary sphincter, the ring-shaped muscle that opens or closes the urethra, through which the bladder empties. According to a Chinese study 1 published in 2024, the vaginal microbiota may also play a role.
Incontinence linked to vaginal dysbiosis
The study shows that 84.5% of young mothers suffering from urinary incontinence present a vaginal microbiota imbalance, compared with 42.1% of mothers not suffering from urinary incontinence. Instead of a healthy vaginal flora where Lactobacillus dominates, the vast majority of young mothers suffering from incontinence present a vaginal flora in which Gardnerella, Streptococcus, Prevotella, Dialister, and Veillonella hold more ground.
Careful readers will ask what connects the vaginal flora to urinary leakage (i.e. to the urinary flora). The answer is simple: the anatomical proximity between the urethral and vaginal orifices. These two regions are separated by just a few millimeters, facilitating close relations between their microbiomes. In fact, previous studies have repeatedly shown the existence of links between vaginal bacteria and urogenital diseases, i.e. diseases of the urinary and/or vaginal system.
30% vs. 15% Many elderly people are affected by urinary incontinence, especially women: 30% of elderly women and 15% of elderly men suffer from urinary incontinence.
18% to 34% Stress urinary incontinence is widespread among post-partum and older women, with a prevalence of 18% to 34% depending on the study.
An overly interconnected vaginal microbiota?
Now back to the subject of bacteria in women suffering from post-partum urinary incontinence. Another characteristic of these women’s flora is a hyper-interconnectedness between the microorganisms inhabiting their vagina. In other words, a highly developed network of relationships between the various microorganisms. This is not a good sign: in general, microbiota with a high degree of interconnectedness are considered less stable and therefore more susceptible to imbalance and dysbiosis.
In conclusion, the authors believe this study points to a possible link between an unstable vaginal microbiota and stress urinary incontinence. However, nothing clearly shows the former causes the latter: the moisture created by leakage may modify the flora, or both the modified flora and incontinence may be two visible consequences of a yet undiscovered phenomenon.
