{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:05:25Z","timestamp":1790661925204,"version":"4.1.0"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004561","name":"Ministry of Education and Science of the Republic of Kazakhstan","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004561","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Stress urinary incontinence (SUI) is one of the most prevalent pelvic floor disorders in women. While previous studies have demonstrated associations between urinary incontinence and changes in vaginal microbial composition, the relationship between vaginal microbiota and anatomical characteristics of the lower urinary tract remains insufficiently investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the association between vaginal microbiota composition and sonographic parameters of the urethrovesical segment in women with SUI before and after surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This study included 100 women with SUI. Ultrasound assessment included measurements of urethral length and diameter, bladder neck mobility,\n                      <jats:italic>\u03b1<\/jats:italic>\n                      and\n                      <jats:italic>\u03b2<\/jats:italic>\n                      angles, and the internal bladder angle at rest and during the Valsalva maneuver. Vaginal samples were cultured and analyzed using MALDI-TOF mass spectrometry for species identification. All patients underwent transobturator midurethral sling surgery. Follow-up examinations were performed one month postoperatively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Prior to surgery, 238 microbial strains representing 49 species were isolated. Gram-positive microorganisms predominated, with Staphylococcus spp. (32.8%), Enterococcus spp. (19.8%), and Lactobacillus spp. (13.0%) being the most common taxa. Following surgery, the proportion of Lactobacillus spp. increased significantly from 13.0% to 33.5% (\n                      <jats:italic>p<\/jats:italic>\n                      =0.0001), while Staphylococcus spp. and Enterococcus spp. decreased significantly (\n                      <jats:italic>p<\/jats:italic>\n                      =0.007 and\n                      <jats:italic>p<\/jats:italic>\n                      =0.030, respectively). Overall bacterial load was also reduced (\n                      <jats:italic>p<\/jats:italic>\n                      =0.037). Significant clinical improvement was observed, reflected by marked reductions in ICIQ-SF, UDI-6, and OABSS scores. Correlation analysis demonstrated significant associations between vaginal microbiota and urethrovesical anatomy. Longer urethral length was associated with gram-positive flora and staphylococcal colonization, whereas gram-negative microorganisms, particularly Enterobacterales, were associated with shorter urethral length and smaller urethral diameter. Enterobacterial colonization was linked to a 12.1% narrower urethra (\n                      <jats:italic>p<\/jats:italic>\n                      =0.003). Additional associations were identified between specific bacterial groups and dynamic changes in\n                      <jats:italic>\u03b2<\/jats:italic>\n                      -angle and internal bladder angle measurements.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Surgical treatment of SUI is associated with significant symptom improvement and early changes in the structure of the cultivable vaginal microbiota, including an increased representation of Lactobacillus spp. The observed associations between characteristics of the vaginal microbiota and sonographic parameters of the urethrovesical segment suggest a possible relationship between the anatomical and functional characteristics of the lower urinary tract and the local microbial environment. However, the nature of these associations and their causal direction remain undetermined. The findings should therefore be considered hypothesis-generating and require confirmation in prospective studies with a control group, longer follow-up, and the use of modern microbiome profiling methods.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1915642","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:50:43Z","timestamp":1790661043000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Anatomy of urethro-vesical segment and vaginal microbiota: is there any connection at stress urinary incontinence?"],"prefix":"10.3389","volume":"13","author":[{"given":"Yermek M.","family":"Turgunov","sequence":"first","affiliation":[{"name":"Department of surgical diseases, Karaganda State Medical University","place":["Karaganda, Kazakhstan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonid V.","family":"Sevastyanov","sequence":"additional","affiliation":[{"name":"Department of urology, pediatric and plastic surgery, Karaganda State Medical University","place":["Karaganda, Kazakhstan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyona V.","family":"Lavrinenko","sequence":"additional","affiliation":[{"name":"Scientific research laboratory, Karaganda State Medical University","place":["Karaganda, Kazakhstan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yelena V.","family":"Avilova","sequence":"additional","affiliation":[{"name":"LLP Alanda Clinic","place":["Karaganda, Kazakhstan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1177\/2053369120927112","article-title":"Management of urinary incontinence","volume":"26","author":"Nightingale","year":"2020","journal-title":"Post Reprod Health"},{"key":"B2","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1080\/13697137.2018.1543263","article-title":"The prevalence of urinary incontinence","volume":"22","author":"Milsom","year":"2019","journal-title":"Climacteric"},{"key":"B3","doi-asserted-by":"publisher","first-page":"123","DOI":"10.21037\/atm.2016.03.16","article-title":"The epidemiology of urinary incontinence: a case still open","volume":"4","author":"Serati","year":"2016","journal-title":"Ann Transl Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"95","DOI":"10.20953\/1726-1678-2025-5-95-101","article-title":"Urogenital microflora in women with urinary incontinence. 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