The Role of the Male Urobiome and Dysbiosis in the Pathogenesis of Prostatic Diseases (CP/CPPS and BPH).
A Narrative Review
DOI:
https://doi.org/10.12775/JEHS.2026.94.72782Keywords
Microbiota, Prostatitis, Prostatic Hyperplasia, DysbiosisAbstract
Background. For decades, the male urinary tract was considered sterile. Next-generation sequencing (NGS) overturned this dogma, revealing a complex urobiome.
Aim. This study aims to summarize literature on the physiological male urobiome and evaluate the impact of its dysbiosis on the pathogenesis of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and benign prostatic hyperplasia (BPH).
Material and methods. A narrative review was conducted using PubMed and Scopus, focusing on contemporary literature (2017–2025). Keywords included: male urobiome, urinary microbiome, chronic prostatitis, benign prostatic hyperplasia, dysbiosis. Case reports and animal models were excluded, prioritizing human clinical data and NGS-based analyses with rigorous negative controls.
Results. The healthy male urobiome exhibits multi-species diversity (e.g., Corynebacterium, Streptococcus). In CP/CPPS, hidden dysbiosis replaces the sterility concept; anaerobic enrichment directly correlates with pain and inflammation. In BPH, dysbiosis acts as an inflammatory cofactor driving tissue growth. Urobiome destabilization is linked to metabolic syndrome and visceral obesity, generating systemic inflammation and exacerbating lower urinary tract symptoms (LUTS).
Conclusions. Dysbiosis plays a pivotal role in CP/CPPS and BPH pathogenesis. Instead of ineffective empirical antibiotic therapy destroying commensal flora, modern strategies should rely on microbiome modulation (targeted probiotics) and biofilm eradication (bacteriophages for catheter infection prevention).
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Copyright (c) 2026 Hubert Bigajski, Filip Basta, Katarzyna Mostowska, Alicja Tomasiak, Krystian Głąbiński, Aleksandra Kałużna, Agata Tutkaj, Julia Nemś, Gabriela Zając, Michał Węgrzyn
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