top of page

BackTable / OBGYN / Podcast / Episode #15

The Microbiome

with Dr. Ian Fields

In this episode, Dr. Ian Fields joins Dr. Mark Hoffman at the mic to discuss the role of the microbiome in obstetrical and gynecological conditions.

Be part of the conversation. Put your sponsored messaging on this episode. Learn how.

The Microbiome with Dr. Ian Fields on the BackTable OBGYN Podcast)
Ep 15 The Microbiome with Dr. Ian Fields
00:00 / 01:04

BackTable, LLC (Producer). (2023, February 23). Ep. 15 – The Microbiome [Audio podcast]. Retrieved from https://www.backtable.com

Free CME

Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs. Follow the button below to claim your credits on CMEfy.

BackTable CMEfy button

Stay Up To Date

Follow:

Subscribe:

Sign Up:

Podcast Contributors

Dr. Ian Fields discusses The Microbiome on the BackTable 15 Podcast

Dr. Ian Fields

Dr. Ian Fields is a urogeyncologist and an assistant professor with OHSU School of Medicine in Portland, Oregon.

Dr. Mark Hoffman discusses The Microbiome on the BackTable 15 Podcast

Dr. Mark Hoffman

Dr. Mark Hoffman is a minimally invasive gynecologic surgeon at the University of Kentucky.

Synopsis

Dr. Ian Fields completed a fellowship in Female Pelvic Medicine & Reconstructive Surgery and received a Master of Clinical Research degree from Oregon Health & Sciences University. His research focuses on changes in the urinary microbiome and their association with lower urinary tract symptoms.

Dr. Fields begins the episode by describing the microbiome as “all of the things outside of our cells that make up the human body,” which includes bacteria, viruses, and fungi. He explains that the microbiome may play a role in how humans maintain states of health, in addition to having large impacts on the pathophysiology or development of disease states. Dr. Fields references the Human Microbiome Project, a United States National Institutes of Health research initiative that was aimed to improve the understanding of microbiota in relation to human health and diseases.

The physicians then transition to cover the role of the microbiome, specifically in the field of obstetrics and gynecology. Dr. Fields explains that the most studied condition is bacterial vaginosis. From a urogynecology perspective, he expresses a particular interest in urinary tract disorders, such as urinary incontinence, recurrent urinary tract infections, and interstitial cystitis. Dr. Fields emphasizes to listeners that urine is not sterile. In addition, he highlights how the use of vaginal estrogen increases the presence of lactobacillus within the genital microbiome, and thus is beneficial in the settings of genitourinary syndrome of menopause and recurrent menopause.

Dr. Fields concludes the episode by briefly addressing other areas of study regarding the microbiome in the field of obstetrics and gynecology. For example, studies have revealed a link between vaginal microbiota and risk of preterm birth, as well as neonatal gut microbiota and the mode of delivery. Ultimately, Dr. Fields states that the microbiome is an underfunded and understudied aspect of medicine, and he urges listeners to acknowledge the large potential the field has.

Resources

The Human Microbiome Project:
https://hmpdacc.org/hmp/overview/

Brubaker L, Nager CW, Richter HE, Visco A, Nygaard I, Barber MD, Schaffer J, Meikle S, Wallace D, Shibata N, Wolfe AJ. Urinary bacteria in adult women with urgency urinary incontinence. Int Urogynecol J. 2014 Sep;25(9):1179-84.

Wolfe AJ, Toh E, Shibata N, Rong R, Kenton K, Fitzgerald M, Mueller ER, Schreckenberger P, Dong Q, Nelson DE, Brubaker L. Evidence of uncultivated bacteria in the adult female bladder. J Clin Microbiol. 2012 Apr;50(4):1376-83.

Hoffman C, Siddiqui NY, Fields I, Gregory WT, Simon HM, Mooney MA, Wolfe AJ, Karstens L. Species-Level Resolution of Female Bladder Microbiota from 16S rRNA Amplicon Sequencing. mSystems. 2021 Oct 26;6(5):e0051821.

Richter HE, Carnes MU, Komesu YM, Lukacz ES, Arya L, Bradley M, Rogers RG, Sung VW, Siddiqui NY, Carper B, Mazloomdoost D, Dinwiddie D, Gantz MG; Eunice Kennedy Shriver National Institute of Child Health and Human Development Pelvic Floor Disorders Network. Association between the urogenital microbiome and surgical treatment response in women undergoing midurethral sling operation for mixed urinary incontinence. Am J Obstet Gynecol. 2022 Jan;226(1):93.e1-93.e15.

Fettweis, J.M., Serrano, M.G., Brooks, J.P. et al. The vaginal microbiome and preterm birth. Nat Med 25, 1012–1021 (2019).

Transcript Preview

[Dr. Mark Hoffman]
What are ways that we think the microbiome is impacting disease processes and the urinary tracts of our patients?

[Dr. Ian Fields]
A lot of work has really been done specifically in urinary incontinence, so both the types of incontinence that I see as a urogynecologist, stress incontinence, which is leakage of urine that happens with activities like cough, laugh, sneeze, exercise, things like that, and urgency urinary incontinence, which is really a lot well less understood how that happens.

I think we can see how stress incontinence happens typically because of pregnancy, childbirth, you lose support of the urethra, therefore, activities that increase intra-abdominal pressure like cough, laugh, and sneeze could potentially lead to loss of urine involuntarily.

[Dr. Mark Hoffman]
That seems more of a functional thing. When you said you thought the microbiome had a role with stress incontinence, I was like, "I thought we understood that, because it was pelvic floor stuff and now you're saying there's like more to the story.

[Dr. Ian Fields]
There is, there is. When we think of stress incontinence specifically, a lot of the work has been done about response to surgery, and there was this large trial that was just presented and published I believe in the GREY Journal within the last year or so showing that the presence of different bacteria in the bladder at the time of surgery or before surgery could predict somebody's response to mid-urethral sling surgery. It was down to a couple different genera of bacteria that when present may potentially lead somebody to not respond as well to mid-urethral sling surgery.

Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

backtable-earn-free-cme.jpg
backtable-plus-vi-cta.jpg
Become a BackTable Sponsor

Up Next

Insights on OBGYN Coding & Reimbursements with Dr. Barbara Levy on the BackTable OBGYN Podcast)
Reevaluating Activity Guidelines After Surgery with Dr. Margaret Mueller and Dr. Kim Kenton on the BackTable OBGYN Podcast)
Innovating Urology: Surgeons Trailblazing Solutions with Dr. Alexandra Haessler, Dr. Jay Shakuri-Rad, and Dr. Tova Weiss on the BackTable OBGYN Podcast)
Navigating Adenomyosis: From Misconceptions to Innovative Solutions with Dr. Keith Isaacson on the BackTable OBGYN Podcast)
Menopause Matters: Clinical Strategies & Patient Support with Dr. Jessica Ritch on the BackTable OBGYN Podcast)
In-Depth: Endometrial Ablation with Dr. Barbara Levy on the BackTable OBGYN Podcast)

Articles

The Microbiome & Its Effects On Human Health

The Microbiome & Its Effects on Human Health

The Role of the Microbiome in Gynecological Disorders

The Role of the Microbiome in Gynecological Disorders

Topics

Urinary Incontinence Condition Overview

Get in touch!

We want to hear from you. Let us know if you’re interested in partnering with BackTable as a Podcast guest, a sponsor, or as a member of the BackTable Team.

Select which show(s) you would like to subscribe to:

Thanks! Message sent.

bottom of page