Mixed Urogenital Flora – All You Need To Know

Julian Selemin
Julian Selemin
March 14, 2023
min read
Technically reviewed by: 
Charisse Cartin
Mixed Urogenital Flora – All You Need To Know

What Is Urogenital Flora?

Urogenital flora is a micro-ecosystem of bacteria that live in the urogenital tract — the combination of the urinary and reproductive systems. This flora helps you maintain a healthy balance in the tract, preventing infections and other health problems.

The bacterial community comprises several species, varying according to a person’s age, health conditions, and several other factors. The most common bacteria found in the urogenital tract are1:

  • Lactobacillus
  • Escherichia coli
  • Peptostreptococci
  • Corynebacteria
  • Streptococci

In women, a balanced urogenital flora is key to maintaining a healthy vagina. These bacteria are responsible for producing the slightly acidic environment of the reproductive system, which helps keep harmful microorganisms away. Yet, this balance can sometimes get disrupted, resulting in a condition called “mixed urogenital flora."

What Is Mixed Urogenital Flora?

Mixed urogenital flora refers to an unusual growth of multiple types of bacteria in your urogenital tract. This can lead to several health problems and cause symptoms similar to a urinary tract infection (UTI)2. It can occur in men and women alike, although it’s often associated with women due to its close link with bacterial vaginosis3.

As most people know, a single type of bacteria overgrowing in the urogenital tract (a clear symptom of a UTI) isn’t uncommon. It’s estimated that about 50% to 60% of adult women get at least one UTI over the course of their lives2. However, when a urine test shows that multiple bacteria are overgrowing, it can be a sign of more severe health problems or a contamination issue.

Mixed Urogenital Flora Meaning in a Test

If you get a mixed urogenital flora test result, there are three main possibilities. The first and more serious one involves an infection or other health problem that arises from the unusual presence of several microorganisms in the urogenital tract.

For example, mixed urogenital flora could mean that you have a UTI that’s caused by one type of those bacteria, like a lactobacillus UTI2. Another possibility is bacterial vaginosis — a bacterial imbalance inside the vagina3. Similarly, yeast infections are also caused by alterations in the vaginal micro-ecosystem4.

However, getting a mixed urogenital flora result from your urine test could also mean that nothing is wrong. As mentioned above, the urogenital flora naturally contains several microorganisms that provide protection against harmful pathogens. As such, your case may need to be supervised by a doctor to distinguish if the result stems from a health problem or natural urogenital tract balance.

Finally, mixed urogenital flora is often the result of contaminated urine samples5, 6. Due to the closeness between your urogenital tract and your anus, sometimes bacteria can get across during a urine test. Manipulating your genitals with your hands during urine collection can also cause the same phenomenon.

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Treating Mixed Urogenital Flora

The treatment for mixed urogenital flora — if it needs any treatment at all — will depend on its exact cause. Doctors may prescribe antibiotics, antifungals, and anti-inflammatory medications to eliminate the excess microorganisms. Unfortunately, there’s no best antibiotic for mixed urogenital flora, as the exact medication will depend on which bacteria are overgrowing.

Similarly, doctors may recommend lifestyle and diet changes along with using barrier protection methods during sex. Probiotics may also help restore vaginal and urinary flora. Lactobacillus rhamnosus GR-1 is one of the most popular choices for this, as it has been widely studied and proven to be successful in restoring microfloral balance7.

Preventing Mixed Urogenital Flora

Preventing mixed urogenital flora, like most flora-related problems, begins with maintaining good genital hygiene. This includes gently and regularly washing the area with soap and water, avoiding harsh chemicals, and practicing safe sex. Similarly, taking probiotics can help you ensure a healthy and balanced urogenital flora.

However, if your mixed urogenital flora result stems from a contaminated urine sample, you’ll need to revise your urine collection technique. To get a clean sample, you need to collect mid-stream urine only (meaning you don't collect the first and last part of urine that comes out), using your hands as little as possible. If you still find yourself accidentally contaminating samples, make sure to check with a doctor for more precise instructions.


Mixed urogenital flora can arise from three causes: overgrowth of multiple bacteria, the natural balance of your urogenital microorganisms, and sample contamination. While a mixed urogenital flora test result usually doesn't indicate something serious, it's best to seek a doctor's advice to ensure you're not at risk of developing infections like UTI.

  1. Davis CP. Normal Flora. In: Baron S, editor. Medical Microbiology. 4th edition. Galveston (TX): University of Texas Medical Branch at Galveston; 1996. Chapter 6.
  2. Medina, M., & Castillo-Pino, E. (2019). An introduction to the epidemiology and burden of urinary tract infections. Therapeutic advances in urology, 11, 1756287219832172.
  3. Abou Chacra, L., Fenollar, F., & Diop, K. (2022). Bacterial Vaginosis: What Do We Currently Know?. Frontiers in cellular and infection microbiology, 11, 672429.
  4. Mayo Foundation for Medical Education and Research. (2022, December 6). How to keep your vagina healthy. Mayo Clinic. Retrieved February 22, 2023,
  5. Siegman-Igra, Y. (1994). The significance of urine culture with mixed flora. Current Opinion in Nephrology and Hypertension, 3(6), 656–659.
  6. Folaranmi, T., Harley, C., Jolly, J., & Kirby, A. (2022). Clinical and microbiological investigation into mixed growth urine cultures. Journal of Medical Microbiology, 71(5).
  7. Reid, G., Charbonneau, D., Erb, J., Kochanowski, B., Beuerman, D., Poehner, R., & Bruce, A. W. (2003). Oral use of Lactobacillus rhamnosus GR-1 and L. fermentum RC-14 significantly alters vaginal flora: randomized, placebo-controlled trial in 64 healthy women. FEMS immunology and medical microbiology, 35(2), 131–134.
About the Author
Julian Selemin

Julian Selemin is a freelance writer with a burning passion for learning new languages. He has a BA in Languages and is currently majoring in Contemporary Music — however, research is one of his strongest points, so he also likes to write outside of those topics. His writing niches include medicine and alternative medicine, music, and business.

About the Reviewer
This blog was
Technically reviewed by: 
Charisse Cartin

Charisse Cartin is a talented and dedicated editor who has contributed significantly to this blog.

The blog was also reviewed by the Diagnox content team. Diagnox Staff consists of a multidisciplinary team of scientists, content writers, and healthcare professionals with an expertise to create and review high-quality, informative, accurate, and easy-to-understand content for both professionals and everyday readers. Our staff follows strict guidelines to ensure the credibility and authenticity of the information, reviewing them independently and verifying them by various scientific and technical sources to ensure accuracy. Our review team believes in delivering knowledge free from bias to improve public health and well-being.

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