Emerging evidence has shown the impact of the microbiome on solid organ malignancies such as gastric (H. pylori) and cervical cancer (HPV). Thus, a clinically relevant question would be whether the urinary microbiome has any effect on bladder carcinogenesis and whether specific microbial profiles can help prognosticate disease outcomes. Another provocative consideration is whether its manipulation can turn patients from non-responders into responders of local therapy. Thus far, the role of microorganisms in bladder cancer pathogenesis has not been fully understood.