1
|
Bilé Silva A, Dinis PJ, Abranches Monteiro L. Systematic review of urinary biomarkers of female bladder outlet obstruction (fBOO). Arch Ital Urol Androl 2022; 94:355-359. [DOI: 10.4081/aiua.2022.3.355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 06/05/2022] [Indexed: 11/22/2022] Open
Abstract
Objective: Diagnosis of bladder outlet obstruction (BOO) in females is often challenging, not only because of the overlap in storage and voiding symptoms in women with various etiologies of lower urinary tract (LUT) dysfunction but also due to the lack of standardized urodynamic criteria to define the condition. There is an unmet need of biologic markers to evaluate BOO in females as an adjunct to other clinical criteria. We sought to elucidate the role of urinary biomarkers in female BOO. Material and methods: We performed a systematic review of studies involving urinary biomarkers in female BOO. The search was performed in PubMed. A total of 58 papers were retrieved and 2 were included for final analysis.Results: Currently, there are no validated biologic markers for female BOO available. Having a biomarker that can be obtained through a urine sample will be an invaluable tool to evaluate and counsel patients with LUT symptoms and possible BOO. The use of NGF as an indicator of BOO in female patients seems to be promising: NGF levels are elevated in women with BOO when compared with normal controls. Conclusions: We found that NGF levels may be applied as a useful biomarker in the diagnosis and evaluation of female patients with BOO symptoms. It will not completely replace other clinical diagnostic tools such as formal urodynamic testing but play a role as a supplement to it. Nevertheless, further studies should be conducted to establish NGF levels as a female BOO biomarker and a routine testing modality.
Collapse
|
2
|
Defining Bladder Outlet Obstruction in Women. CURRENT BLADDER DYSFUNCTION REPORTS 2022. [DOI: 10.1007/s11884-022-00654-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
|
3
|
The surgical effect on overactive bladder symptoms in women with pelvic organ prolapse. Sci Rep 2021; 11:20193. [PMID: 34642384 PMCID: PMC8511333 DOI: 10.1038/s41598-021-99537-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 09/03/2021] [Indexed: 12/15/2022] Open
Abstract
This study aimed to explore the effect of pelvic reconstruction surgery on the relation of pelvic organ prolapse (POP) and overactive bladder (OAB) and the impact of preoperative vaginal oestrogen supplement on vaginal tissue. A total of 100 postmenopausal women with symptomatic POP who underwent pelvic reconstruction surgery (laparoscopic sacrocolpopexy or transvaginal mesh) were enrolled in this study. Preoperative vaginal oestrogen was prescribed in 28 cases. The evaluation tools consisted of POP-Q, urodynamic study, Overactive Bladder Symptom Score (OABSS), and urinary NGF. Vaginal maturation index and vaginal specimens for hormone receptors study were investigated during operation to evaluate the effect of topical oestrogen. Follow-up assessments were performed at 1, 3, and 6 months after surgery. Preoperatively, 58 (58%) were POP with OAB. After reconstruction surgery, the OABSS decreased significantly (6.87 ± 0.85 vs 3.77 ± 0.61, p < 0.001) at postoperative 6 months in the group. Remarkable increasing trends of urinary NGF levels are noted till 3 months postoperatively, then decreasing to the baseline level at 6 months postoperative follow-up. Remarkable decrease of mRNA of the androgen receptor and significant higher expression of progesterone receptor (PR) were noted after use of the vaginal oestrogen cream. The severity of OAB in the POP women shows moderate degree according to OABSS. Pelvic reconstruction surgery can significantly improve the OAB symptoms. The surgery induced inflammation effect lasts for about 6 months. Short-term preoperative supplement of topical oestrogen brings alterations of the vaginal epithelium.
Collapse
|
4
|
Salehi-Pourmehr H, Ghojazadeh M, Jahantabi E, Hajebrahimi S. Diagnostic value of nerve growth factor in detrusor overactivity: a study on women with mixed urinary incontinence. Int Urol Nephrol 2021; 53:1557-1562. [PMID: 33866484 DOI: 10.1007/s11255-021-02864-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/11/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Urinary incontinence has a profound impact on women's quality of life. Studies have shown that changes in urinary protein levels could be a potential diagnostic biomarker in some urological diseases. The aim of present study is to determine the diagnostic value of nerve growth factor (NGF) in women with mixed urinary incontinence (MUI) as a diagnostic biomarkers of detrusor overactivity (DO). METHODS Seventy women aged between 20 and 75 years with MUI were enrolled in this prospective study. All participants underwent urodynamic study. Urine NGF levels were measured using an ELISA method. NGF level was compared between groups using Mann-Whitney U test. Receiver Operator Characteristic (ROC) analysis was employed to evaluate the diagnostic performance of urinary NGF. RESULTS The results showed that the median (min, max) of NGF in patients with DO was significantly higher in comparing to its level in women without DO [184.10 (31, 346.60) pg/ml vs. 151.80 (21, 210.70)], respectively (P = 0.035). Using receiver-operator characteristics analysis, the threshold urinary NGF value of 102.00 pg/ml provided a sensitivity of 88% and specificity of 40% in diagnosing DO, PPV of 39.1%, and NPV of 88.2%, positive likelihood ratio 2.18 and negative likelihood ratio of 0.45 (P = 0.02). CONCLUSION Based on high sensitivity and low specificity, we can conclude that NGF can be a good tool for ruling out the OAB when the test is negative. However, the future investigations are needed to expand the observed correlation in larger groups of women with DO.
Collapse
Affiliation(s)
- Hanieh Salehi-Pourmehr
- Research Center for Evidence-Based Medicine, Iranian EBM Centre: A Joanna Briggs Institute (JBI) Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Morteza Ghojazadeh
- Research Center for Evidence-Based Medicine, Iranian EBM Centre: A Joanna Briggs Institute (JBI) Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elham Jahantabi
- Urology Department, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sakineh Hajebrahimi
- Research Center for Evidence-Based Medicine, Iranian EBM Centre: A Joanna Briggs Institute (JBI) Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran.
- Urology Department, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
| |
Collapse
|
5
|
Jiang YH, Jhang JF, Hsu YH, Ho HC, Kuo HC. Potential urine biomarkers in bladder outlet obstruction-related detrusor underactivity. Tzu Chi Med J 2021; 34:388-393. [PMID: 36578642 PMCID: PMC9791853 DOI: 10.4103/tcmj.tcmj_298_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 12/27/2020] [Accepted: 12/30/2020] [Indexed: 12/31/2022] Open
Abstract
Detrusor underactivity (DU), an important but under-researched issue, is thought to be complex and multifactorial in etiology, pathophysiology, and diagnosis. Bladder outlet obstruction (BOO) is one of the important known etiologies of DU, with significant morphologic and physiologic changes of the urothelium, suburothelium, and detrusor muscle in the urinary bladder. Chronic urinary bladder ischemia and repeated cycles of ischemia and reperfusion injury cause excessive oxidative stress, and it is thought to be responsible for the development of DU. DU might be the late phase or decompensated status of BOO, with the possible mechanisms of afferent nervous dysfunction, increased inflammation, denervation of the detrusor muscle, and myogenic failure. Prostaglandin E2 (PGE2) involves in the physiological detrusor contraction, and might provide the prognostic value for the recoverability of DU. Neurotrophins, including nerve growth factor and brain-derived neurotrophic factor, involve in the neuroplastic changes in many inflammatory bladder diseases, including BOO and DU. Oxidative stress biomarkers, including 8-hydroxy-2-deoxyguanosine, F2-isoprostane, and the involved pro-inflammatory cytokines, have been applied in BOO due to their involvements in chronic bladder ischemia. PGE2, neurotrophins, inflammatory cytokines, and oxidative stress biomarkers are the potential urine biomarkers in BOO-related DU.
Collapse
Affiliation(s)
- Yuan-Hong Jiang
- Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
| | - Jia-Fong Jhang
- Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
| | - Yung-Hsiang Hsu
- Department of Pathology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
| | - Han-Chen Ho
- Department of Anatomy, Tzu Chi University, Hualien, Taiwan
| | - Hann-Chorng Kuo
- Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan,Address for correspondence: Dr. Hann-Chorng Kuo, Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 707, Section 3, Chung-Yang Road, Hualien, Taiwan. E-mail:
| |
Collapse
|
6
|
Rada MP, Ciortea R, Măluţan AM, Doumouchtsis SK, Bucuri CE, Clim A, Roman A, Mihu D. The profile of urinary biomarkers in overactive bladder. Neurourol Urodyn 2020; 39:2305-2313. [PMID: 32813897 DOI: 10.1002/nau.24487] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 08/06/2020] [Indexed: 12/20/2022]
Abstract
AIMS In overactive bladder (OAB) research, different biomarkers have been proposed as diagnostic tools and may be used to create individual patient profiles. Assessing the diagnostic performance of biomarkers would better outline their utility. Therefore, our aim was to investigate the diagnostic value of four urinary biomarkers: human brain derived neurotrophic factor (hBDNF), malondialdehyde (MDA), h nerve growth factor (hNGF) and h 8-hydroxydeoxyguanosine in women with OAB. These are neurotrophins/oxidative stress markers that have been linked to lower urinary tract symptoms. METHODS A total of 105 women were included in the study and distributed in two groups: a group with OAB (n = 53) and a control group (n = 50). The levels of the biomarkers were determined using enzyme-linked immunosorbent assay technique and they were compared between the groups. If the Mann-Whitney test demonstrated a statistically significant difference, receiver operating curves (ROC) analysis was undertaken. RESULTS When normalized to urinary creatinine, hBDNF, MDA, and hNGF showed significantly increased values in women with OAB as compared to controls, whereas 8-OHdG showed no significant difference. The diagnostic performance of these biomarkers was analyzed based on the area under the ROC curve (AUC). MDA had the highest AUC (0.75), followed by hNGF (0.69) and hBDNF (0.67). CONCLUSIONS Our findings suggest that MDA, a relatively novel biomarker in OAB research, has a fair performance as a diagnostic tool for OAB. Moreover, urinary neurotrophins (NGF and BDNF) as biomarkers may have a role in the diagnostic pathways of women with OAB symptoms.
Collapse
Affiliation(s)
- Maria Patricia Rada
- 2nd Department of Obstetrics-Gynaecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Răzvan Ciortea
- 2nd Department of Obstetrics-Gynaecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Andrei Mihai Măluţan
- 2nd Department of Obstetrics-Gynaecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Stergios K Doumouchtsis
- Department of Obstetrics and Gynaecology, Epsom & St Helier University Hospitals NHS Trust, UK
- Institute of Medical and Biomedical Education, St George's University of London, London, UK
- Laboratory of Experimental Surgery and Surgical Research N S Christeas, Athens University Medical School, Athens, Greece
- American University of the Caribbean School of Medicine, Florida
| | - Carmen Elena Bucuri
- 2nd Department of Obstetrics-Gynaecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Adelina Clim
- 2nd Department of Obstetrics-Gynaecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Andrei Roman
- Department of Radiology, "Prof. Dr. Ion Chiricuţă" Oncology Institute Cluj-Napoca, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Dan Mihu
- 2nd Department of Obstetrics-Gynaecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| |
Collapse
|
7
|
Abstract
PURPOSE OF REVIEW The diagnosis and evaluation of bladder outlet obstruction (BOO) in women remains a challenging topic. The goal of this study is to review recent literature and summarize the diagnosis and management of BOO with special focus on recent progress. RECENT FINDINGS In recent years, numerous advances in the area of female BOO have taken place including a movement towards unified diagnostic criteria, summary of functional and anatomic causes, and exploration of potential diagnostic options. SUMMARY This review discusses the known diagnosis and management of female bladder outlet obstruction, yet highlights specific functional causes, new criteria available for diagnosis, and long-term results of treatment options.
Collapse
|
8
|
New frontiers in molecular and imaging research on evaluation and diagnosis of bladder outlet obstruction in women. CURRENT BLADDER DYSFUNCTION REPORTS 2017; 12:291-297. [PMID: 29225720 DOI: 10.1007/s11884-017-0429-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Purpose Diagnosis of bladder outlet obstruction (BOO) often presents a challenge in female patients. Traditional diagnostic elements such as symptom history and urodynamic data are rarely clear cut in women. Therefore, we sought to review the current literature on diagnosis of female BOO, focusing on new frontiers in the realm of molecular markers and imaging modalities. Recent Findings In addition to fluoroscopy in the setting of videourodynamics, ultrasound and MRI can augment the diagnosis and aid in therapeutic planning in certain etiologies of female BOO. Furthermore, multiple potential biomarkers (i.e. nerve growth factor, prostaglandins, ATP) that have been studied in correlation to BOO in animal models as well as human subjects hold promise for diagnostic applications. Summary These novel techniques may augment standard clinical and urodynamic evaluation of BOO in females. Future directions include further studies of each of these biomarkers in female patients with BOO compared to normal controls to test their feasibility as potential screening tools.
Collapse
|
9
|
Gordon A, Skarecky D, Babaian KN, Dhaliwal H, Ahlering TE. Diminished long-term recovery of peak flow rate (PFR) after robotic prostatectomy in men with baseline PFR <10 mL/s and incidental association with high-risk prostate cancer. Low Urin Tract Symptoms 2017; 11:78-84. [PMID: 29193833 DOI: 10.1111/luts.12199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 07/18/2017] [Accepted: 08/03/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the effects of robot-assisted radical prostatectomy (RARP) on uroflowmetry (UF) parameters among men with baseline peak flow rates (PFR) <10 mL/s. METHODS A single-surgeon RARP database of 1082 men who underwent prospective UF testing was analyzed. Men filled out International Prostate Symptom Score questionnaires and underwent uroflowmetry and post-void bladder ultrasound before surgery and at each follow-up visit. Patients were divided into 2 groups based on preoperative PFR: those with PFR <10 mL/s (n = 158) and those with PFR ≥10 mL/s (n = 924). Univariate and multivariate regression models tested the association of preoperative characteristics in predicting postoperative PFR improvement. Within the PFR <10 mL/s group, preoperative variables were analyzed to predict pathologic outcomes. RESULTS Three months after RARP, men with baseline PFR <10 mL/s had a 3-fold improvement in PFR (from mean of 7.0 to 24.2 mL/s), whereas in men with PFR ≥10 mL/s there was a 50% improvement (from mean of 19.7 to 28.9 mL/s; P < .001). Improvement in PFR remained stable for >5 years, but mean postoperative PFR was 20% lower in men with baseline PFR <10 mL/s. Preoperative prostate-specific antigen (odds ratio [OR] 0.75; 95% confidence interval [CI] 0.59-0.95) and PFR (OR 0.52; 95% CI 0.34-0.80) were independent predictors of the percentage improvement in men with baseline PFR <10 mL/s. Preoperative PFR ≤7 mL/s was an independent predictor of Gleason score ≥8 (P = .016), seminal vesicle invasion (P = .010), and lymph node invasion (0.029). CONCLUSIONS After RARP, PFR improved significantly, with the improvement persisting over long-term follow-up. However, men with baseline PFR <10 mL/s had a 20% lower postoperative PFR over 5 years, suggesting permanent damage to the bladder and the need for early treatment to maintain bladder health. There appears to be an association between baseline PFR ≤7 mL/s and adverse pathologic features.
Collapse
Affiliation(s)
- Adam Gordon
- Department of Urology, University of California Irvine, Orange, California.,Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Douglas Skarecky
- Department of Urology, University of California Irvine, Orange, California
| | - Kara N Babaian
- Department of Urology, University of California Irvine, Orange, California
| | - Harleen Dhaliwal
- Department of Urology, University of California Irvine, Orange, California
| | - Thomas E Ahlering
- Department of Urology, University of California Irvine, Orange, California
| |
Collapse
|
10
|
Urinary Biomarkers for Bladder Outlet Obstruction. CURRENT BLADDER DYSFUNCTION REPORTS 2017. [DOI: 10.1007/s11884-017-0418-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
11
|
Gammie A, Kirschner-Hermanns R, Rademakers K. Evaluation of obstructed voiding in the female: how close are we to a definition? Curr Opin Urol 2015; 25:292-5. [PMID: 26049870 DOI: 10.1097/mou.0000000000000182] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The difficulties of defining and evaluating bladder outlet obstruction (BOO) in the female patient have been described for several years. This review aims to examine recent literature to summarize progress in the area. RECENT FINDINGS Within the last 2 years, functional causes of female BOO have been summarized, new nomograms proposed, several case reports of different causes of BOO have been published and work on surgical outcomes and possible diagnostics reported. SUMMARY Women complain of voiding dysfunction because of different reasons. For clinical decision-making, and to evaluate different surgical procedures, finding a way of detecting and quantifying infravesical obstruction is immensely helpful. This review aims to clarify questions concerning definitions of BOO in women and provide an update on recent advances.
Collapse
Affiliation(s)
- Andrew Gammie
- aBristol Urological Institute, Southmead Hospital, Bristol, UK bUniversity Clinic, Rheinisch Friedrich-Wilhelms University - Clinic of Urology/Neuro-Urology, Bonn, Germany cDepartment of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | | |
Collapse
|