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Kwon J, Kim DY, Cho KJ, Hashimoto M, Matsuoka K, Kamijo T, Wang Z, Karnup S, Robertson AM, Tyagi P, Yoshimura N. Pathophysiology of Overactive Bladder and Pharmacologic Treatments Including β3-Adrenoceptor Agonists -Basic Research Perspectives. Int Neurourol J 2024; 28:12-33. [PMID: 38461853 DOI: 10.5213/inj.2448002.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 01/10/2024] [Indexed: 03/12/2024] Open
Abstract
Overactive bladder (OAB) is a symptom-based syndrome defined by urinary urgency, frequency, and nocturia with or without urge incontinence. The causative pathology is diverse; including bladder outlet obstruction (BOO), bladder ischemia, aging, metabolic syndrome, psychological stress, affective disorder, urinary microbiome, localized and systemic inflammatory responses, etc. Several hypotheses have been suggested as mechanisms of OAB generation; among them, neurogenic, myogenic, and urothelial mechanisms are well-known hypotheses. Also, a series of local signals called autonomous myogenic contraction, micromotion, or afferent noises, which can occur during bladder filling, may be induced by the leak of acetylcholine (ACh) or urothelial release of adenosine triphosphate (ATP). They can be transmitted to the central nervous system through afferent fibers to trigger coordinated urgency-related detrusor contractions. Antimuscarinics, commonly known to induce smooth muscle relaxation by competitive blockage of muscarinic receptors in the parasympathetic postganglionic nerve, have a minimal effect on detrusor contraction within therapeutic doses. In fact, they have a predominant role in preventing signals in the afferent nerve transmission process. β3-adrenergic receptor (AR) agonists inhibit afferent signals by predominant inhibition of mechanosensitive Aδ-fibers in the normal bladder. However, in pathologic conditions such as spinal cord injury, it seems to inhibit capsaicin-sensitive C-fibers. Particularly, mirabegron, a β3-agonist, prevents ACh release in the BOO-induced detrusor overactivity model by parasympathetic prejunctional mechanisms. A recent study also revealed that vibegron may have 2 mechanisms of action: inhibition of ACh from cholinergic efferent nerves in the detrusor and afferent inhibition via urothelial β3-AR.
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Affiliation(s)
- Joonbeom Kwon
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Leaders Urology Clinic, Daegu, Korea
| | - Duk Yoon Kim
- Department of Urology, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Kang Jun Cho
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Mamoru Hashimoto
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kanako Matsuoka
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Tadanobu Kamijo
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Zhou Wang
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Sergei Karnup
- Department of Pharmacology and Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Anne M Robertson
- Department of Mechanical Engineering and Materials Science, University of Pittsburgh School of Bioengineering, Pittsburgh, PA, USA
| | - Pradeep Tyagi
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Naoki Yoshimura
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Pharmacology and Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Vale L, Cruz F, Charrua A. Detrusor Overactivity After Partial Bladder Outlet Obstruction Is Associated With High Urinary Adenosine Triphosphate Levels in Female Wistar Rats. Int Neurourol J 2024; 28:34-39. [PMID: 38461854 DOI: 10.5213/inj.2346196.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/23/2023] [Indexed: 03/12/2024] Open
Abstract
PURPOSE Bladder outlet obstruction (BOO) commonly causes detrusor overactivity (DO). In this study, a post hoc analysis of previous obtained data, we investigate if DO occurring in initial phases of BOO is associated with changes in urinary adenosine triphosphate (ATP) levels. METHODS Adult female Wistar rats were submitted to partial BOO (pBOO) or to sham obstruction. Cystometry was performed at 3 or 15 days after pBOO and saline voided was collected for ATP determination. Normality was tested using Shapiro-Wilk test. The mean frequency of voiding contractions (VCs) of the sham-operated animals at 15 days after surgery, plus or minus 3 standard deviations, was used to represent the normal range. Statistical analyses were performed using the chi-square and Mann-Whitney tests. RESULTS DO was indicated by a VC frequency greater than or equal to 0.9 VCs/min. DO was observed in 63% of animals at 3 days and in 33% at 15 days following pBOO. ATP levels were significantly higher in rats with DO compared to those without DO. CONCLUSION The DO phenotype, occurring in the initial phases of BOO, is associated with comparatively high urinary ATP levels.
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Affiliation(s)
- Luís Vale
- Departmento de Biomedicina-Unidade de Farmacologia e Terapêutica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
- Serviço de Urologia, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Francisco Cruz
- Serviço de Urologia, Centro Hospitalar Universitário São João, Porto, Portugal
- Departmento de Cirurgia e Fisiologia-Faculdade de Medicina da Universidade do Porto, Porto, Portugal
- Translational Neurourology group, IBMC-Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal
- I3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Ana Charrua
- Translational Neurourology group, IBMC-Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal
- I3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- Departmento de Biomedicina-Unidade de Biologia Experimental, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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Casanova MR, Mota P, Vala H, Nóbrega C, Morais ADS, Silva CS, Barros AA, Reis RL, Lima E, Martins A, Neves NM. Functional recovery of injured cavernous nerves achieved through endogenous nerve growth factor-containing bioactive fibrous membrane. Acta Biomater 2023; 168:416-428. [PMID: 37467838 DOI: 10.1016/j.actbio.2023.07.015] [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: 01/31/2023] [Revised: 07/07/2023] [Accepted: 07/13/2023] [Indexed: 07/21/2023]
Abstract
Radical prostatectomy is a highly successful treatment for prostate cancer, among the most prevalent manifestations of the illness. Damage of the cavernous nerve (CN) during prostatectomy is the main cause of postoperative erectile dysfunction (ED). In this study, the capability of a personalized bioactive fibrous membrane to regenerate injured CN was investigated. The fibrous membrane bioactivity is conferred by the selectively bound nerve growth factor (NGF) present in the rat urine. In a rat model of bilateral CN crush, the implanted bioactive fibrous membrane induces CN regeneration and restoration of erectile function, showing a significantly increased number of smooth muscle cells and content of endothelial and neuronal nitric oxide synthases (eNOS; nNOS). In addition, the bioactive fibrous membrane promotes nerve regeneration by increasing the number of myelinated axons and nNOS-positive cells, therefore reversing the CN fibrosis found in untreated rats or rats treated with a bare fibrous membrane. Therefore, this personalized regenerative strategy could overcome the recognized drawbacks of currently available treatments for CN injuries. It may constitute an effective treatment for prostate cancer patients suffering from ED after being subject to radical prostatectomy. STATEMENT OF SIGNIFICANCE: The present work introduces a unique strategy to address post-surgical ED resulting from CN injury during pelvic surgery (e.g., radical prostatectomy, radical cystoprostatectomy, abdominoperineal resection). It comprises a bioactive and cell-free fibrous implant, customized to enhance CN recovery. Pre-clinical results in a rat model of bilateral CN crush demonstrated that the bioactive fibrous implant can effectively heal injured CN, and restore penile structure and function. This implant selectively binds NGF from patient fluids (i.e. urine) due to its functionalized surface and high surface area. Moreover, its local implantation reduces adverse side effects. This tailored regenerative approach has the potential to revolutionize the treatment of ED in prostate cancer patients following radical prostatectomy, overcoming current treatment limitations.
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Affiliation(s)
- Marta R Casanova
- 3B's Research Group; I3Bs - Research Institute on Biomaterials, Biodegradable and Biomimetics - University of Minho, European Institute of Excellence in Tissue Engineering and Regenerative Medicine Headquarters, Parque de Ciência e Tecnologia, Zona Industrial da Gandra - Avepark, Barco, Guimarães 4805-017, Portugal; ICVS/3B's - PT Government Associate Laboratory, Guimarães/Braga, Portugal
| | - Paulo Mota
- ICVS/3B's - PT Government Associate Laboratory, Guimarães/Braga, Portugal; Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga 4710-057, Portugal; Department of Urology, Hospital of Braga, E.P.E, Braga, Portugal
| | - Helena Vala
- Agrarian Superior School of Viseu (ESAV), Polytechnic Institute of Viseu, Viseu 3500-606, Portugal; Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes e Alto Douro, Portugal
| | - Carmen Nóbrega
- Agrarian Superior School of Viseu (ESAV), Polytechnic Institute of Viseu, Viseu 3500-606, Portugal; Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes e Alto Douro, Portugal
| | - Alain da Silva Morais
- 3B's Research Group; I3Bs - Research Institute on Biomaterials, Biodegradable and Biomimetics - University of Minho, European Institute of Excellence in Tissue Engineering and Regenerative Medicine Headquarters, Parque de Ciência e Tecnologia, Zona Industrial da Gandra - Avepark, Barco, Guimarães 4805-017, Portugal; ICVS/3B's - PT Government Associate Laboratory, Guimarães/Braga, Portugal
| | - Catarina S Silva
- 3B's Research Group; I3Bs - Research Institute on Biomaterials, Biodegradable and Biomimetics - University of Minho, European Institute of Excellence in Tissue Engineering and Regenerative Medicine Headquarters, Parque de Ciência e Tecnologia, Zona Industrial da Gandra - Avepark, Barco, Guimarães 4805-017, Portugal; ICVS/3B's - PT Government Associate Laboratory, Guimarães/Braga, Portugal
| | - Alexandre A Barros
- 3B's Research Group; I3Bs - Research Institute on Biomaterials, Biodegradable and Biomimetics - University of Minho, European Institute of Excellence in Tissue Engineering and Regenerative Medicine Headquarters, Parque de Ciência e Tecnologia, Zona Industrial da Gandra - Avepark, Barco, Guimarães 4805-017, Portugal; ICVS/3B's - PT Government Associate Laboratory, Guimarães/Braga, Portugal
| | - Rui L Reis
- 3B's Research Group; I3Bs - Research Institute on Biomaterials, Biodegradable and Biomimetics - University of Minho, European Institute of Excellence in Tissue Engineering and Regenerative Medicine Headquarters, Parque de Ciência e Tecnologia, Zona Industrial da Gandra - Avepark, Barco, Guimarães 4805-017, Portugal; ICVS/3B's - PT Government Associate Laboratory, Guimarães/Braga, Portugal
| | - Estevão Lima
- ICVS/3B's - PT Government Associate Laboratory, Guimarães/Braga, Portugal; Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga 4710-057, Portugal; Department of Urology, Hospital of Braga, E.P.E, Braga, Portugal
| | - Albino Martins
- 3B's Research Group; I3Bs - Research Institute on Biomaterials, Biodegradable and Biomimetics - University of Minho, European Institute of Excellence in Tissue Engineering and Regenerative Medicine Headquarters, Parque de Ciência e Tecnologia, Zona Industrial da Gandra - Avepark, Barco, Guimarães 4805-017, Portugal; ICVS/3B's - PT Government Associate Laboratory, Guimarães/Braga, Portugal
| | - Nuno M Neves
- 3B's Research Group; I3Bs - Research Institute on Biomaterials, Biodegradable and Biomimetics - University of Minho, European Institute of Excellence in Tissue Engineering and Regenerative Medicine Headquarters, Parque de Ciência e Tecnologia, Zona Industrial da Gandra - Avepark, Barco, Guimarães 4805-017, Portugal; ICVS/3B's - PT Government Associate Laboratory, Guimarães/Braga, Portugal.
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Gülersoy E, Maden M, Parlak TM, Sayin Z. Comparative evaluation of selected serum and urine biomarkers in cats with interstitial and bacterial cystitis. Vet Clin Pathol 2023; 52:79-87. [PMID: 36345051 DOI: 10.1111/vcp.13174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 05/27/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Although feline urine is increasingly submitted for bacterial culture and susceptibility testing in veterinary practice, bacterial cystitis (BC) is relatively uncommon compared with feline interstitial cystitis (FIC), which shares similar clinical manifestations. Therefore, an investigation of certain urothelial (glycosaminoglycan [GAG], tissue inhibition metalloproteinase-2 [TIMP-2]), cytokine (interleukin 12 [IL-12]), and neurotrophic factor (nerve growth factor [NGF]) markers may aid diagnosis. OBJECTIVES We aimed to evaluate the diagnostic effectiveness of selected serum/urine biomarkers in the diagnosis of cats with FIC and BC. METHODS Twelve healthy cats (Control group) and 24 cats with feline lower urinary tract disease (FLUTD) were used, and the cats with FLUTD were divided into FIC and BC groups. RESULTS When comparing the three groups, serum GAG, IL-12, NGF, and TIMP-2 concentrations were highest in the FIC group; urine GAG, IL-12, NGF, and TIMP-2 concentrations were higher in the FIC and BC groups than those in the Control group. Serum NGF concentrations were higher in the FIC group than in all other groups. Also, serum GAG, IL-12, NGF, and TIMP-2 concentrations were found to be effective in the differential diagnosis of FIC vs BC. CONCLUSIONS We showed that serum NGF is a candidate biomarker that could be used in the diagnosis and differentiation of FIC. Urine GAG, IL-12, NGF, and TIMP-2 concentrations might be helpful in determining urinary bladder inflammation and/or damage in cats with FIC and BC. ROC analyses revealed that serum and urine biomarkers were effective for diagnosing FIC and that serum biomarkers rather than urine biomarkers were effective for the differential diagnosis of FIC and feline BC.
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Affiliation(s)
- Erdem Gülersoy
- Veterinary Faculty, Department of Internal Medicine, Harran University, Şanlıurfa, Turkey
| | - Mehmet Maden
- Veterinary Faculty, Department of Internal Medicine, Selçuk University, Konya, Turkey
| | - Tuğba Melike Parlak
- Veterinary Faculty, Department of Pharmacology and Toxicology, Selçuk University, Konya, Turkey
| | - Zafer Sayin
- Veterinary Faculty, Department of Microbiology, Selçuk University, Konya, Turkey
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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.
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Castellani D, Rubilotta E, Fabiani A, Maggi M, Wroclawski M, Teoh JYC, Pirola GM, Gubbioti M, Pavia MP, Gomez Sancha F, Galosi AB, Gauhar V. Correlation between transurethral interventions and their influence on type and duration of postoperative urinary incontinence: results from a systematic review and meta-analysis of comparative studies. J Endourol 2022; 36:1331-1347. [PMID: 35587146 DOI: 10.1089/end.2022.0222] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective To perform a systematic review to assess the incidence of transient (<6-month) and persistent (>6-month) stress (SUI), urge (UUI), and mixed urinary incontinence (MUI) after transurethral surgeries for benign prostatic hyperplasia (BPH). Materials and Methods A systematic literature search was performed using Embase, PubMed, and Web of Science. We included studies comparing monopolar(M)/bipolar(B) TURP vs ablation vs enucleation procedures. Incidence of incontinence was assessed using Cochran-Mantel-Haenszel Method and reported as odds ratio (OR), 95% confidence interval (CI), and p-values. Statistical significance was set at p <0.05 Evidence synthesis 28 studies were included. Incidence of transient SUI was 4.6%, 6.0%, 3.0%, 2.4% after ablation, enucleation, M-TURP, and B-TURP, respectively. Incidence of persistent SUI was 1.1% after ablation, 1.7%, after enucleation and M-TURP, 1.0% after B-TURP. Incidence of transient UUI was 2.0%, 7.3%, 4.4%, 2.8% after ablation, enucleation, M-TURP, and B-TURP, respectively. Incidence of persistent UUI was 2.2% after M-TURP. The incidence of transient MUI was 5.1%, 0.8%, 5.4%, 0.9% after ablation, enucleation, M-TURP, and B-TURP, respectively. Incidence of persistent MUI was 3.1% after ablation, and 4.8% after M-TURP. Incidence of transient and persistent SUI and UUI did not differ after TURP vs enucleation. Incidence of transient (OR 3.32, 95% CI 0.41-26.65, p=0.26) and persistent SUI (OR 4.79, 95%CI 0.52-43.89,p=0.17) was not significantly higher after ablation. Incidence of transient UUI was not significantly higher after ablation (OR 2.62, 95%CI 0.04-166.01,p=0.65), whilst persistent UUI did not differ. Incidence of transient MUI was significantly higher after enucleation (OR 3.26, 95%CI 1.51-7.05,p=0.003). Incidence of transient and persistent MUI did not differ after TURP vs ablation. Conclusions Ablation, enucleation, and TURP have an impact on all forms of incontinence but this is transient in most cases with no difference between the groups, except for MUI which was higher after enucleation vs M-TURP.
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Affiliation(s)
- Daniele Castellani
- AOU Ospedali Riuniti di Ancona, 18494, via conca 71, Ancona, Italy, 60126;
| | - Emanuele Rubilotta
- Azienda Ospedaliera Universitaria Integrata Verona, 9286, Urology, Verona, Veneto, Italy;
| | - Andrea Fabiani
- ASUR Area Vasta 3 Macerata, 125697, Macerata, Marche, Italy;
| | - Martina Maggi
- Sapienza University of Rome, 9311, Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, Viale del Policlinico 155, Roma, Lazio, Italy, 00161;
| | - Marcelo Wroclawski
- Hospital Israelita Albert Einstein, Urology, Sao Paulo, Sao Paulo, Brazil;
| | - Jeremy Y C Teoh
- Prince of Wales Hospital, Surgery, 30-32 Ngan Shing Street, Shatin, New Territories., Hong Kong, Hong Kong;
| | | | | | - Maria Pia Pavia
- ASUR Area Vasta 4 Fermo, 165362, Dept of Urology, Porto San Giorgio, Italy;
| | - Fernando Gomez Sancha
- Clinica Cemtro, Av. ventisquero de la condesa 42, Madrid, Spain, Urology, Ventisquero de la Condesa 42, Madrid, Madrid, Spain, 28034;
| | - Andrea Benedetto Galosi
- Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona Umberto I G M Lancisi G Salesi, 18494, Urology, Via Conca, Ancona, Marche, Italy, I-60100.,Polytechnic University of Marche, 9294, Ancona, Italy, 60121;
| | - Vineet Gauhar
- Ng Teng Fong General Hospital, 242949, Urology, Singapore, Singapore;
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Mykoniatis I, Tsiakaras S, Samarinas M, Anastasiadis A, Symeonidis EN, Sountoulides P. Monoclonal Antibody Therapy for the Treatment of Interstitial Cystitis. Biologics 2022; 16:47-55. [PMID: 35619987 PMCID: PMC9129098 DOI: 10.2147/btt.s290286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/06/2022] [Indexed: 11/29/2022]
Abstract
An emerging theory regarding the potentially autoimmune nature of painful bladder syndrome/interstitial cystitis (PBS/IC) had led to several studies being conducted to assess the possible therapeutic effect of immunotherapeutic options for PBS/IC. This review presents the available evidence regarding the potential autoimmunity-based pathogenesis of PBS/IC and focuses on a main representative of the immunotherapeutic modalities for PBS/IC, aiming to summarize, evaluate, and present available data regarding the potential therapeutic role of monoclonal antibodies for PBS/IC patients. A non-systematic narrative and interpretative literature review was performed. The monoclonal antibodies included in the review were the anti-tumor necrosis factor-α (anti-TNF-α) agents adalimumab, which showed no difference compared to placebo, and certolizumab pegol, which showed statistically important differences in all outcome measures compared to placebo at the 18-week follow-up visit. Anti-nerve growth factor (anti-NGF) agents were also reviewed, including tanezumab, which showed both positive and negative efficacy results compared to placebo, and fulranumab, the study of which was discontinued owing to adverse events. In summary, monoclonal antibody therapy remains to be further researched in order for it to be proposed as a promising future treatment option for PBS/IC.
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Affiliation(s)
- Ioannis Mykoniatis
- First Urology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Correspondence: Ioannis Mykoniatis, First Urology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece, Email
| | - Stavros Tsiakaras
- First Urology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Michael Samarinas
- Department of Urology, General Hospital “Koutlibanio”, Larissa, Greece
| | - Anastasios Anastasiadis
- First Urology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evangelos N Symeonidis
- First Urology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Petros Sountoulides
- First Urology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Castellani D, Di Rosa M, Saredi G, Pacchetti A, Banchero R, Ambrosini F, Meroni P, Guano G, Boltri M, Bucci S, Simonetti E, Maestroni U, Ferretti S, Terrone C, Dellabella M. Change in postoperative storage symptoms and de novo urge-incontinence after Thulium: YAG laser enucleation of the prostate: results from a prospective, multicenter study. J Endourol 2022; 36:1223-1230. [PMID: 35414264 DOI: 10.1089/end.2022.0118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To assess the change of storage symptoms and their impact on quality of life in men undergoing Thulium: YAG laser enucleation of the prostate (ThuLEP) for benign prostatic hyperplasia (BPH). MATERIALS AND METHODS BPH patients requiring surgery were prospectively evaluated (April 2019-October 2020). INCLUSION CRITERIA International Prostate Symptom Score (IPSS) ≥8, maximum urinary flow rate ≤15 ml/s, and urinary retention. EXCLUSION CRITERIA previous urethral/prostatic surgery, pelvic irradiation, bladder/prostate cancer, neurogenic bladder, concomitant transurethral surgery, and active urinary tract infection. IPSS, International Continence Society-Overactive Bladder (ICIQ-OAB) and International Continence Society-Overactive Bladder Quality of Life (ICIQ-OABq) scores were gathered before surgery and 1,3,6 and 12 months after surgery. RESULTS 117 men were included. Mean age was 68.0±7.7 years. Mean prostate volume was 86.6±34 cc. Mean IPSS subscore was 8.7±3.1 and 11.7±4.7 for storage and voiding symptoms, respectively. Mean ICIQ-OAB was 29.1±16.8. Mean ICIQ-OABq was 80.3±30.6. Voiding IPSS decreased 72.8% at 1-month, whereas the reduction of storage IPSS was 38.0%. ICIQ-OAB decreased 49.6% at 1-month. ICIQ-OABq showed a 30.0% reduction. One year after surgery, the reduction of voiding IPSS was 94.8%, ICIQ-OAB 85.5%, storage IPSS 76.7%, and ICIQ-OABq 60.5%. Urge-incontinence was present in 26.5% of men at 1-month, 15.4% at 3-month and 4.3% at 6-month. 4(3.4%) patients complained of urge-incontinence 12 months after surgery. CONCLUSION Both storage and voiding LUTS significantly decreased after ThuLEP but storage symptoms showed less reduction with a significant impact on patients' quality of life, particularly during the first 3 months.
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Affiliation(s)
- Daniele Castellani
- AOU Ospedali Riuniti di Ancona, 18494, via conca 71, Ancona, Italy, 60126;
| | | | - Giovanni Saredi
- Ospedale di Circolo e Fondazione Macchi, Urology, Varese, Italy;
| | - Andrea Pacchetti
- Ospedale di Circolo e Fondazione Macchi, Urology, via Tagliamento 14, Induno Olona, Italy, 21056;
| | | | | | - Paola Meroni
- Ospedale di Circolo e Fondazione Macchi, Urology, Varese, Italy;
| | - Giovanni Guano
- University of Genoa, 9302, Urology, Genova, Liguria, Italy;
| | - Matteo Boltri
- Hospital of Cattinara, 415994, Trieste, Friuli-Venezia Giulia, Italy;
| | | | - Elisa Simonetti
- Azienda Ospedaliero-Universitaria di Parma, 18630, Parma, Emilia-Romagna, Italy;
| | - Umberto Maestroni
- Hospital and University of Parma, Urology OU, Surgical Department, Parma, Italy;
| | - Stefania Ferretti
- Hospital and University of Parma, O.U. Urology, Via Gramsci, n° 14, Parma, Italy, 43100;
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DU Is Induced by Low Levels of Urinary ATP in a Rat Model of Partial Bladder Outlet Obstruction: The Incidence of Both Events Decreases after Deobstruction. Adv Urol 2022; 2022:6292457. [PMID: 35265122 PMCID: PMC8901296 DOI: 10.1155/2022/6292457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/11/2022] [Indexed: 11/18/2022] Open
Abstract
Objectives. To investigate, in initial phases of bladder outlet obstruction (BOO), the urinary ATP levels, the incidence of detrusor underactivity (DU), and if they change after deobstruction. Methods. Adult female Wistar rats submitted to partial BOO (pBOO) and sham-obstruction were used. Cystometry was performed 3 or 15 days after pBOO and fluid was collected from the urethra for ATP determination. Bladders were harvested for morphological evaluation of the urothelium. DU was defined as the average of voiding contractions (VC) of sham-operated animals, with 3 SD at 15 days after the sham surgery. In another group of animals in which pBOO was relieved at 15 days and bladders were let to recover for 15 days, the incidence of DU and ATP levels were also accessed. The Kruskal–Wallis test was followed by Dunn’s multiple comparisons test, and Spearman’s correlation test was used. Results. DU was present in 13% and 67% of the bladders at 3 and 15 days after pBOO, respectively, and in 20% of the bladders at 15 days after deobstruction. ATP levels were significantly lower in DU/pBOO versus sham and non-DU/pBOO rats. A strong positive correlation between ATP levels and VC/min was obtained (r = 0.63). DU bladders had extensive areas in which umbrella cells appeared stretched, the width exceeding that presented by sham animals. Conclusions. Low urothelial ATP parallels with a high incidence of DU early after pBOO.
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Langdale CL, Degoski D, Milliken PH, Grill WM. Voiding behavior in awake unrestrained untethered spontaneously hypertensive and Wistar control rats. Am J Physiol Renal Physiol 2021; 321:F195-F206. [PMID: 34151591 DOI: 10.1152/ajprenal.00564.2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The spontaneously hypertensive rat (SHR), a genetic model of high blood pressure, has also been studied as a potential model of overactive bladder. In vivo studies have confirmed the presence of surrogate markers of overactive bladder, including detrusor overactivity, increased urinary frequency, decreased bladder capacity and voided volume (VV), and afferent hypersensitivity to bladder irritation. However, these observations were during awake cystometry using implanted bladder catheters tethered to an infusion pump and artificially filled. We conducted experiments in awake unrestrained untethered age-matched female SHRs and Wistar rats to quantify naïve consumption and voiding behavior and the effect of capsaicin desensitization on consumption and voiding behavior. Food and water consumption, body weight, voiding frequency, and VV were recorded. Rats were placed in metabolism cages for 24 h, up to twice a week, from 17 to 37 wk of age. Compared with Wistar rats, SHRs exhibited decrease in VV and did not exhibit diurnal variation in VV between light and dark periods, suggesting that SHRs may have bladder hypersensitivity. Furthermore, SHRs may also have smaller bladder capacities, as they consumed less water, voided less volume (regardless of light cycle), and had equal urinary frequencies compared with age-matched Wistar rats. We detected no change in SHR voiding behavior following capsaicin desensitization, which was in contrast to a prior awake in vivo cystometry study describing increased VV and micturition interval in SHRs and suggests that C-fiber activity may not contribute to bladder hypersensitivity in SHRs.NEW & NOTEWORTHY We characterized the long-term (20 wk) voiding, defecation, and consumption behavior of age-matched spontaneously hypertensive and Wistar rats without the influence of anesthesia or catheters. Spontaneously hypertensive rats exhibited bladder hypersensitiviy that persisted for the 20-wk duration and was unaffected by capsacin desensitization.
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Affiliation(s)
| | - Danielle Degoski
- Department of Biomedical Engineering, Duke University, Durham, North Carolina
| | | | - Warren M Grill
- Department of Biomedical Engineering, Duke University, Durham, North Carolina.,Department of Electrical and Computer Engineering, Duke University, Durham, North Carolina.,Department of Neurobiology, Duke University, Durham, North Carolina.,Department of Neurosurgery, Duke University, Durham, North Carolina
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11
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von Siebenthal M, Besic M, Gheinani AH, Akshay A, Lizun-Platoni S, Kunz N, Burkhard FC, Monastyrskaya K. Urinary miRNA profiles discriminate between obstruction-induced bladder dysfunction and healthy controls. Sci Rep 2021; 11:10204. [PMID: 33986358 PMCID: PMC8119692 DOI: 10.1038/s41598-021-89535-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 04/28/2021] [Indexed: 02/07/2023] Open
Abstract
Urgency, frequency and incomplete emptying are the troublesome symptoms often shared between benign prostatic obstruction-induced (BLUTD) and neurogenic (NLUTD) lower urinary tract dysfunction. Previously, using bladder biopsies, we suggested a panel of miRNA biomarkers for different functional phenotypes of the bladder. Urine is a good source of circulating miRNAs, but sex- and age-matched controls are important for urinary metabolite comparison. In two groups of healthy subjects (average age 32 and 57 years old, respectively) the total protein and RNA content was very similar between age groups, but the number of secreted extracellular vesicles (uEVs) and expression of several miRNAs were higher in the young healthy male volunteers. Timing of urine collection was not important for these parameters. We also evaluated the suitability of urinary miRNAs for non-invasive diagnosis of bladder outlet obstruction (BOO). A three urinary miRNA signature (miR-10a-5p, miR-301b-3p and miR-363-3p) could discriminate between controls and patients with LUTD (BLUTD and NLUTD). This panel of representative miRNAs can be further explored to develop a non-invasive diagnostic test for BOO. The age-related discrepancy in the urinary miRNA content observed in this study points to the importance of selecting appropriate, age-matched controls.
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Affiliation(s)
- Michelle von Siebenthal
- Urology Research Laboratory, Department for BioMedical Research DBMR, University of Bern, Bern, Switzerland
| | - Mustafa Besic
- Urology Research Laboratory, Department for BioMedical Research DBMR, University of Bern, Bern, Switzerland
| | - Ali Hashemi Gheinani
- Urological Diseases Research Center, Boston Children's Hospital, Harvard Medical School, Boston, USA.,Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Akshay Akshay
- Urology Research Laboratory, Department for BioMedical Research DBMR, University of Bern, Bern, Switzerland
| | | | - Nadine Kunz
- Department of Urology, Inselspital University Hospital, 3010, Bern, Switzerland
| | - Fiona C Burkhard
- Urology Research Laboratory, Department for BioMedical Research DBMR, University of Bern, Bern, Switzerland.,Department of Urology, Inselspital University Hospital, 3010, Bern, Switzerland
| | - Katia Monastyrskaya
- Urology Research Laboratory, Department for BioMedical Research DBMR, University of Bern, Bern, Switzerland. .,Department of Urology, Inselspital University Hospital, 3010, Bern, Switzerland.
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12
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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.
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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.
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13
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Gabella G. Muscle cells, nerves, fibroblasts and vessels in the detrusor of the rat urinary bladder. J Smooth Muscle Res 2020; 55:34-67. [PMID: 31708509 PMCID: PMC6851244 DOI: 10.1540/jsmr.55.34] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
All the cells of rat detrusor muscle fall into one of five ultrastructural types: muscle
cells, fibroblasts, axons and glia, and vascular cells (endothelial cells and pericytes).
The tissue is ~79% cellular and 21% non-cellular. Muscle cells occupy 72%, nerves ~4% (1/3
axons, 2/3 glia), and fibroblast >3% of space. Muscle cells (up to 6 µm across and ~600
µm long, packed to almost 100,000 per mm2) have surface-to-volume ratio of 2.4
µm2/µm3 ~93% of cell volume is contractile apparatus, 3.1%
mitochondria and 2.5% nucleus. Cell profiles are irregular but sectional area decreases
regularly towards either end of the cell. Muscle cells are gathered into bundles (the
mechanical units of detrusor), variable in length and size, but of constant width. The
musculature is highly compact (without fascia or capsule) with smooth outer surfaces and
extensive association and adhesion between its cells. Among many types of intercellular
contact and junction, digitations are very common, each muscle cell issuing minute
finger-like processes that abut on adjacent cells. Sealed apposition are wide areas of
specialized contact, possibly forming a chamber between two muscle cells, distinct from
the extracellular space at large (stromal space). The innervation is very dense, virtually
all intramuscular axons being varicose (including afferent ones). There are identifiable
neuro-muscular junctions on each muscle cell, often several junctions on a single cell.
There are also unattached terminals. Fibroblasts (involved in the production of collagen),
~1% of the total number of cells, do not make specialized contacts.
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Yildiz Ş, Cengiz H, Kural A, Kaya C, Alay İ, Ekin M. Association between overactive bladder and serum nerve growth factor concentrations in women with high-grade uterine prolapse. Int Urogynecol J 2020; 32:345-351. [PMID: 32440884 DOI: 10.1007/s00192-020-04336-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 05/08/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The association between overactive bladder (OAB) and uterine prolapse remains unclear. The extent of the role of serum nerve growth factor (NGF) levels in this relationship is also not known. Therefore, our study evaluated the association among OAB, high-grade uterine prolapse and serum NGF levels. METHODS A total of 90 patients participated in our study and were grouped as follows. Group I included patients with high-grade uterine prolapse and OAB, group II included patients with only high-grade uterine prolapse, and group III included healthy women without uterine prolapse or OAB. Serum NGF level analysis was performed in all groups. RESULTS Serum NGF levels varied greatly among the three groups, with significantly higher levels in group 1 than in groups 2 and 3 (p < 0.001). Serum NGF levels with a cutoff point of 120.49 pg/ml identified women with significant OAB symptoms to discriminate among groups with a sensitivity of 80%, specificity of 86.7%, positive predictive value of 75.0%, negative predictive value of 89.7% and positive likelihood ratio of 6.01 (p < 0.001). CONCLUSIONS Our study showed that NGF-related pathways may play an active role in the pathophysiology of OAB with high-grade uterine prolapse patients based on obstruction hypothesis.
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Affiliation(s)
- Şükrü Yildiz
- University of Health Sciences Istanbul, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Obstetrics and Gynecology, 34180, Istanbul, Turkey.
| | - Hüseyin Cengiz
- Istanbul Aydin University, Faculty of Medicine, Department of Obstetrics and Gynecology, 34140, Istanbul, Turkey
| | - Alev Kural
- University of Health Sciences Istanbul, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Deparment of Biochemistry, 34180, Istanbul, Turkey
| | - Cihan Kaya
- University of Health Sciences Istanbul, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Obstetrics and Gynecology, 34180, Istanbul, Turkey
| | - İsmail Alay
- University of Health Sciences Istanbul, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Obstetrics and Gynecology, 34180, Istanbul, Turkey
| | - Murat Ekin
- University of Health Sciences Istanbul, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Obstetrics and Gynecology, 34180, Istanbul, Turkey
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15
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Michel MC. Where will the next generation of medical treatments for overactive bladder syndrome come from? Int J Urol 2020; 27:289-294. [DOI: 10.1111/iju.14189] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 01/05/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Martin C Michel
- Department of Pharmacology Johannes Gutenberg University Mainz Germany
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16
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Spinal cord injury leads to atrophy in pelvic ganglia neurons. Exp Neurol 2020; 328:113260. [PMID: 32109447 DOI: 10.1016/j.expneurol.2020.113260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 01/27/2020] [Accepted: 02/24/2020] [Indexed: 11/21/2022]
Abstract
Among the most devastating sequelae of spinal cord injury (SCI) are genitourinary and gastrointestinal dysfunctions. Post-ganglionic neurons in pelvic ganglia (PG) directly innervate and regulate the function of the lower urinary tract (LUT), bowel, and sexual organs. A better understanding of how SCI affects PG neurons is essential to develop therapeutic strategies for devastating gastrointestinal and genitourinary complications ensuing after injury. To evaluate the impact of SCI on the morphology of PG neurons, we used a well- characterized rat model of upper thoracic SCI (T3 transection) that causes severe autonomic dysfunction. Using immunohistochemistry for neuronal markers, the neuronal profile size frequency distribution was quantified at one-, four-, and eight-weeks post SCI using recursive translation. Our investigation revealed an SCI-dependent leftward shift in neuronal size (i.e. atrophy), observable as early as one-week post injury. However, this effect was more pronounced at four and eight-weeks post-SCI. These findings demonstrate the first characterization of SCI-associated temporal changes in morphology of PG neurons and warrant further investigation to facilitate development of therapeutic strategies for recovery of autonomic functions following SCI.
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Chen JL, Kuo HC. Clinical application of intravesical botulinum toxin type A for overactive bladder and interstitial cystitis. Investig Clin Urol 2019; 61:S33-S42. [PMID: 32055752 PMCID: PMC7004832 DOI: 10.4111/icu.2020.61.s1.s33] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 08/25/2019] [Indexed: 01/30/2023] Open
Abstract
After decades of clinical and basic science research, the clinical application of botulinum toxin A (Botox) in urology has been extended to neurogenic detrusor overactivity (NDO), idiopathic detrusor overactivity, refractory overactive bladder (OAB), interstitial cystitis/bladder pain syndrome (IC/BPS), lower urinary tract symptoms, benign prostatic hyperplasia, and neurogenic or non-neurogenic lower urinary tract dysfunction in children. Botox selectively disrupts and modulates neurotransmission, suppresses detrusor overactivity, and modulates sensory function, inflammation, and glandular function. In addition to motor effects, Botox has been found to have sensory inhibitory effects and anti-inflammatory effects; therefore, it has been used to treat IC/BPS and OAB. Currently, Botox has been approved for the treatment of NDO and OAB. Recent clinical trials on Botox for the treatment of IC/BPS have reported promising therapeutic effects, including reduced bladder pain. Additionally, the therapeutic duration was found to be longer with repeated Botox injections than with a single injection. However, the use of Botox for IC/BPS has not been approved. This paper reviews the recent advances in intravesical Botox treatment for OAB and IC/BPS.
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Affiliation(s)
- Jing-Liang Chen
- Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and 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
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Coelho A, Oliveira R, Antunes-Lopes T, Cruz CD. Partners in Crime: NGF and BDNF in Visceral Dysfunction. Curr Neuropharmacol 2019; 17:1021-1038. [PMID: 31204623 PMCID: PMC7052822 DOI: 10.2174/1570159x17666190617095844] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/23/2019] [Accepted: 06/03/2019] [Indexed: 12/12/2022] Open
Abstract
Neurotrophins (NTs), particularly Nerve Growth Factor (NGF) and Brain-Derived Neurotrophic Factor (BDNF), have attracted increasing attention in the context of visceral function for some years. Here, we examined the current literature and presented a thorough review of the subject. After initial studies linking of NGF to cystitis, it is now well-established that this neurotrophin (NT) is a key modulator of bladder pathologies, including Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC) and Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS. NGF is upregulated in bladder tissue and its blockade results in major improvements on urodynamic parameters and pain. Further studies expanded showed that NGF is also an intervenient in other visceral dysfunctions such as endometriosis and Irritable Bowel Syndrome (IBS). More recently, BDNF was also shown to play an important role in the same visceral dysfunctions, suggesting that both NTs are determinant factors in visceral pathophysiological mechanisms. Manipulation of NGF and BDNF improves visceral function and reduce pain, suggesting that clinical modulation of these NTs may be important; however, much is still to be investigated before this step is taken. Another active area of research is centered on urinary NGF and BDNF. Several studies show that both NTs can be found in the urine of patients with visceral dysfunction in much higher concentration than in healthy individuals, suggesting that they could be used as potential biomarkers. However, there are still technical difficulties to be overcome, including the lack of a large multicentre placebo-controlled studies to prove the relevance of urinary NTs as clinical biomarkers.
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Affiliation(s)
| | | | | | - Célia Duarte Cruz
- Address correspondence to this author at the Department of Experimental Biology, Experimental Biology Unit, Faculty of Medicine of the University of Porto, Alameda Hernâni Monteiro; Tel: 351 220426740; Fax: +351 225513655; E-mail:
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Effects of Qianlie Tongqiao Capsule on Bladder Weight and Growth Factors in Bladder Tissue of Rats with Testosterone-Induced Benign Prostatic Hyperplasia. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:5059267. [PMID: 30519263 PMCID: PMC6241338 DOI: 10.1155/2018/5059267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Accepted: 10/22/2018] [Indexed: 11/18/2022]
Abstract
Qianlie Tongqiao Capsule (QTC) is clinically confirmed to be efficacious and safe in treating lower urinary tract syndromes and bladder dysfunction that are induced by benign prostatic hyperplasia (BPH). However, the functional mechanisms of QTC remain unclear. We aim to investigate the effects of QTC on both bladder weight and several growth factors in the bladder tissue of rats with testosterone-induced BPH. BPH in the rats was established through bilateral orchiectomy and subcutaneous administration of testosterone propionate (5 mg/kg) dissolved in corn oil. At the end of the study, all bladder tissues were collected and weighed, and a histological examination was conducted using H&E staining. Immunohistochemistry and quantitative reverse transcription-polymerase chain reaction (qRT-PCR) were applied to detect the expression of nerve growth factor (NGF), basic fibroblast growth factor (bFGF), and transformation growth factor-β1 (TGF-β1) in the bladder tissue. The expression of Bcl-2 and Bax in the bladder tissue was tested by Western Blot and qRT-PCR. We found that QTC, especially when administered in high-dosages, had a significant inhibitory effect on bladder weight gain and overexpression of NGF, bFGF, and TGF-β1 in rats with BPH. In addition, QTC downregulated and upregulated protein and mRNA expression of Bcl-2 and Bax in the bladder after prostatic obstruction, respectively. Furthermore, QTC balanced the Bcl-2/Bax ratio. Overall, these results reveal possible functional mechanisms of QTC in treating BPH-caused bladder dysfunction, and further studies are needed.
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Adedeji TG, Olapade-Olaopa EO. Dietary macronutrient content affects inflammatory and fibrotic factors in normal and obstructed bladders. Life Sci 2018; 210:192-200. [DOI: 10.1016/j.lfs.2018.08.069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 08/23/2018] [Accepted: 08/30/2018] [Indexed: 10/28/2022]
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21
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Shared Pathophysiology of Detrusor Overactivity and Detrusor Underactivity. CURRENT BLADDER DYSFUNCTION REPORTS 2018. [DOI: 10.1007/s11884-018-0490-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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22
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Electrochemical detection of NGF using a reduced graphene oxide- titanium nitride nanocomposite. Sci Rep 2018; 8:6929. [PMID: 29720604 PMCID: PMC5931993 DOI: 10.1038/s41598-018-25196-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 04/16/2018] [Indexed: 11/25/2022] Open
Abstract
There is a correlation between the severity of neurological impairment in patients that have suffered a cerebrovascular accident and the nerve growth factor (NGF) level. This study addressed the fabrication of a titanium nitride (TiN) and reduced graphene oxide (RGO)-based composite with remarkable electrocatalytic activity towards NGF oxidation in a phosphate buffer solution (PB, 0.1 M). The proposed electrochemical sensor was linearly related to the NGF concentration in the range of 10 nM-5 μM with a detection limit of 2.6 nM.
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Shimizu T, Majima T, Suzuki T, Shimizu N, Wada N, Kadekawa K, Takai S, Takaoka E, Kwon J, Kanai AJ, de Groat WC, Tyagi P, Saito M, Yoshimura N. Nerve growth factor-dependent hyperexcitability of capsaicin-sensitive bladder afferent neurones in mice with spinal cord injury. Exp Physiol 2018; 103:896-904. [PMID: 29603450 DOI: 10.1113/ep086951] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 03/20/2018] [Indexed: 01/03/2023]
Abstract
NEW FINDINGS What is the central question of this study? Nerve growth factor (NGF) is reportedly a mediator inducing urinary bladder dysfunction. Is NGF directly involved in hyperexcitability of capsaicin-sensitive C-fibre bladder afferent pathways after spinal cord injury (SCI)? What is the main finding and its importance? Neutralization of NGF by anti-NGF antibody treatment reversed the SCI-induced increase in the number of action potentials and the reduction in spike thresholds and A-type K+ current density in mouse capsaicin-sensitive bladder afferent neurones. Thus, NGF plays an important and direct role in hyperexcitability of capsaicin-sensitive C-fibre bladder afferent neurones attributable to the reduction in A-type K+ channel activity in SCI. ABSTRACT Nerve growth factor (NGF) has been implicated as an important mediator in the induction of C-fibre bladder afferent hyperexcitability, which contributes to the emergence of neurogenic lower urinary tract dysfunction after spinal cord injury (SCI). In this study, we determined whether NGF immunoneutralization using an anti-NGF antibody (NGF-Ab) normalizes the SCI-induced changes in electrophysiological properties of capsaicin-sensitive C-fibre bladder afferent neurones in female C57BL/6 mice. The spinal cord was transected at the Th8/Th9 level. Two weeks later, continuous administration of NGF-Ab (10 μg kg-1 h-1 , s.c. for 2 weeks) was started. Bladder afferent neurones were labelled with Fast-Blue (FB), a fluorescent retrograde tracer, injected into the bladder wall 3 weeks after SCI. Four weeks after SCI, freshly dissociated L6-S1 dorsal root ganglion neurones were prepared. Whole-cell patch-clamp recordings were then performed in FB-labelled neurones. After recording action potentials or voltage-gated K+ currents, the sensitivity of each neurone to capsaicin was evaluated. In capsaicin-sensitive FB-labelled neurones, SCI significantly reduced the spike threshold and increased the number of action potentials during membrane depolarization for 800 ms. These SCI-induced changes were reversed by NGF-Ab. Densities of slow-decaying A-type K+ (KA ) and sustained delayed rectifier-type K+ currents were significantly reduced by SCI. The NGF-Ab treatment reversed the SCI-induced reduction in the KA current density. These results indicate that NGF plays an important role in hyperexcitability of mouse capsaicin-sensitive C-fibre bladder afferent neurones attributable to a reduction in KA channel activity. Thus, NGF-targeting therapies could be effective for treatment of afferent hyperexcitability and neurogenic lower urinary tract dysfunction after SCI.
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Affiliation(s)
- Takahiro Shimizu
- Department of Pharmacology, Kochi Medical School, Kochi University, Nankoku, Kochi, 783-8505, Japan.,Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - Tsuyoshi Majima
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - Takahisa Suzuki
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - Nobutaka Shimizu
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - Naoki Wada
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - Katsumi Kadekawa
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - Shun Takai
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - Eiichiro Takaoka
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - Joonbeom Kwon
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - Anthony J Kanai
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - William C de Groat
- Department of Pharmacology & Cell Biology, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - Pradeep Tyagi
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - Motoaki Saito
- Department of Pharmacology, Kochi Medical School, Kochi University, Nankoku, Kochi, 783-8505, Japan
| | - Naoki Yoshimura
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA.,Department of Pharmacology & Cell Biology, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
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Fusco F, Creta M, De Nunzio C, Iacovelli V, Mangiapia F, Li Marzi V, Finazzi Agrò E. Progressive bladder remodeling due to bladder outlet obstruction: a systematic review of morphological and molecular evidences in humans. BMC Urol 2018; 18:15. [PMID: 29519236 PMCID: PMC5844070 DOI: 10.1186/s12894-018-0329-4] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 02/28/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Bladder outlet obstruction is a common urological condition. We aimed to summarize available evidences about bladder outlet obstruction-induced molecular and morphological alterations occurring in human bladder. METHODS We performed a literature search up to December 2017 including clinical and preclinical basic research studies on humans. The following search terms were combined: angiogenesis, apoptosis, bladder outlet obstruction, collagen, electron microscopy, extracellular matrix, fibrosis, hypoxia, histology, inflammation, innervation, ischemia, pressure, proliferation, remodeling, suburothelium, smooth muscle cells, stretch, urothelium. RESULTS We identified 36 relevant studies. A three-stages model of bladder wall remodeling can be hypothesized involving an initial hypertrophy phase, a subsequent compensation phase and a later decompensation. Histological and molecular alterations occur in the following compartments: urothelium, suburothelium, detrusor smooth muscle cells, detrusor extracellular matrix, nerves. Cyclic stretch, increased hydrostatic and cyclic hydrodynamic pressure and hypoxia are stimuli capable of modulating multiple signaling pathways involved in this remodeling process. CONCLUSIONS Bladder outlet obstruction leads to progressive bladder tissue remodeling in humans. Multiple signaling pathways are involved.
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Affiliation(s)
- Ferdinando Fusco
- Dipartimento di Neuroscienze e Scienze Riproduttive ed Odontostomatologiche, Università Degli Studi Di Napoli Federico II, Via Pansini, 5, 80131 Naples, Italy
| | - Massimiliano Creta
- Dipartimento di Neuroscienze e Scienze Riproduttive ed Odontostomatologiche, Università Degli Studi Di Napoli Federico II, Via Pansini, 5, 80131 Naples, Italy
| | - Cosimo De Nunzio
- Dipartimento di Urologia, Ospedale Sant’Andrea, Università Degli Studi di Roma “La Sapienza”, Rota, Italy
| | - Valerio Iacovelli
- Dipartimento di Medicina Sperimentale e Chirurgia, Università Degli Studi di Roma “Tor Vergata”, Roma, Italy
| | - Francesco Mangiapia
- Dipartimento di Neuroscienze e Scienze Riproduttive ed Odontostomatologiche, Università Degli Studi Di Napoli Federico II, Via Pansini, 5, 80131 Naples, Italy
| | - Vincenzo Li Marzi
- Dipartimento di Urologia, Ospedale Careggi, Università Degli Studi di Firenze, Firenze, Italy
| | - Enrico Finazzi Agrò
- Dipartimento di Medicina Sperimentale e Chirurgia, Università Degli Studi di Roma “Tor Vergata”, Roma, Italy
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Hubscher CH, Herrity AN, Williams CS, Montgomery LR, Willhite AM, Angeli CA, Harkema SJ. Improvements in bladder, bowel and sexual outcomes following task-specific locomotor training in human spinal cord injury. PLoS One 2018; 13:e0190998. [PMID: 29385166 PMCID: PMC5791974 DOI: 10.1371/journal.pone.0190998] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 12/22/2017] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE Locomotor training (LT) as a therapeutic intervention following spinal cord injury (SCI) is an effective rehabilitation strategy for improving motor outcomes, but its impact on non-locomotor functions is unknown. Given recent results of our labs' pre-clinical animal SCI LT studies and existing overlap of lumbosacral spinal circuitries controlling pelvic-visceral and locomotor functions, we addressed whether LT can improve bladder, bowel and sexual function in humans at chronic SCI time-points (> two years post-injury). STUDY DESIGN Prospective cohort study; pilot trial with small sample size. METHODS Eight SCI research participants who were undergoing 80 daily one-hour sessions of LT on a treadmill using body-weight support, or one-hour of LT and stand training on alternate days, as part of another research study conducted at the Kentucky Spinal Cord Injury Research Center, University of Louisville, were enrolled in this pilot trial. Urodynamic assessments were performed and International Data Set questionnaire forms completed for bladder, bowel and sexual functions at pre-and post-training time points. Four usual care (non-trained; regular at-home routine) research participants were also enrolled in this study and had the same assessments collected twice, at least 3 months apart. RESULTS Filling cystometry documented significant increases in bladder capacity, voiding efficiency and detrusor contraction time as well as significant decreases in voiding pressure post-training relative to baseline. Questionnaires revealed a decrease in the frequency of nocturia and urinary incontinence for several research participants as well as a significant decrease in time required for defecation and a significant increase in sexual desire post-training. No significant differences were found for usual care research participants. CONCLUSIONS These results suggest that an appropriate level of sensory information provided to the spinal cord, generated through task-specific stepping and/or loading, can positively benefit the neural circuitries controlling urogenital and bowel functions. TRIAL REGISTRATION ClinicalTrials.gov NCT03036527.
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Affiliation(s)
- Charles H. Hubscher
- Department of Anatomical Sciences and Neurobiology, University of Louisville, Louisville, Kentucky, United States of America
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky, United States of America
- * E-mail:
| | - April N. Herrity
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky, United States of America
- Department of Neurological Surgery, University of Louisville, Louisville, Kentucky, United States of America
| | - Carolyn S. Williams
- Department of Urology, University of Louisville, Louisville, Kentucky, United States of America
| | - Lynnette R. Montgomery
- Department of Anatomical Sciences and Neurobiology, University of Louisville, Louisville, Kentucky, United States of America
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky, United States of America
| | - Andrea M. Willhite
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky, United States of America
- Department of Neurological Surgery, University of Louisville, Louisville, Kentucky, United States of America
| | - Claudia A. Angeli
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky, United States of America
- Frazier Rehabilitation Institute, Louisville, Kentucky, United States of America
| | - Susan J. Harkema
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky, United States of America
- Department of Neurological Surgery, University of Louisville, Louisville, Kentucky, United States of America
- Frazier Rehabilitation Institute, Louisville, Kentucky, United States of America
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Urinary Nerve Growth Factor as a Potential Biomarker of Treatment Outcomes in Overactive Bladder Patients. Int Neurourol J 2017; 21:270-281. [PMID: 29298466 PMCID: PMC5756815 DOI: 10.5213/inj.1732794.397] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 03/07/2017] [Indexed: 11/26/2022] Open
Abstract
Purpose The aim of this study was to investigate urinary nerve growth factor (NGF) as a biomarker of treatment efficacy and recurrence in overactive bladder (OAB) patients. Methods We enrolled 189 OAB subjects who visited our outpatient clinic from February 2010 to February 2015. All subjects with OAB received antimuscarinic treatment. A 3-day voiding diary and questionnaire were collected from each patient. Urinary levels of NGF were evaluated at baseline, the beginning of antimuscarinic treatment, and the end of antimuscarinic treatment. Urinary NGF was normalized to urine creatinine (Cr). Between-group comparisons of baseline characteristics were made using the Mann-Whitney U-test. Multivariate logistic regression analyses were used to predict responses to anticholinergic treatment and recurrence. The Wilcoxon signed-rank test with the Bonferroni correction was used for intragroup comparisons. A receiver operating characteristic curve was used to analyze the utility of this biomarker. Results Urinary levels of NGF/Cr tended to decrease in patients who responded to treatment (n=62), but this was not significant (P=0.260). Urinary NGF levels were higher at baseline in patients who did not experience recurrence than in those who did (P=0.047). In those who did not experience recurrence (n=29), urinary NGF/Cr decreased at the end of treatment compared to baseline, and this reduction was maintained at 12 weeks after the end of treatment (P<0.05). Conclusions Urinary NGF is a potential biomarker for predicting the outcome of antimuscarinic treatment in OAB patients. This may provide useful information when deciding to stop antimuscarinic treatment in responders.
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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.
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Kitta T, Kanno Y, Chiba H, Higuchi M, Ouchi M, Togo M, Moriya K, Shinohara N. Benefits and limitations of animal models in partial bladder outlet obstruction for translational research. Int J Urol 2017; 25:36-44. [PMID: 28965358 DOI: 10.1111/iju.13471] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 08/28/2017] [Indexed: 11/26/2022]
Abstract
The functions of the lower urinary tract have been investigated for more than a century. Lower urinary tract symptoms, such as incomplete bladder emptying, weak urine stream, daytime urinary frequency, urgency, urge incontinence and nocturia after partial bladder outlet obstruction, is a frequent cause of benign prostatic hyperplasia in aging men. However, the pathophysiological mechanisms have not been fully elucidated. The use of animal models is absolutely imperative for understanding the pathophysiological processes involved in bladder dysfunction. Surgical induction has been used to study lower urinary tract functions of numerous animal species, such as pig, dog, rabbit, guinea pig, rat and mouse, of both sexes. Several morphological and functional modifications under partial bladder outlet obstruction have not only been observed in the bladder, but also in the central nervous system. Understanding the changes of the lower urinary tract functions induced by partial bladder outlet obstruction would also contribute to appropriate drug development for treating these pathophysiological conditions. In the present review, we discuss techniques for creating partial bladder outlet obstruction, the characteristics of several species, as well as issues of each model, and their translational value.
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Affiliation(s)
- Takeya Kitta
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Yukiko Kanno
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Hiroki Chiba
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Madoka Higuchi
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Mifuka Ouchi
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Mio Togo
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Kimihiko Moriya
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Nobuo Shinohara
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
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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]
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Yadav SS, Bhattar R, Sharma L, Banga G, Sadasukhi TC. Electron microscopic changes of detrusor in benign enlargement of prostate and its clinical correlation. Int Braz J Urol 2017; 43:1092-1101. [PMID: 28537696 PMCID: PMC5734072 DOI: 10.1590/s1677-5538.ibju.2016.0350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 09/11/2016] [Indexed: 11/22/2022] Open
Abstract
AIMS To study the ultra structural changes in bladder musculature in cases of BPE and their clinical relevance. MATERIAL AND METHODS In this descriptive longitudinal, controlled, observational study patients were enrolled into three groups, group 1, group 2A and group 2B. Control group (group-1) consisted of age matched normal male patients, who underwent surveillance or diagnostic cystoscopy for microscopic hematuria or irritative symptoms. Case group (group-2) comprised of patients with BPE, undergoing TURP. Case group (group-2) was further classified into: Category 2A (patients not on catheter) and cat-egory 2B (patients on catheter). All relevant clinical parameters like IPSS, prostate size, Qmax, PVR were recorded. Cystoscopy and bladder biopsy were performed in all patients. Various ultrastructural parameters like myocytes, fascicular pattern, interstitial tissue, nerve hypertrophy and cell junction pattern were analyzed under electron microscope and they were clinically correlated using appropriate statistical tests. RESULTS Control group had significant difference as compared to case group in terms of baseline parameters like IPSS, flow rate and prostate size, both preoperatively and postoperatively, except for PVR, which was seen only preoperatively. There was statistically significant difference in ultrastructural patterns between case and control group in all five electron microscopic patterns. However, no significant difference was found between the subcategories of case groups. CONCLUSIONS BPE is responsible for ultra structural changes in detrusor muscle and these changes remain persistent even after TURP. Nerve hypertrophy, which was not thoroughly discussed in previous studies, is also one of the salient feature of this study.
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Affiliation(s)
- Sher Singh Yadav
- Department of Urology and Renal Transplantation, SMS Medical College, Jaipur, Rajasthan, India
| | - Rohit Bhattar
- Department of Urology and Renal Transplantation, SMS Medical College, Jaipur, Rajasthan, India
| | - Lokesh Sharma
- Department of Urology, NIMS Medical College, Jaipur, Rajasthan, India
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Barbosa JABA, Reis ST, Nunes M, Ferreira YA, Leite KR, Nahas WC, Srougi M, Antunes AA. The Obstructed Bladder: Expression of Collagen, Matrix Metalloproteinases, Muscarinic Receptors, and Angiogenic and Neurotrophic Factors in Patients With Benign Prostatic Hyperplasia. Urology 2017; 106:167-172. [PMID: 28506859 DOI: 10.1016/j.urology.2017.05.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 04/13/2017] [Accepted: 05/05/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate the gene expression of collagen, matrix metalloproteinases (MMPs) and inhibitors, cholinergic muscarinic receptors (CHRMs), and angiogenic and nerve growth factors (NGFs) in the bladder of patients with bladder outlet obstruction caused by benign prostatic hyperplasia (BPH). METHODS We analyzed bladder specimens from 43 patients with obstructive BPH undergoing transurethral resection of the prostate as compared to 10 age-matched controls with an International Prostatic Symptom Score of <8 and a prostate volume of <30 g. A bladder biopsy was performed for relative gene expression analysis with quantitative real-time polymerase chain reaction of collagens I and III, MMP-1, MMP-2, and MMP-9; tissue inhibitors of metalloproteinases (TIMPs) TIMP-1, TIMP-2, and reversion-inducing cysteine-rich protein with kazal motifs (RECK); CHRM2 and CHRM3; VEGF and CD105; and NGF and nerve growth factor receptor (NGFr). RESULTS Patients with bladder outlet obstruction presented a statistically significant overexpression of collagens I and III, VEGF, CHRM2, and CHRM3. CD105, MMP-9, and TIMP-1 were underexpressed. Expressions of NGF, NGFr, MMP-1, MMP-2, TIMP-2, and RECK were heterogeneous. CHRM2 and CHRM3 were overexpressed in patients with persistent detrusor overactivity. Smokers presented an upregulation of NGFr and VEGF; dyslipidemic patients had an overexpression of NGFr. CONCLUSION Bladder upregulation of collagens I and III on transcriptional level appears to be relevant in BPH. Muscarinic receptors CHRM2 and CHRM3 are also overexpressed, more so in patients with persistent detrusor overactivity. Upregulation of VEGF and NGFr, particularly in subjects with risk factors for atherosclerosis, reinforces the role of ischemia in BPH-induced modifications of the bladder.
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Affiliation(s)
| | - Sabrina T Reis
- Laboratory of Investigative Urology, LIM55, University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
| | - Marco Nunes
- Laboratory of Investigative Urology, LIM55, University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
| | - Yuri A Ferreira
- Laboratory of Investigative Urology, LIM55, University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
| | - Katia R Leite
- Laboratory of Investigative Urology, LIM55, University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
| | - William C Nahas
- Division of Urology, University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
| | - Miguel Srougi
- Division of Urology, University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
| | - Alberto A Antunes
- Division of Urology, University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil; Laboratory of Investigative Urology, LIM55, University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
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Patnaik SS, Laganà AS, Vitale SG, Butticè S, Noventa M, Gizzo S, Valenti G, Rapisarda AMC, La Rosa VL, Magno C, Triolo O, Dandolu V. Etiology, pathophysiology and biomarkers of interstitial cystitis/painful bladder syndrome. Arch Gynecol Obstet 2017; 295:1341-1359. [DOI: 10.1007/s00404-017-4364-2] [Citation(s) in RCA: 137] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 03/30/2017] [Indexed: 12/30/2022]
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Ekman M, Zhu B, Swärd K, Uvelius B. Neurite outgrowth in cultured mouse pelvic ganglia - Effects of neurotrophins and bladder tissue. Auton Neurosci 2017; 205:41-49. [PMID: 28347639 DOI: 10.1016/j.autneu.2017.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 03/14/2017] [Accepted: 03/17/2017] [Indexed: 10/19/2022]
Abstract
Neurotrophic factors regulate survival and growth of neurons. The urinary bladder is innervated via both sympathetic and parasympathetic neurons located in the major pelvic ganglion. The aim of the present study was to characterize the effects of the neurotrophins nerve growth factor (NGF), brain derived neurotrophic factor (BDNF) and neurotrophin 3 (NT-3) on the sprouting rate of sympathetic and parasympathetic neurites from the female mouse ganglion. The pelvic ganglion was dissected out and attached to a petri dish and cultured in vitro. All three factors (BDNF, NT-3 and NGF) stimulated neurite outgrowth of both sympathetic and parasympathetic neurites although BDNF and NT-3 had a higher stimulatory effect on parasympathetic ganglion cells. The neurotrophin receptors TrkA, TrkB and TrkC were all expressed in neurons of the ganglia. Co-culture of ganglia with urinary bladder tissue, but not diaphragm tissue, increased the sprouting rate of neurites. Active forms of BDNF and NT-3 were detected in urinary bladder tissue using western blotting whereas tissue from the diaphragm expressed NGF. Neurite outgrowth from the pelvic ganglion was inhibited by a TrkB receptor antagonist. We therefore suggest that the urinary bladder releases trophic factors, including BDNF and NT-3, which regulate neurite outgrowth via activation of neuronal Trk-receptors. These findings could influence future strategies for developing pharmaceuticals to improve re-innervation due to bladder pathologies.
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Affiliation(s)
- Mari Ekman
- Department of Experimental Medical Science, Lund University, Lund, Sweden; Department of Biology, Lund University, Lund, Sweden.
| | - Baoyi Zhu
- Department of Experimental Medical Science, Lund University, Lund, Sweden; Department of Urology, The Sixth Affiliated Hospital of Guangzhou Medical University, Guang Dong, China
| | - Karl Swärd
- Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Bengt Uvelius
- Department of Urology, Clinical Sciences, Lund University, Lund, Sweden
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Role of Estrogens in the Size of Neuronal Somata of Paravaginal Ganglia in Ovariectomized Rabbits. BIOMED RESEARCH INTERNATIONAL 2017; 2017:2089645. [PMID: 28316975 PMCID: PMC5339489 DOI: 10.1155/2017/2089645] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 12/18/2016] [Accepted: 01/15/2017] [Indexed: 01/07/2023]
Abstract
We aimed to determine the role of estrogens in modulating the size of neuronal somata of paravaginal ganglia. Rabbits were allocated into control (C), ovariectomized (OVX), and OVX treated with estradiol benzoate (OVX + EB) groups to evaluate the neuronal soma area; total serum estradiol (E2) and testosterone (T) levels; the percentage of immunoreactive (ir) neurons anti-aromatase, anti-estrogen receptor (ERα, ERβ) and anti-androgen receptor (AR); the intensity of the immunostaining anti-glial cell line-derived neurotrophic factor (GDNF) and the GDNF family receptor alpha type 1 (GFRα1); and the number of satellite glial cells (SGCs) per neuron. There was a decrease in the neuronal soma size for the OVX group, which was associated with low T, high percentages of aromatase-ir and neuritic AR-ir neurons, and a strong immunostaining anti-GDNF and anti-GFRα1. The decrease in the neuronal soma size was prevented by the EB treatment that increased the E2 without affecting the T levels. Moreover, there was a high percentage of neuritic AR-ir neurons, a strong GDNF immunostaining in the SGC, and an increase in the SGCs per neuron. Present findings show that estrogens modulate the soma size of neurons of the paravaginal ganglia, likely involving the participation of the SGC.
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Top T, Sekerci CA, Isbilen-Basok B, Tanidir Y, Tinay I, Isman FK, Akbal C, Simsek F, Tarcan T. The effect of intradetrusor botulinum neurotoxin type A on urinary NGF, TGF BETA-1, TIMP-2 levels in children with neurogenic detrusor overactivity due to myelodysplasia. Neurourol Urodyn 2017; 36:1896-1902. [DOI: 10.1002/nau.23207] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 12/06/2016] [Indexed: 11/07/2022]
Affiliation(s)
- Tuncay Top
- Department of Urology; School of Medicine; Marmara University; Istanbul Turkey
| | - Cagri Akin Sekerci
- Department of Urology; School of Medicine; Marmara University; Istanbul Turkey
| | - Banu Isbilen-Basok
- Deparment of Biochemistry; Tepecik Training and Research Hospital; Izmir Turkey
| | - Yiloren Tanidir
- Department of Urology; School of Medicine; Marmara University; Istanbul Turkey
| | - Ilker Tinay
- Department of Urology; School of Medicine; Marmara University; Istanbul Turkey
| | - Ferruh Kemal Isman
- Department of Biochemistry, School of Medicine; Medeniyet University; Istanbul Turkey
| | - Cem Akbal
- Department of Urology; School of Medicine; Marmara University; Istanbul Turkey
| | - Ferruh Simsek
- Department of Urology; School of Medicine; Marmara University; Istanbul Turkey
| | - Tufan Tarcan
- Department of Urology; School of Medicine; Marmara University; Istanbul Turkey
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Antunes-Lopes T, Coelho A, Pinto R, Barros SC, Cruz CD, Cruz F, Silva CM. Urinary Neurotrophin Levels Increase in Women With Stress Urinary Incontinence After a Midurethral Sling Procedure. Urology 2017; 99:49-56. [DOI: 10.1016/j.urology.2016.08.048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 08/17/2016] [Accepted: 08/22/2016] [Indexed: 12/17/2022]
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The immunohistochemical and urodynamic evaluation towards the collagen-coated and non-coated polypropylene meshes implanted in the pelvic wall of the rats. Sci Rep 2016; 6:38960. [PMID: 27991501 PMCID: PMC5172279 DOI: 10.1038/srep38960] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 11/10/2016] [Indexed: 11/08/2022] Open
Abstract
Our aim is to study the inflammatory response towards the collagen-coated and non-coated polypropylene meshes in rats and the urodynamic investigation post-operatively. Forty-two female Sprague Dawley were divided into 7 groups of 6 rats; Control, Day 7 and 30 for Sham, Avaulta Plus (MPC), Perigee (MP). UDS were taken at days 7 and 30. Mesh with the vagina and bladder wall was removed and sent for immunohistochemical examination. Results showed intense inflammatory reaction on day 7 in the study groups which decreased on day 30. IL-1, TNF-α, MMP-2 and CD31 were observed to decrease from day 7 to day 30. NGF was almost normal on day 30 in all groups. UDS showed no difference in voiding pressure. Both Study and Sham groups had shorter voiding interval (VI) on day 7 but significantly lower in MPC. VI had significantly increased on day 30 in all groups. Voided volume was significantly lower in the mesh groups even when an increase was seen on day 30. In conclusion, the higher levels of IL-1, TNF-α and MMP-2 in collagen-coated polypropylene mesh imply greater inflammation than the non-coated polypropylene mesh. Mesh implantation can lead to shorter voiding interval and smaller bladder capacity.
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Lo TS, Lin YH, Chu HC, Cortes EFM, Pue LB, Tan YL, Uy-Patrimonio MC. Association of urodynamics and lower urogenital tract nerve growth factor after synthetic vaginal mesh implantation on a rat model. J Obstet Gynaecol Res 2016; 43:173-178. [PMID: 27762470 DOI: 10.1111/jog.13158] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 08/07/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Tsia-Shu Lo
- Department of Obstetrics and Gynecology; Chang Gung Memorial Hospital, Keelung Medical Center; Keelung Taiwan Republic of China
- Division of Urogynecology, Department of Obstetrics and Gynecology; Linkou, Chang Gung Memorial Hospital, Linkou Medical Center; Taoyuan Taiwan Republic of China
- School of Medicine, Obstetrics and Gynecology; Chang Gung University; Taoyuan Taiwan Republic of China
| | - Yi-Hao Lin
- Division of Urogynecology, Department of Obstetrics and Gynecology; Linkou, Chang Gung Memorial Hospital, Linkou Medical Center; Taoyuan Taiwan Republic of China
- School of Medicine, Obstetrics and Gynecology; Chang Gung University; Taoyuan Taiwan Republic of China
| | - Hsiao-Chien Chu
- Division of Urogynecology, Department of Obstetrics and Gynecology; Linkou, Chang Gung Memorial Hospital, Linkou Medical Center; Taoyuan Taiwan Republic of China
| | - Eileen Feliz M. Cortes
- Division of Urogynecology, Department of Obstetrics and Gynecology; Linkou, Chang Gung Memorial Hospital, Linkou Medical Center; Taoyuan Taiwan Republic of China
- Department of Obstetrics and Gynecology; De La Salle University Medical Center; Dasmariñas Cavite Philippines
| | - Leng Boi Pue
- Department of Obstetrics and Gynecology; Kuala Lumpur Hospital; Kuala Lumpur Malaysia
| | - Yiap Loong Tan
- Department of Obstetrics and Gynecology; Kuching Specialist Hospital; Sarawak Malaysia
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Singla N, Singla AK. Evaluation and Management of Lower Urinary Tract Symptoms After Outlet Surgery for Benign Prostatic Hyperplasia. CURRENT BLADDER DYSFUNCTION REPORTS 2016; 11:242-247. [PMID: 32362986 DOI: 10.1007/s11884-016-0376-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
There are many options available in the surgical treatment of outlet obstruction secondary to benign prostatic hyperplasia (BPH). While most patients exhibit improvement in their lower urinary tract symptoms (LUTS) following intervention, up to 35 % of patients may exhibit persistent or recurrent LUTS. In the present review, we discuss the patho-physiology of LUTS after bladder outlet surgery and discuss considerations in evaluating and managing such patients. We highlight the crucial role of thorough evaluation with complete urodynamics testing, as pure obstruction only accounts for a minority of post-operative LUTS. Hence, detrusor contractility, detrusor overactivity, urethral sphincter function, and urinary incontinence must be assessed to appropriately guide subsequent therapy and improve patients' quality of life.
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Affiliation(s)
- Nirmish Singla
- Department of Urology, University of Texas, Southwestern Medical Center, 5201 Harry Hines Blvd, Dallas, TX 75235, USA
| | - Ajay K Singla
- Department of Urology, University of Toledo Medical Center, 3000 Arlington Avenue, MS1091, Toledo, OH 43614, USA
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Li LF, Ka-Kit Leung G, Lui WM. Sacral Nerve Stimulation for Neurogenic Bladder. World Neurosurg 2016; 90:236-243. [DOI: 10.1016/j.wneu.2016.02.108] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 02/24/2016] [Accepted: 02/25/2016] [Indexed: 01/23/2023]
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Ergin G, Kibar Y, Ebiloğlu T, Irkılata HC, Kopru B, Kaya E, Uyanık M, Tapan S, Dayanc MM. The role of urinary nerve growth factor for the diagnosis and assessment of the biofeedback success in children with dysfunctional voiding. J Pediatr Urol 2016; 12:118.e1-6. [PMID: 26701107 DOI: 10.1016/j.jpurol.2015.09.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 09/27/2015] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Dysfunctional voiding (DV) occurs in neurologically normal children who are not able to establish brain control on detrusor muscle contractions (DMCs). It is also reported to be the result of incorrect voiding habits during toilet training. Children contract pelvic floor muscles (PFMs) to suppress DMC and DV begins. Urinary nerve growth factor (uNGF) is necessary for the synthesis and regulation of neurotransmitters, development of dorsal root ganglia (sensory neurons), and development of sympathetic cells during embryonic and post-natal life. uNGF has also a role in the intracellular signal transduction in nerve cells towards the target organ. To our knowledge, no study has investigated the association between uNGF, biofeedback treatment and DV in children. OBJECTIVES The aim was to examine the potential effect of uNGF in the assessment of the effectiveness of biofeedback success in children with lower urinary tract disorders. STUDY DESIGN Fifty-two children with the suspicion of DV and 48 children from a primary school reporting no urinary complaints were enrolled in this study from October 2010 to April 2013 in the Urology Department. uNGF levels were compared. RESULTS The mean uNGF/creatinine (Cr) level was 0.23 ± 0.26 in the control group and 0.96 ± 0.88 in the DV group (p < 0.001). The mean uNGF/Cr levels in the DV group at baseline and at the end of biofeedback therapy at 6 and 12 months were 0.90 ± 0.78, 0.26 ± 0.32, and 0.40 ± 0.50, respectively (p < 0.001) (Figure). DISCUSSION To our knowledge this study is the first to show the correlations between uNGF levels and biofeedback therapy in children with DV. Tissue NGF in 12 patients with overactive bladder (OAB)/detrusor overactivity and 15 healthy women was previously compared and it was suggested that there was no correlation between bladder tissue NGF and OAB. uNGF levels in the bladder in patients with interstitial cystitis and idiopathic sensorial urgency were evaluated previously, and uNGF levels reported. Similar to these reports, most of the previous studies handled uNGF in patients with diseases such as interstitial cystitis, OAB, urinary tract infections, urolithiasis, spinal cord injury, and prostate cancer, and found significantly higher uNGF levels. These studies were generally in adults. A previous study about uNGF comprised 40 children with OAB, in contrast to other studies. According to this study, 40 children diagnosed with OAB were administered anti-muscarinic therapy (oxybutynin 0.3-0.5 mg/kg/day). It was reported that uNGF/Cr levels of the OAB group were higher than control group. In the current study, we evaluated the uNGF difference in DV and the effect of biofeedback treatment on uNGF levels. CONCLUSIONS uNGF levels were higher in children with DV and decreased after biofeedback therapy. uNGF levels could be used for the diagnosis and the assessment of biofeedback success in these children.
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Affiliation(s)
- Giray Ergin
- Ağrı Military Hospital, Department of Urology, Ağri, Turkey.
| | - Yusuf Kibar
- Gulhane Military Medical Academy, Department of Urology, Gulhane, Turkey
| | - Turgay Ebiloğlu
- Etimesgut Military Hospital, Department of Urology, Etimesgut, Turkey
| | - H Cem Irkılata
- Gulhane Military Medical Academy, Department of Urology, Gulhane, Turkey
| | - Burak Kopru
- Gulhane Military Medical Academy, Department of Urology, Gulhane, Turkey
| | - Engin Kaya
- Gulhane Military Medical Academy, Department of Urology, Gulhane, Turkey
| | - Metin Uyanık
- Gulhane Military Medical Academy, Department of Biochemistry, Gulhane, Turkey
| | - Serkan Tapan
- Gulhane Military Medical Academy, Department of Biochemistry, Gulhane, Turkey
| | - M Murat Dayanc
- Gulhane Military Medical Academy, Department of Urology, Gulhane, Turkey
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Krebs J, Pavlicek D, Stoyanov J, Pannek J, Wöllner J. Nerve growth factor does not seem to be a biomarker for neurogenic lower urinary tract dysfunction after spinal cord injury. Neurourol Urodyn 2016; 36:659-662. [PMID: 26950046 DOI: 10.1002/nau.22987] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 02/12/2016] [Indexed: 12/24/2022]
Abstract
AIM To prospectively investigate the association of bladder function with the nerve growth factor (NGF) concentration in the urine of individuals with neurogenic lower urinary tract dysfunction (NLUTD) after spinal cord injury (SCI). METHODS Individuals with chronic SCI and NLUTD presenting for a routine urologic examination at a tertiary urologic referral center were recruited for the study. Patient characteristics, the current bladder evacuation method and urodynamic parameters were collected. As controls, individuals with normal bladder function were recruited from the staff of a SCI rehabilitation center. The urinary NGF concentration was measured in triplicates by enzyme linked immunosorbent assay with a minimal sensitivity of 10 pg/ml. RESULTS The data of 10 and 37 individuals with normal bladder function and NLUTD, respectively, were analyzed. The urinary NGF concentration was below 10 pg/ml in all investigated samples. CONCLUSIONS The urinary NGF concentration did not differentiate between individuals with normal bladder function and those with NLUTD. At least in patients with SCI, the urinary NGF concentration does not seem to be a clinically relevant biomarker for NLUTD. Neurourol. Urodynam. 36:659-662, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Jörg Krebs
- Clinical Trial Unit, Swiss Paraplegic Centre, Nottwil, Switzerland
| | | | | | - Jürgen Pannek
- Neurourology, Swiss Paraplegic Centre, Nottwil, Switzerland
| | - Jens Wöllner
- Neurourology, Swiss Paraplegic Centre, Nottwil, Switzerland
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Chan R, Munoz A, Wenker EP, Whipple M, Miles B, Boone TB. Solifenacin and Tamsulosin Combination Therapy Decreases Urine Nerve Growth Factor/Creatinine Levels in Men. Urology 2016; 91:150-3. [PMID: 26829718 DOI: 10.1016/j.urology.2016.01.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 01/17/2016] [Accepted: 01/19/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To evaluate urinary nerve growth factor (NGF)/creatinine (Cr) levels from men with symptomatic lower urinary tract symptoms (LUTS) and measure the effect of combination therapy with solifenacin and tamsulosin. MATERIALS AND METHODS From January 2012 to February 2014, all male patients referred for evaluation and management of LUTS were screened for enrollment. In all subjects, urinary NGF and Cr levels were measured and normalized to the urinary Cr concentrations (NGF/Cr). Uroflow, postvoid residual, and symptom questionnaires were measured at baseline, 4 weeks, 8 weeks, and 12 weeks after starting combination therapy with solifenacin 5 mg and tamsulosin 0.4 mg. The primary endpoint was urinary NGF and NGF/Cr change from baseline compared with week 12. RESULTS Ten patients were recruited into the study. Peak urine flow at baseline 20.3 ± 2.5 ml/s and postvoid residual 45.3 ± 13.6 ml did not significantly change with 3 months of combination treatment 14.9 ± 1.8 ml/s and 58.5 ± 23.9 ml. However, urine NGF/Cr (pg/mg) levels were significantly reduced following treatment with levels of 39.7 ± 6.6 at baseline to 17.9 ± 5.1 at 3 months (P value <.05). The decrease in urine NGF/Cr levels correlated with significant decreases in patient reported outcomes. CONCLUSION Male patients with LUTS had decreased urinary NGF/Cr levels after treatment with combination solifenacin and tamsulosin in this novel pilot study. This corresponded with improvement in patient reported outcomes.
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Affiliation(s)
- Robert Chan
- Department of Urology, Houston Methodist Hospital, Houston, TX; Baylor College of Medicine, Houston, TX.
| | - Alvaro Munoz
- Houston Methodist Research Institute, Houston, TX
| | | | - Melissa Whipple
- Department of Urology, Houston Methodist Hospital, Houston, TX
| | - Brian Miles
- Department of Urology, Houston Methodist Hospital, Houston, TX; Baylor College of Medicine, Houston, TX
| | - Timothy B Boone
- Department of Urology, Houston Methodist Hospital, Houston, TX; Baylor College of Medicine, Houston, TX; Houston Methodist Research Institute, Houston, TX
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Kordass U, Carlson R, Stein VM, Tipold A. Measurements of C-reactive protein (CRP) and nerve-growth-factor (NGF) concentrations in serum and urine samples of dogs with neurologic disorders. BMC Vet Res 2016; 12:7. [PMID: 26746899 PMCID: PMC4706657 DOI: 10.1186/s12917-015-0628-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 12/29/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The purpose of this study was to prove the hypothesis that C-reactive protein (CRP) and nerve growth factor (NGF) may be potential biomarkers for lower urinary tract disorders and may be able to distinguish between micturition dysfunctions of different origin in dogs with spinal cord diseases. NGF- and CRP- concentrations were measured in serum and urine samples using specific ELISA-Kits. Results in urine were standardized by urine-creatinine levels. RESULTS CRP in serum was detectable in 32/76 and in urine samples in 40/76 patients. NGF could be measured in all serum and in 70/76 urine samples. Urinary CRP concentrations were significantly higher in dogs with micturition dysfunction (p = 0.0009) and in dogs with different neurological diseases (p = 0.0020) compared to the control group. However, comparing dogs with spinal cord disorders with and without associated micturition dysfunction no significant difference could be detected for NGF and CRP values in urine or serum samples. Additionally, levels did not decrease significantly, when measured at the time when the dogs regained the ability to urinate properly (urinary NGF p = 0.7962; urinary CRP p = 0.078). Urine samples with bacteria and/or leukocytes had no significant increase in urinary NGF (p = 0.1112) or CRP (p = 0.0534) concentrations, but higher CRP-levels in urine from dogs with cystitis were found compared to dogs without signs of cystitis. CONCLUSIONS From these data we conclude that neither CRP nor NGF in urine or serum can be considered as reliable biomarkers for micturition disorders in dogs with spinal cord disorders in a clinical setting, but their production might be part of the pathogenesis of such disorders. Significantly higher levels of CRP could be found in the urine of dogs with micturition dysfunctions compared to control dogs. This phenomenon could potentially be explained by unspecific extrahepatic CRP production by smooth muscle cells in the dilated bladder.
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Affiliation(s)
- Ulrike Kordass
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany.
| | - Regina Carlson
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany.
| | - Veronika Maria Stein
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany.
| | - Andrea Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany.
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The association of urinary nerve growth factor levels with bladder outlet obstruction in women. Female Pelvic Med Reconstr Surg 2016; 21:111-5. [PMID: 25185598 DOI: 10.1097/spv.0000000000000126] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES Nerve growth factor (NGF) has been proposed as a urinary biomarker and previously shown to be elevated in male patients with bladder outlet obstruction (BOO) and other lower urinary tract symptoms. No published studies have examined NGF as a potential urinary biomarker in women with BOO. The aims of this prospective study were to evaluate NGF levels in urine from women with anatomic BOO resulting from pelvic organ prolapse (POP) and/or previous incontinence surgery and to measure the effect associated with surgical or conservative management. METHODS From January to September 2012, all female patients referred for evaluation and management of BOO from POP or previous incontinence surgery were screened for enrollment. Inclusion criteria included elevated postvoid residual, valsalva voiding on urodynamics, or urinary peak flow (Qmax) of 12 mL/s or less. A control group of 10 asymptomatic age-matched female volunteers was also recruited. In all subjects, urinary NGF and creatinine (Cr) levels were measured and normalized to the urinary Cr concentrations (NGF/Cr). Urinary NGF levels were measured at 1 month and 3 months after either surgical correction or initiation of clean intermittent catheterization. RESULTS A total of 10 female patients with anatomic BOO (mean [SD] age of 66.2 [3.88] years) and 10 female control subjects (mean [SD] age of 62 [7] years) were recruited. Nine patients had POP. Six patients had undergone a previous anti-incontinence procedure. Five patients had both POP and undergone a previous anti-incontinence procedure. The urinary NGF/Cr levels in the study patients with BOO (mean [SE] 20.8 [4.31] pg/mg) were significantly higher (P = 0.0001) than the levels in the age-matched control group (5.6 [0.65] pg/mg). After treatment, the urinary NGF/Cr level significantly decreased to 6.50 (0.57) pg/mg (P = 0.01) CONCLUSIONS: In this study, female patients with anatomic BOO resulting from POP and/or previous incontinence surgery had significantly higher urinary NGF/Cr levels when compared with age-matched controls. After treatment, the urinary NGF/Cr levels significantly decreased.
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Chang SD, Lin YH, Liang CC, Chen TC. Effects of sacral nerve stimulation on postpartum urinary retention-related changes in rat bladder. Taiwan J Obstet Gynecol 2015; 54:671-7. [PMID: 26700983 DOI: 10.1016/j.tjog.2015.10.001] [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] [Accepted: 08/21/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To examine the effect of sacral nerve stimulation (SNS) on the urodynamic function and molecular structure of bladders in rats following acute urinary retention (AUR) after parturition. MATERIAL AND METHODS Thirty primiparous rats were divided into three groups: postpartum, postpartum+AUR, and postpartum+AUR+SNS. AUR was achieved by clamping the distal urethra of a rat for 60 minutes. The postpartum+AUR+SNS group received electrical stimulation 60 minutes daily for 3 days after AUR. In addition to cystometric studies and external urethral sphincter electromyography, the expression of caveolins and nerve growth factor (NGF) and caveolae number in bladder muscle were analyzed. RESULTS The postpartum+AUR group has significantly greater residual volume than the postpartum group, but the residual volume decreased significantly after SNS treatment. The postpartum+AUR group had significantly lower peak voiding pressure, a longer bursting period and lower amplitude of electromyograms of external urethral sphincter activity than the postpartum and postpartum+AUR+SNS groups. The postpartum+AUR rats had higher NGF expression, lower caveolin-1 expression, and fewer caveolae in bladder muscle compared with the postpartum rats. Conversely, the caveolin-1 expression and caveolae number increased, and the NGF expression decreased after SNS treatment. CONCLUSION Bladder dysfunction after parturition in a rat model caused by AUR may be restored to the non-AUR structural and functional level after SNS treatment.
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Affiliation(s)
- Shuenn-Dhy Chang
- Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Hao Lin
- Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ching-Chung Liang
- Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Tse-Ching Chen
- College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Pathology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
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Kuo HC. Potential Biomarkers Utilized to Define and Manage Overactive Bladder Syndrome. Low Urin Tract Symptoms 2015; 4 Suppl 1:32-41. [PMID: 26676698 DOI: 10.1111/j.1757-5672.2011.00131.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Clinical diagnosis of overactive bladder (OAB) syndrome has great variation and usually can only be based on subjective symptoms. Measurement of urgency severity score in adjunct with voiding diary may reflect the occurrence of OAB and incontinence severity in daily life. Urodynamic study can detect detrusor overactivity (DO), but not in all OAB patients. A more objective way and less invasive tool to diagnose and assess therapeutic outcome in OAB patients is needed. Recent investigations of the potential biomarkers for OAB include urinary and serum biomarkers and bladder wall thickness. Evidence has also shown that urinary proteins, such as nerve growth factor (NGF) and prostaglandin E2 (PGE2 ) levels increase in patients with OAB, bladder outlet obstruction (BOO) and DO. Patients with OAB have significantly higher urinary NGFlevels and urinary NGF levels decrease after antimuscarinic therapy and further decrease after detrusor botulinum toxin injections. However, the sensitivity of single urinary protein in the diagnosis of OAB is not high and several lower urinary tract diseases may also have elevated urinary NGF levels. Searching for a group of inflammatory biomarkers by microsphere-based array in urine might be a better method in differential diagnosis of OAB from interstitial cystitis, urinary tract infection (UTI) or urolithiasis. Bladder wall thickness has been widely investigated in the diagnosis of BOO and pediatric voiding dysfunction.The role of bladder wall thickness in the diagnosis of OAB, however, has not reach a consistent conclusion. We hereby review the latest medical advances in this field.
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Affiliation(s)
- Hann-Chorng Kuo
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
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Is Postpartum Urinary Retention a Neurogenic Phenomenon? CURRENT BLADDER DYSFUNCTION REPORTS 2015. [DOI: 10.1007/s11884-015-0321-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Urinary nerve growth factor and a variable solifenacin dosage in patients with an overactive bladder. Int Urogynecol J 2015; 27:275-80. [DOI: 10.1007/s00192-015-2825-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 08/04/2015] [Indexed: 11/27/2022]
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