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Urinary Neurotrophin Levels Increase in Women With Stress Urinary Incontinence After a Midurethral Sling Procedure.
Urology. 2017 Jan; 99:49-56.U

Abstract

OBJECTIVE

To investigate the association between urinary neurotrophin levels, maximum flow rate (Qmax) variation, and the appearance of urgency in women with stress urinary incontinence (SUI) after a midurethral sling (MUS) procedure.

MATERIALS AND METHODS

Thirty-one women with SUI were treated with a MUS. One year later, the outcome of surgery and the onset of urgency were assessed. At baseline and 1-year follow-up, urine was collected to measure nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) concentration, and Qmax variation was calculated. Urine samples from healthy women (n = 20) without lower urinary tract symptoms and overactive bladder (OAB) wet patients (n = 32) were used as controls. Urinary neurotrophin levels were measured by enzyme-linked immunosorbent assay and normalized to creatinine concentration.

RESULTS

At baseline, urinary levels of NGF and BDNF were similar between SUI and healthy women (NGF: 2.10 ± 0.68 vs 1.99 ± 1.05; BDNF: 1.99 ± 0.71 vs 1.81 ± 0.90), and significantly inferior to OAB wet patients (NGF: 2.10 ± 0.68 vs 2.50 ± 0.54, P < .05; BDNF: 1.99 ± 0.71 vs 2.71 ± 0.45, P < .05). After surgery, there was a significant increase of both neurotrophins (vs baseline, P < .05) to the values of OAB wet patients. Moreover, there was a significantly higher percentage increase of NGF in women with de novo urgency than in those without lower urinary tract symptoms (P = .019). A trend for a higher mean Qmax reduction in women with de novo urgency was also found (P = .085).

CONCLUSION

These findings suggest that increased bladder outlet resistance after a MUS may play a key role in the rise of urinary neurotrophins, promoting sensitization of bladder primary afferents and causing de novo urgency in susceptible patients.

Authors+Show Affiliations

Department of Urology, Hospital de S. João, Porto, Portugal; Faculty of Medicine, University of Porto, Portugal; I3S - Instituto de Inovação e Investigação em Saúde, IBMC - Institute for Molecular and Cell Biology, University of Porto, Portugal. Electronic address: tiagoantuneslopes@gmail.com.I3S - Instituto de Inovação e Investigação em Saúde, IBMC - Institute for Molecular and Cell Biology, University of Porto, Portugal; Department of Experimental Biology, Faculty of Medicine, University of Porto, Portugal.Department of Urology, Hospital de S. João, Porto, Portugal; Faculty of Medicine, University of Porto, Portugal; I3S - Instituto de Inovação e Investigação em Saúde, IBMC - Institute for Molecular and Cell Biology, University of Porto, Portugal.I3S - Instituto de Inovação e Investigação em Saúde, IBMC - Institute for Molecular and Cell Biology, University of Porto, Portugal; Department of Experimental Biology, Faculty of Medicine, University of Porto, Portugal.I3S - Instituto de Inovação e Investigação em Saúde, IBMC - Institute for Molecular and Cell Biology, University of Porto, Portugal; Department of Experimental Biology, Faculty of Medicine, University of Porto, Portugal.Department of Urology, Hospital de S. João, Porto, Portugal; Faculty of Medicine, University of Porto, Portugal; I3S - Instituto de Inovação e Investigação em Saúde, IBMC - Institute for Molecular and Cell Biology, University of Porto, Portugal.Department of Urology, Hospital de S. João, Porto, Portugal; Faculty of Medicine, University of Porto, Portugal; I3S - Instituto de Inovação e Investigação em Saúde, IBMC - Institute for Molecular and Cell Biology, University of Porto, Portugal.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27697460

Citation

Antunes-Lopes, Tiago, et al. "Urinary Neurotrophin Levels Increase in Women With Stress Urinary Incontinence After a Midurethral Sling Procedure." Urology, vol. 99, 2017, pp. 49-56.
Antunes-Lopes T, Coelho A, Pinto R, et al. Urinary Neurotrophin Levels Increase in Women With Stress Urinary Incontinence After a Midurethral Sling Procedure. Urology. 2017;99:49-56.
Antunes-Lopes, T., Coelho, A., Pinto, R., Barros, S. C., Cruz, C. D., Cruz, F., & Silva, C. M. (2017). Urinary Neurotrophin Levels Increase in Women With Stress Urinary Incontinence After a Midurethral Sling Procedure. Urology, 99, 49-56. https://doi.org/10.1016/j.urology.2016.08.048
Antunes-Lopes T, et al. Urinary Neurotrophin Levels Increase in Women With Stress Urinary Incontinence After a Midurethral Sling Procedure. Urology. 2017;99:49-56. PubMed PMID: 27697460.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Urinary Neurotrophin Levels Increase in Women With Stress Urinary Incontinence After a Midurethral Sling Procedure. AU - Antunes-Lopes,Tiago, AU - Coelho,Ana, AU - Pinto,Rui, AU - Barros,Sérgio C, AU - Cruz,Célia D, AU - Cruz,Francisco, AU - Silva,Carlos M, Y1 - 2016/09/30/ PY - 2016/05/19/received PY - 2016/08/17/revised PY - 2016/08/22/accepted PY - 2016/10/5/pubmed PY - 2018/3/15/medline PY - 2016/10/5/entrez SP - 49 EP - 56 JF - Urology JO - Urology VL - 99 N2 - OBJECTIVE: To investigate the association between urinary neurotrophin levels, maximum flow rate (Qmax) variation, and the appearance of urgency in women with stress urinary incontinence (SUI) after a midurethral sling (MUS) procedure. MATERIALS AND METHODS: Thirty-one women with SUI were treated with a MUS. One year later, the outcome of surgery and the onset of urgency were assessed. At baseline and 1-year follow-up, urine was collected to measure nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) concentration, and Qmax variation was calculated. Urine samples from healthy women (n = 20) without lower urinary tract symptoms and overactive bladder (OAB) wet patients (n = 32) were used as controls. Urinary neurotrophin levels were measured by enzyme-linked immunosorbent assay and normalized to creatinine concentration. RESULTS: At baseline, urinary levels of NGF and BDNF were similar between SUI and healthy women (NGF: 2.10 ± 0.68 vs 1.99 ± 1.05; BDNF: 1.99 ± 0.71 vs 1.81 ± 0.90), and significantly inferior to OAB wet patients (NGF: 2.10 ± 0.68 vs 2.50 ± 0.54, P < .05; BDNF: 1.99 ± 0.71 vs 2.71 ± 0.45, P < .05). After surgery, there was a significant increase of both neurotrophins (vs baseline, P < .05) to the values of OAB wet patients. Moreover, there was a significantly higher percentage increase of NGF in women with de novo urgency than in those without lower urinary tract symptoms (P = .019). A trend for a higher mean Qmax reduction in women with de novo urgency was also found (P = .085). CONCLUSION: These findings suggest that increased bladder outlet resistance after a MUS may play a key role in the rise of urinary neurotrophins, promoting sensitization of bladder primary afferents and causing de novo urgency in susceptible patients. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/27697460/Urinary_Neurotrophin_Levels_Increase_in_Women_With_Stress_Urinary_Incontinence_After_a_Midurethral_Sling_Procedure_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-4295(16)30642-2 DB - PRIME DP - Unbound Medicine ER -