MP76-06 URINARY NEUROTROPHINS AND QMAX VARIATION MAY PREDICT DE NOVO URGENCY IN SUI PATIENTS AFTER A MIDURETHRAL SLING (MUS) SURGERY

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Non-neurogenic Voiding Dysfunction1 Apr 2014MP76-06 URINARY NEUROTROPHINS AND QMAX VARIATION MAY PREDICT DE NOVO URGENCY IN SUI PATIENTS AFTER A MIDURETHRAL SLING (MUS) SURGERY Tiago Antunes-Lopes, Daniel Costa, Rui Pinto, Sérgio Carvalho-Barros, Carlos Martins-Silva, Célia Duarte-Cruz, and Francisco Cruz Tiago Antunes-LopesTiago Antunes-Lopes More articles by this author , Daniel CostaDaniel Costa More articles by this author , Rui PintoRui Pinto More articles by this author , Sérgio Carvalho-BarrosSérgio Carvalho-Barros More articles by this author , Carlos Martins-SilvaCarlos Martins-Silva More articles by this author , Célia Duarte-CruzCélia Duarte-Cruz More articles by this author , and Francisco CruzFrancisco Cruz More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2399AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Nearly 10% of women with stress urinary incontinence (SUI) submitted to a midurethral sling (MUS) surgery develop urgency, eventually maintaining incontinence and low quality of life. High levels of nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) were measured in the urine of OAB patients, while low levels of both neurotrophins (NT) were reported in SUI women. Therefore, NT might be involved in the emergence of urgency, throughout sensitization of bladder afferent nerves. We measured urinary levels of NGF and BDNF, and calculated maximum flow rate (Qmax) variation, in women with SUI, before and after a midurethral sling (MUS) surgery, to investigate the role of NT and flow reduction in the emergence of urgency. METHODS Urine samples were collected from 31 patients with pure clinical SUI and 20 healthy women. SUI patients underwent surgical treatment with a transobturator MUS or a mini-sling. At 1-yr follow-up, patients were reevaluated and the onset of de novo urgency was investigated. Uroflowmetry and urine sampling were repeated. Urinary NGF and BDNF levels were measured by ELISA and normalized to creatinine concentration (pg/mg). The Qmax variation was calculated for each patient and correlated with urinary levels of NT after surgery. RESULTS At baseline, urinary levels of NGF and BDNF were similar between SUI and healthy women (NGF/Cr: 199.0±176.5 vs. 188.3±290.2, p=0.884; BDNF/Cr: 173.8±193.4 vs. 110.4±159.5, p=0.236). In SUI patients, 1-yr after surgery, NGF increased to 448.2±360.3 (vs. baseline, p=0.002) and BDNF to 472.8±541.8 (vs. baseline, p=0.002). Eight patients developed de novo urgency. In this group, NGF increased from 183.5±182.3 to 646.7±471.9 (p=0.034), and BDNF from 188.3±159.0 to 815.6±833.7 (p=0.037). In patients without urgency (n=23), there was a lower, but significant, increase of NT (NGF: 204.3±178.2 to 379.2±294.8, p=0.031; BDNF: 177.0±206.5 to 352.5±348.6, p=0.021). Comparing both groups, patients who developed urgency had significantly higher levels of NGF (646.7±471.9 vs. 379.2±294.8, p=0.029) and BDNF (815.6±833.7 vs. 352.5±348.6, p=0.034). Moreover, women who developed urgency had a higher Qmax reduction than women without urgency (23.8±4.9% vs. 18.3±8.4%, p=0.085). CONCLUSIONS In SUI women, after a MUS surgery, urinary NT significantly increase. This raise was remarkably higher in women who develop urgency, who also presented a higher reduction in Qmax. These data suggest that obstruction may cause long-term changes in urinary NT, promoting the emergence of urgency. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e884 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Tiago Antunes-Lopes More articles by this author Daniel Costa More articles by this author Rui Pinto More articles by this author Sérgio Carvalho-Barros More articles by this author Carlos Martins-Silva More articles by this author Célia Duarte-Cruz More articles by this author Francisco Cruz More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...