Systematic review of urinary biomarkers of female bladder outlet obstruction (fBOO)
https://doi.org/10.4081/aiua.2022.3.355
Accepted: June 5, 2022
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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.
Martinez L, Khavari R. New frontiers in molecular and imaging research on evaluation and diagnosis of bladder outlet obstruction in women. Curr Bladder Dysfunct Rep 2017; 12:291-297. DOI: https://doi.org/10.1007/s11884-017-0429-0
Haylen BT, de Ridder D, Freeman RM, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010; 29:4-20. DOI: https://doi.org/10.1002/nau.20798
Blaivas JG, Groutz A. Bladder outlet obstruction nomogram for women with lower urinary tract symptomatology. Neurourol Urodyn. 2000; 19:553-64. DOI: https://doi.org/10.1002/1520-6777(2000)19:5<553::AID-NAU2>3.0.CO;2-B
Meier K, Padmanabhan P. Female bladder outlet obstruction: an update on diagnosis and management. Curr Opin Urol. 2016; 26:334-41. DOI: https://doi.org/10.1097/MOU.0000000000000303
Chan R, Munoz A, Wenker EP, et al. The association of urinary nerve growth factor levels with bladder outlet obstruction in women. Female Pelvic Med Reconstr Surg. 2015; 21:111-5. DOI: https://doi.org/10.1097/SPV.0000000000000126
Steers WD, Kolbeck S, Creedon D, Tuttle JB. Nerve growth factor in the urinary bladder of the adult regulates neuronal form and function. J Clin Invest. 1991; 88:1709-15. DOI: https://doi.org/10.1172/JCI115488
Malde S, Solomon E, Spilotros M, et al. Female bladder outlet obstruction: Common symptoms masking an uncommon cause. Low Urin Tract Symptoms. 2019; 11:72-77. DOI: https://doi.org/10.1111/luts.12196
Santis-Moya F, Calvo CI, Rojas T, et al. Urodynamic and clinical features in women with overactive bladder: When to suspect concomitant voiding dysfunction? Neurourol Urodyn. 2021; 40:1509-1514. DOI: https://doi.org/10.1002/nau.24688
Mytilekas KV, Oeconomou A, Sokolakis I, et al. Defining voiding dysfunction in women: bladder outflow obstruction versus detrusor underactivity. Int Neurourol J. 2021; 25:244-251. DOI: https://doi.org/10.5213/inj.2040342.171
Pang KH, Campi R, Arlandis S, et al. Diagnostic tests for female bladder outlet obstruction: a systematic review from the European Association of Urology Non-neurogenic Female LUTS Guidelines Panel. Eur Urol Focus. 2021;S2405-4569(21)00231-5. DOI: https://doi.org/10.1016/j.euf.2021.09.003
Wada N, Matsumoto S, Kita M, et al. Decreased urinary nerve growth factor reflects prostatic volume reduction and relief of outlet obstruction in patients with benign prostatic enlargement treated with dutasteride. Int J Urol. 2014; 21:1258-62. DOI: https://doi.org/10.1111/iju.12570
Kim JC, Park EY, Seo SI, et al. Nerve growth factor and prostaglandins in the urine of female patients with overactive bladder. J Urol. 2006; 175:1773-6. DOI: https://doi.org/10.1016/S0022-5347(05)00992-4
Kuo HC. Potential biomarkers utilized to define and manage overactive bladder syndrome. Low Urin Tract Symptoms. 2012; 4 Suppl 1:32-41. DOI: https://doi.org/10.1111/j.1757-5672.2011.00131.x
Mikhailidis DP, Jeremy JY, Dandona P. Urinary bladder prostanoids--their synthesis, function and possible role in the pathogenesis and treatment of disease. J Urol. 1987; 137:577-82. DOI: https://doi.org/10.1016/S0022-5347(17)44109-7
Vlaskovska M, Kasakov L, Rong W, et al. P2X3 knock-out mice reveal a major sensory role for urothelially released ATP. J Neurosci. 2001; 211:5670-7. DOI: https://doi.org/10.1523/JNEUROSCI.21-15-05670.2001
Shiina K, Hayashida KI, Ishikawa K, Kawatani M. ATP release from bladder urothelium and serosa in a rat model of partial bladder outlet obstruction. Biomed Res. 2016; 37:299-304. DOI: https://doi.org/10.2220/biomedres.37.299
Chen Z, Liu Y, Zhao M, et al. Urinary ATP may be a biomarker for bladder outlet obstruction and its severity in patients with benign prostatic hyperplasia. Transl Androl Urol. 2020; 9:284-294. DOI: https://doi.org/10.21037/tau.2020.02.18
Silva-Ramos M, Silva I, Oliveira JC, Correia-de-Sá P. Increased urinary adenosine triphosphate in patients with bladder outlet obstruction due to benign prostate hyperplasia. Prostate. 2016;76:1353-63. DOI: https://doi.org/10.1002/pros.23207
Gheinani AH, Kiss B, Moltzahn F, et al. Characterization of miRNA-regulated networks, hubs of signaling, and biomarkers in obstruction-induced bladder dysfunction. JCI Insight. 2017;2:e89560. DOI: https://doi.org/10.1172/jci.insight.89560
von Siebenthal M, Besic M, Gheinani AH, et al. Urinary miRNA profiles discriminate between obstruction-induced bladder dysfunction and healthy controls. Sci Rep. 2021; 11:10204. DOI: https://doi.org/10.1038/s41598-021-89535-3
Lin WY, Chen CS, Wu SB, et al. Oxidative stress biomarkers in urine and plasma of rabbits with partial bladder outlet obstruction. BJU Int. 2011; 107:1839-43. DOI: https://doi.org/10.1111/j.1464-410X.2010.09597.x
Lin WY, Hsieh CC, Yang TY, et al. Transient increase in circulating myeloid-derived suppressor cells after partial bladder outlet obstruction. J Urol. 2014; 192:1569-73. DOI: https://doi.org/10.1016/j.juro.2014.05.045
Clayton DB, Stephany HA, Ching CB, et al. F2-isoprostanes as a biomarker of oxidative stress in the mouse bladder. J Urol. 2014; 191(5 Suppl):1597-601. DOI: https://doi.org/10.1016/j.juro.2013.09.027
Brierly RD, Hindley RG, McLarty E, et al. A prospective evaluation of detrusor ultrastructural changes in bladder outlet obstruction. BJU Int. 2003; 91:360-4. DOI: https://doi.org/10.1046/j.1464-410X.2003.04092.x
Wang A, Brammah S, Tse V, Chan L. Comparison of ultrastructural features in female and male bladder outlet obstruction: a potential role for diagnostic detrusor muscle biopsy. J Urol. 2015; 193 (Suppl 4): E1105. DOI: https://doi.org/10.1016/j.juro.2015.02.1813
Fusco F, Creta M, De Nunzio C, et al. Progressive bladder remodeling due to bladder outlet obstruction: a systematic review of morphological and molecular evidences in humans. BMC Urol. 2018;18:15. DOI: https://doi.org/10.1186/s12894-018-0329-4
Hughes FM Jr, Hill HM, Wood CM, et al. The NLRP3 inflammasome mediates inflammation produced by bladder outlet obstruction. J Urol. 2016; 195:1598-1605. DOI: https://doi.org/10.1016/j.juro.2015.12.068
Michishita M, Yano K, Tomita KI,, et al. Piezo1 expression increases in rat bladder after partial bladder outlet obstruction. Life Sci. 2016; 166:1-7. DOI: https://doi.org/10.1016/j.lfs.2016.10.017
Chung HC, Lee CK, Park KH, Jeong SW. Bladder outlet obstruction causes up-regulation of nicotinic acetylcholine receptors in bladder-projecting pelvic ganglion neurons. Brain Res. 2015; 1602:111-8. DOI: https://doi.org/10.1016/j.brainres.2015.01.026
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