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Urinary Biomarkers of Detrusor Underactivity

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Abstract

Purpose of Review

Detrusor underactivity (DU) is a urodynamic diagnosis, often related with the multifactorial symptom complex designated as underactive bladder (UAB), resulting in prolonged and/or incomplete bladder emptying, and many times with a high postvoid residual. DU is a largely under-researched topic and constitutes a multifactorial condition, with several underlying pathophysiological mechanisms, which can be categorized as idiopathic, neurogenic, myogenic, or functional. The main etiological factors of DU are aging, diabetes mellitus, neurogenic disorders, and bladder outlet obstruction (BOO). Biomarkers constitute objectively measurable characteristics that can be evaluated as indicators of physiological and pathogenic processes and might be used as diagnostic, prognostic, or predictive tools in clinical care. Herein, we review up-to-date knowledge of urinary biomarkers of DU.

Recent Findings

Several urinary biomarkers, including neurotrophins (NGF and BDNF), markers of oxidative stress, prostaglandins, inflammatory cytokines, ATP/NO, and miRNA, have recently been studied in relation to DU, providing potential insights into the pathophysiology and possible therapeutic targets for this condition.

Summary

In DU, biomarkers could allow for early DU diagnosis and monitoring, also granting a larger potential for therapies to halt or revert pathologic changes, such as afferent neurogenic dysfunction, neuroinflammation, denervation and fibrosis of detrusor muscle, and myogenic failure.

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Funding

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Author information

Authors and Affiliations

  1. Department of Urology, São João University Hospital, Porto, Portugal

    João Oliveira, Luís Vale, João Silva & Tiago Antunes-Lopes

  2. Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal

    João Oliveira, Gabriel Faria-Costa, Luís Vale, João Silva & Tiago Antunes-Lopes

  3. Department of Urology, ULS Matosinhos, Porto, Portugal

    Gabriel Faria-Costa

  4. Department of Experimental Biology, Faculty of Medicine, University of Porto, Porto, Portugal

    Ana Charrua

  5. i3S – Institute for Research and Innovation in Health, University of Porto, Porto, Portugal

    Ana Charrua & Tiago Antunes-Lopes

Authors
  1. João Oliveira
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  3. Ana Charrua
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  4. Luís Vale
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  5. João Silva
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  6. Tiago Antunes-Lopes
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Contributions

JO, FC, and TAL wrote the main manuscript. LV reviewed the section on urinary ATP and NO levels. AC and JS reviewed the literature review and the rational and interpretation of study results. All authors reviewed the manuscript.

Corresponding author

Correspondence to Tiago Antunes-Lopes.

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João Oliveira, Gabriel Costa, Ana Charrua, Luís Vale, João Silva, Tiago Antunes-Lopes declare that they have no conflict of interest.

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Oliveira, J., Faria-Costa, G., Charrua, A. et al. Urinary Biomarkers of Detrusor Underactivity. Curr Bladder Dysfunct Rep 19, 83–88 (2024). https://doi.org/10.1007/s11884-024-00737-7

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