Presentation Authors: Paulo Sajovic de Conti, São Paulo, Brazil, Joao A B A Barbosa*, Sabrina Reis, Naya Viana, Marco Nunes, William Nahas, Miguel Srougi, Alberto Antunes, Sao Paulo, Brazil
Introduction: The Mechanisms leading to detrusor hyperactivity (DH) associated with BPH and the chance of postoperative resolution remains incompletely understood. Identifying urinary markers associated with DH related to BPH, and with the prediction of resolution may further elucidate some of these mechanisms as well as provide prognostic tests. Our objective was to evaluate the expression of EGF, MMP-1, IL-6, NGF and MCP-1 in the urine of patients with BPH undergoing transurethral resection of the prostate (TURP) and identify within these biomarkers which are associated with postoperative outcomes.
Methods: We analyzed urine samples from 71 patients undergoing TURP from 2011 to 2017. Urinary levels of EGF, MMP-1, IL-6, NGF and MCP-1 (by commercial ELISA kit) normalized to creatinine were analyzed according to prostate volume, IPSS, estimated postvoid residual volume, and urodynamic parameters in the preoperative period and 12 months after surgery.
Results: Urinary levels of MCP-1/Cr were higher in patients presenting DH preoperativerly (1.38 vs 3.6 ng/mL, p=0.002). Regarding persistence of DH 12 months after surgery, the levels of the NGF/Cr (0.13 vs 0.08, p=0.005) and MMP-1/Cr (0.11 vs 0.04, p=0.021) biomarkers were higher among patients in whom DH persisted postoperatively. The biomarker NGF/Cr, with a cutoff of 0.08 had 84% sensitivity and 70% specificity for prediction of persistence of DH (Area under curve 0.77; 95% CI: 0.62-0.92; p=0.006). MMP-1/Cr, with a cutoff of 0.016 had 76% sensitivity and 64% specificity in predicting persistence of DH (AUC 0.72 ; 95% CI: 0.56-0.88; p=0.022).
Conclusions: NGF/Cr and MMP-1/Cr were shown to be useful in predicting the persistence of DH in the postoperative period.
Source of Funding: FundaÃ§Ã£o de Amparo Ã Pesquisa do Estado de SÃ£o Paulo - FAPESP