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Urinary Biomarkers in Women with Refractory Urgency Urinary Incontinence Randomized to Sacral Neuromodulation versus OnabotulinumtoxinA Compared to Controls.

Publication ,  Journal Article
Richter, HE; Moalli, P; Amundsen, CL; Malykhina, AP; Wallace, D; Rogers, R; Myers, D; Paraiso, M; Albo, M; Shi, H; Nolen, T; Meikle, S ...
Published in: J Urol
June 2017

PURPOSE: We measured urinary biomarker levels in women with refractory urgency urinary incontinence and controls at baseline and 6 months after treatment with sacral neuromodulation or intradetrusor injection of onabotulinumtoxinA. We also assessed the association of baseline biomarkers with posttreatment urgency urinary incontinence episodes and overactive bladder symptom bother outcomes. MATERIALS AND METHODS: First morning urine samples were collected from consented trial participants and age matched women without urgency urinary incontinence. Biomarkers reflecting general inflammation, neuroinflammation, afferent neurotransmitters and tissue remodeling were measured using standardized enzyme-linked immunosorbent assay and activity assays as appropriate. Symptom bother was assessed by the overactive bladder questionnaire and urgency urinary incontinence episodes were determined by bladder diary. Linear models were used to examine differences in mean biomarker levels and the change in urgency urinary incontinence episodes and symptom bother between baseline and 6 months. Modest evidence of a potential association was represented by p ≤0.01 and p ≤0.004 represented moderate evidence of an association with outcomes. RESULTS: Baseline biomarker levels differed little between cases and controls except tropoelastin (p = 0.001) and N-terminal telopeptide collagen type 1 (p <0.001). Changes in biomarker levels 6 months after intervention included decreases in collagenase (p <0.001) in both treatment groups and increases in interleukin-8 (p = 0.002) and matrix metalloprotease-9 (p <0.001) in the onabotulinumtoxinA group. Higher baseline calcitonin gene-related peptide across both treatments (p = 0.007) and nerve growth factor in the onabotulinumtoxinA arm (p = 0.007) were associated with less reduction in overactive bladder symptom bother. CONCLUSIONS: Refractory urgency urinary incontinence is a complex condition. These data suggest that matrix remodeling and neuropeptide mediation may be involved in its pathophysiological mechanisms and response to treatment.

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Published In

J Urol

DOI

EISSN

1527-3792

Publication Date

June 2017

Volume

197

Issue

6

Start / End Page

1487 / 1495

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Urinary Incontinence, Urge
  • Urinary Bladder, Overactive
  • Transcutaneous Electric Nerve Stimulation
  • Prospective Studies
  • Middle Aged
  • Lumbosacral Plexus
  • Humans
  • Female
  • Botulinum Toxins, Type A
 

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Richter, H. E., Moalli, P., Amundsen, C. L., Malykhina, A. P., Wallace, D., Rogers, R., … Pelvic Floor Disorders Network, . (2017). Urinary Biomarkers in Women with Refractory Urgency Urinary Incontinence Randomized to Sacral Neuromodulation versus OnabotulinumtoxinA Compared to Controls. J Urol, 197(6), 1487–1495. https://doi.org/10.1016/j.juro.2017.01.037
Richter, Holly E., Pamela Moalli, Cindy L. Amundsen, Anna P. Malykhina, Dennis Wallace, Rebecca Rogers, Deborah Myers, et al. “Urinary Biomarkers in Women with Refractory Urgency Urinary Incontinence Randomized to Sacral Neuromodulation versus OnabotulinumtoxinA Compared to Controls.J Urol 197, no. 6 (June 2017): 1487–95. https://doi.org/10.1016/j.juro.2017.01.037.
Richter HE, Moalli P, Amundsen CL, Malykhina AP, Wallace D, Rogers R, et al. Urinary Biomarkers in Women with Refractory Urgency Urinary Incontinence Randomized to Sacral Neuromodulation versus OnabotulinumtoxinA Compared to Controls. J Urol. 2017 Jun;197(6):1487–95.
Richter, Holly E., et al. “Urinary Biomarkers in Women with Refractory Urgency Urinary Incontinence Randomized to Sacral Neuromodulation versus OnabotulinumtoxinA Compared to Controls.J Urol, vol. 197, no. 6, June 2017, pp. 1487–95. Pubmed, doi:10.1016/j.juro.2017.01.037.
Richter HE, Moalli P, Amundsen CL, Malykhina AP, Wallace D, Rogers R, Myers D, Paraiso M, Albo M, Shi H, Nolen T, Meikle S, Word RA, Pelvic Floor Disorders Network. Urinary Biomarkers in Women with Refractory Urgency Urinary Incontinence Randomized to Sacral Neuromodulation versus OnabotulinumtoxinA Compared to Controls. J Urol. 2017 Jun;197(6):1487–1495.
Journal cover image

Published In

J Urol

DOI

EISSN

1527-3792

Publication Date

June 2017

Volume

197

Issue

6

Start / End Page

1487 / 1495

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Urinary Incontinence, Urge
  • Urinary Bladder, Overactive
  • Transcutaneous Electric Nerve Stimulation
  • Prospective Studies
  • Middle Aged
  • Lumbosacral Plexus
  • Humans
  • Female
  • Botulinum Toxins, Type A