How do we make progress in phenotyping patients with lower urinary tract such as overactive bladder and underactive detrusor, including using urine markers and microbiome data, to personalize therapy? ICI-RS 2023-Part 2

Enrico Finazzi Agrò; Eleonora Rosato; Adrian Wagg; Sanjay Sinha; Claudia Fede Spicchiale; Maurizio Serati; Vito Mancini; Mathijs de Rijk; Tufan Tarcan; Alan Wein; Paul Abrams; George Bou Kheir

doi:10.1002/nau.25379

How do we make progress in phenotyping patients with lower urinary tract such as overactive bladder and underactive detrusor, including using urine markers and microbiome data, to personalize therapy? ICI-RS 2023-Part 2

Neurourol Urodyn. 2024 Jan 4. doi: 10.1002/nau.25379. Online ahead of print.

Authors

Affiliations

¹ Department of Surgical Sciences, University of Rome Tor Vergata and Urology Unit, Policlinico Tor Vergata University Hospital, Rome, Italy.
² School of Specialization in Urology, University of Rome Tor Vergata and Urology Unit, Policlinico Tor Vergata University Hospital, Rome, Italy.
³ Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
⁴ Department of Urology, Apollo Hospital, Hyderabad, India.
⁵ Department of Urology, University Hospital Monklands, NHS Lanarkshire, Airdrie, UK.
⁶ Department Obstetrics and Gynecology. Urogynecology Unit, University of Insubria, Varese, Italy.
⁷ Urinary Incontinence Center, Urology and Renal Transplantation Unit, Policlinico di Foggia Hospital and University of Foggia, Foggia, Italy.
⁸ Department of Urology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Center, Maastricht University, Maastricht, The Netherlands.
⁹ Marmara University School of Medicine, Istanbul, Turkey.
¹⁰ Koç University, Istanbul, Turkey.
¹¹ Desai Sethi Institute of Urology, Miller School of Medicine, University of Miami, Miami, Florida, USA.
¹² Department of Urology, University of Bristol, Bristol, UK.
¹³ Gent University Hospital, Gent, Belgium.

PMID: 38178629
DOI: 10.1002/nau.25379

Abstract

Introduction: Overactive bladder (OAB) and underactive bladder (UAB) could be associated with metabolic syndrome, affective disorders, sex hormone deficiency, changes in urinary microbiota, functional gastrointestinal disorders, or autonomic nervous system dysfunction.

Objectives: The aim of this Think Tank was to provide a guide on how to investigate OAB and/or detrusor underactivity (DU) patients to better clarify the underlying pathophysiology and possibly personalize the treatment.

Methods: A compendium of discussion based on the current evidence related to phenotyping patients with OAB or DU using urodynamic tests, functional neuro-imaging, urinary markers, and microbiome.

Results and conclusions: The article emphasizes the critical significance of adopting a comprehensive yet tailored approach to phenotyping patients with lower urinary tract (LUT) symptoms, such as OAB and UAB. The intricate interplay between the LUT and various factors, metabolic, neurological, psychological, and gastrointestinal can define unique LUT profiles, enabling personalized therapies to replace the one-size-fits-all approach.

Keywords: functional neuro-imaging; microbiome; overactive bladder; underactive bladder; urinary markers; urodynamic tests.