How do we make progress in phenotyping patients with LUT such as OAB and underactive detrusor, including using urine markers and microbiome data, in order to personalize therapy? ICI-RS 2023: Part 1

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.25377

How do we make progress in phenotyping patients with LUT such as OAB and underactive detrusor, including using urine markers and microbiome data, in order to personalize therapy? ICI-RS 2023: Part 1

Neurourol Urodyn. 2024 Jan 4. doi: 10.1002/nau.25377. 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, Policlinico Tor Vergata University Hospital, University of Rome Tor Vergata and Urology Unit, 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 Urology and renal transplantation Unit, Urinary incontinence center, 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 and Koç University School of Medicine, Istanbul, Turkey.
¹⁰ University of Miami Miller School of Medicine, Desai Sethi Institute of Urology, Miami, Florida, USA.
¹¹ Department of Urology, University of Bristol, Bristol, UK.
¹² Gent University Hospital, Gent, Belgium.

PMID: 38178627
DOI: 10.1002/nau.25377

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 investigating metabolic, neurogical, psychological and gastrointestinal aspects with the aim to personalize the treatment.

Results and conclusions: The article emphasizes the critical significance of adopting a comprehensive yet tailored approach to phenotyping patients with lower urinary tract symptoms, such as OAB and UAB. The intricate interplay between the lower urinary tract 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: affective disorders; autonomic nervous system dysfunction; gastrointestinal disorders; metabolic syndrome; microbiome; overactive bladder; underactive bladder.