Department of Urology, Peking University People's Hospital, Beijing, China.
Department of Urology, 1st Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
J Urol. 2018 Sep;200(3):620-625. doi: 10.1016/j.juro.2018.03.130. Epub 2018 Apr 7.
We investigated changes in urinary nerve growth factor in patients with benign prostatic hyperplasia after transurethral prostate resection. We also assessed the association between nerve growth factor and changes of overactive bladder symptoms and long-term treatment outcomes after surgery.
This was a prospective study of 178 patients at Peking University People's Hospital with benign prostatic hyperplasia between January 2011 and January 2013. Urinary nerve growth factor levels were determined preoperatively using a commercial enzyme-linked immunosorbent assay kit. We also determined prostate volume, I-PSS (International Prostate Symptom Score), quality of life, OABSS (Overactive Bladder Symptom Score), ultrasound estimated post-void residual urine and urodynamics before surgery. Urinary nerve growth factor levels, I-PSS and OABSS were assessed again 1 year after transurethral prostate resection.
Urinary nerve growth factor/creatinine levels differed between patients with moderate and severe lower urinary tract symptoms (mean ± SD 10.513 ± 4.255 vs 12.334 ± 4.048 pg/μmol, p = 0.002). There was no significant difference between patients with grades III/IV and V/VI bladder outlet obstruction (mean 11.285 ± 4.069 vs 11.781 ± 4.437 pg/μmol, p = 0.354). However, differences were significant for urinary nerve growth factor/creatinine levels in patients without overactive bladder, and mild, moderate and severe overactive bladder (mean 8.132 ± 3.489, 10.128 ± 3.817, 13.232 ± 3.290 and 14.029 ± 3.820 pg/μmol, respectively, p <0.001). One year after transurethral prostate resection we noted a decrease vs baseline in mean urinary nerve growth factor/creatinine (8.978 ± 4.022 pg/μmol, p <0.001), and I-PSS and OABSS (10.2 ± 5.4 and 4.3 ± 3.7, respectively, each p <0.001). Compared with the good outcome group, the fair/poor group had higher mean baseline urinary nerve growth factor/creatinine (12.319 ± 4.017 vs 11.015 ± 4.298 pg/μmol, p = 0.045), higher mean 1-year urinary nerve growth factor/creatinine (10.847 ± 4.267 vs 7.850 ± 3.419 pg/μmol, p <0.001) and a lesser mean postoperative change in urinary nerve growth factor/creatinine (1.472 ± 4.928 vs 3.165 ± 4.863 pg/μmol, p = 0.031).
Nerve growth factor was associated with overactive bladder symptoms in patients with benign prostatic hyperplasia as well as with the assessment of successful long-term treatment outcome of bladder outlet obstruction with symptoms of overactive bladder.
我们研究了良性前列腺增生患者经尿道前列腺切除术后尿神经生长因子的变化。我们还评估了神经生长因子与膀胱过度活动症状变化以及术后长期治疗结果之间的关系。
这是北京大学人民医院 2011 年 1 月至 2013 年 1 月期间 178 例良性前列腺增生患者的前瞻性研究。使用商业酶联免疫吸附试验试剂盒术前测定尿神经生长因子水平。我们还在手术前测定了前列腺体积、I-PSS（国际前列腺症状评分）、生活质量、OABSS（膀胱过度活动症状评分）、超声估计残余尿量和尿动力学。经尿道前列腺切除术后 1 年再次评估尿神经生长因子、I-PSS 和 OABSS。
尿神经生长因子/肌酐水平在中重度下尿路症状患者之间存在差异（平均值 ± SD 为 10.513 ± 4.255 比 12.334 ± 4.048 pg/μmol，p = 0.002）。III/IV 级和 V/VI 级膀胱出口梗阻患者之间无显著差异（平均为 11.285 ± 4.069 比 11.781 ± 4.437 pg/μmol，p = 0.354）。然而，在无膀胱过度活动症、轻度、中度和重度膀胱过度活动症患者中，尿神经生长因子/肌酐水平存在显著差异（平均值分别为 8.132 ± 3.489、10.128 ± 3.817、13.232 ± 3.290 和 14.029 ± 3.820 pg/μmol，p <0.001）。经尿道前列腺切除术后 1 年，我们发现与基线相比，尿神经生长因子/肌酐（8.978 ± 4.022 pg/μmol，p <0.001）、I-PSS 和 OABSS（10.2 ± 5.4 和 4.3 ± 3.7，分别为 p <0.001）均有所下降。与良好结局组相比，不良/差结局组基线时尿神经生长因子/肌酐水平较高（12.319 ± 4.017 比 11.015 ± 4.298 pg/μmol，p = 0.045），1 年时尿神经生长因子/肌酐水平较高（10.847 ± 4.267 比 7.850 ± 3.419 pg/μmol，p <0.001），术后尿神经生长因子/肌酐水平变化较小（1.472 ± 4.928 比 3.165 ± 4.863 pg/μmol，p = 0.031）。
神经生长因子与良性前列腺增生患者的膀胱过度活动症状有关，也与评估有膀胱过度活动症状的膀胱出口梗阻的长期成功治疗结果有关。
