Aşırı aktif mesane tanı, tedavi ve izleminde idrar biyokimyasal belirteçlerinin rolü

Abstract

Overactive Bladder (OAB) is a syndrome based on symptoms whose etiopathogenesis couldn't have put forward clearly. Also its diagnosis is difficult and subjective because of being based on symptoms. Only %50-60 of success rate was achieved by antimuscarinics which are shown as gold standard for treatment. This condition pushed researchers to find an objective diagnosis system. Biomarkers were put forward because of this reason and it was studied by many researchers whether it could be used or not, for OAB diagnosis. Also in this study, 4 different biomarkers (BDNF, NGF, GAG, MCP-1) were researched on OAB patients, about the level of indicators and if it could foresee the success of medical treatment.OAB diagnosed patients, whose complaints were being in need for urinate once, or more than once a day, were chosen for the study. 3 days of voiding diary was applied for all patients. These patients were examined for diagnosis and were monitored urinary USG. OAB distinctive diagnosis was cleared by urine analysis, urine culture, measuring serum creatinin and CRP levels. Furthermore, OAB questionaries which is validated in Turkish, applied for all patients before and after medical treatment. 45 chosen OAB patients were begun to study. 45 healthy volunteers who did not have any urinary system complaints, were chosen from hospital workers or their relatives, for control group. Solifenasin (Kinzy 5mg) which is a recommended medical treatment based on the guidelines, was given to patient group. Urine samples were collected before the medical treatment and after one month from the initiation of medical treatment, as midstream urine. After collecting all the urine samples from the patients and healthy volunteers, BDNF, NGF, GAG and MCP-1 levels were measured by SunRed labeled ELİSA kits. Results are corrected, also by measuring urine creatinin (Cr). After analyzing the results, biomarkers were found at high levels in OAB patients and lowered after medical treatment in responders, but did not in patients who are refractory to treatment. There aren't any significant differences in refractory patients compared to responders about the levels of biomarkers from the beginning. For the summary, we have shown that biomarkers could be used for OAB diagnosis, determining subtypes and assessment of therapeutic outcome. We've got findings that maintain the hypothesis of OAB which is an inflammatory process. On the other hand, we couldn't have shown the hypothesis of foreseeing the medical treatment success.