title: Sacral nerve stimulation reduces elevated urinary nerve growth factor levels in women with symptomatic detrusor overactivity.
abstract: OBJECTIVE
  To investigate changes in urinary nerve growth factor (uNGF) in women with symptomatic detrusor overactivity (DO) following peripheral nerve evaluation (PNE) for sacral neuromodulation vs controls.
  
  
  METHODS
  There were 23 subjects with overactive bladder symptoms and DO who failed management with anticholinergics and 22 controls consented to participate in this prospective pilot study. Urine specimens were collected from controls at baseline for evaluation of uNGF and creatinine. Subjects were evaluated at baseline and 5 days after a trial of sacral nerve stimulation referred to as a PNE. Each visit included urine collection for uNGF and, Incontinence Quality of Life Questionnaire, Urinary Distress Inventory Questionnaire, postvoid residual volume, and a 3-day voiding diary. uNGF levels were measured by enzyme-linked immunosorbent assay and expressed as uNGF pg/creatinine mg.
  
  
  RESULTS
  Subjects with DO had significantly higher baseline uNGF levels (corrected for creatinine) compared with controls (19.82 pg/mg vs 7.88 pg/mg, P < .002). Seventeen DO subjects underwent PNE and were evaluated at the end of the testing period. There was a significant improvement in quality of life scores for subjects after PNE compared with baseline (Urinary Distress Inventory Questionnaire: 7.0 vs 13.7, P < .001; Incontinence Quality of Life Questionnaire: 87.3 vs 52.8, P < .0001). Concordantly, uNGF levels significantly decreased from 17.23 pg/mg to 9.24 pg/mg (P < .02) after PNE.
  
  
  CONCLUSIONS
  uNGF levels decrease with symptomatic response in DO subjects undergoing PNE. DO subjects had significantly higher uNGF at baseline vs controls, and uNGF levels significantly decreased after only 5 days of sacral nerve stimulation. These findings support a larger study to validate the use of uNGF as an objective tool to assess therapeutic outcome in patients undergoing PNE for sacral neuromodulation.
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, North Shore-Long Island Jewish Health System, Great Neck, NY.
authors.forename: Dara Faye
authors.initials: DF
authors.lastname: Shalom
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, North Shore-Long Island Jewish Health System, Great Neck, NY. Electronic address: npillalama@nshs.edu.
authors.forename: Nirmala
authors.initials: N
authors.lastname: Pillalamarri
authors.affiliation: Center for Immunology and Inflammation, The Feinstein Institute for Medical Research, Manhasset, NY.
authors.forename: Xiangying
authors.initials: X
authors.lastname: Xue
authors.affiliation: Biostatistics Unit, Feinstein Institute for Medical Research, Manhasset, NY.
authors.forename: Nina
authors.initials: N
authors.lastname: Kohn
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, North Shore-Long Island Jewish Health System, Great Neck, NY.
authors.forename: Lawrence Russell
authors.initials: LR
authors.lastname: Lind
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, North Shore-Long Island Jewish Health System, Great Neck, NY.
authors.forename: Harvey Allen
authors.initials: HA
authors.lastname: Winkler
authors.affiliation: Center for Immunology and Inflammation, The Feinstein Institute for Medical Research, Manhasset, NY; Biostatistics Unit, Feinstein Institute for Medical Research, Manhasset, NY.
authors.forename: Christine Noel
authors.initials: CN
authors.lastname: Metz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D008160:Lumbosacral Plexus; D008875:Middle Aged; D020932:Nerve Growth Factor / Q000652:urine*; D010865:Pilot Projects; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000150:complications / Q000628:therapy* / Q000652:urine; D053202:Urinary Incontinence, Urge / Q000209:etiology / Q000628:therapy* / Q000652:urine; D055815:Young Adult
chemical_list: D020932:Nerve Growth Factor
keywords: detrusor overactivity (DO); overactive bladder (OAB); sacral neuromodulation; urinary nerve growth factor (uNGF)