title: Decreased urinary nerve growth factor reflects prostatic volume reduction and relief of outlet obstruction in patients with benign prostatic enlargement treated with dutasteride.
abstract: OBJECTIVE
  To examine urinary nerve growth factor before and after dutasteride treatment, and to analyze correlations between clinical parameters and change of urinary nerve growth factor in patients with benign prostatic enlargement.
  
  
  METHODS
  We prospectively studied 30 patients with benign prostatic enlargement who had not been satisfied with α-adrenergic antagonist monotherapy for more than 3 months. Before and 24 weeks after dutasteride add-on treatment, we assessed International Prostate Symptom Score, prostatic volume, filling cystometry and pressure-flow study. Urinary nerve growth factor was measured by enzyme-linked immunosorbent assay, and normalized to the urinary creatinine (nerve growth factor/creatinine) before and 24 weeks after dutasteride add-on treatment.
  
  
  RESULTS
  In baseline characteristics before dutasteride, there was no significant correlation between urinary nerve growth factor/creatinine and any clinical parameters including age, International Prostate Symptom Score, prostatic volume, presence of detrusor overactivity, detrusor pressure at maximum flow rate, bladder outlet obstruction index or bladder contractility index. Dutasteride significantly reduced prostatic volume (from 68 ± 31 mL to 49 ± 28 mL) and improved International Prostate Symptom Score (from 17.2 ± 8.7 to 13.1 ± 6.8), storage (from 8.0 ± 4.3 to 6.0 ± 2.9) and voiding symptom subscore of International Prostate Symptom Score (from 9.3 ± 5.7 to 7.1 ± 4.5). In urodynamic study, detrusor pressure at maximum flow rate (from 77 ± 32 cmH2 O to 59 ± 24 cmH2 O) and bladder outlet obstruction index (from 62 ± 32 to 42 ± 27) were significantly decreased after dutasteride treatment. Urinary nerve growth factor/creatinine was significantly decreased after dutasteride from 2.61 ± 2.50 to 1.64 ± 1.68. The change of urinary nerve growth factor/creatinine significantly correlated only with the change of prostatic volume (r = 0.38) and bladder outlet obstruction index (r = 0.36).
  
  
  CONCLUSIONS
  Urinary nerve growth factor decreases in association with reduction of prostatic volume and relief of bladder outlet obstruction. Urinary nerve growth factor might be useful as a biomarker to monitor the improvement of bladder outlet obstruction in patients with benign prostatic enlargement.
authors.affiliation: Department of Renal and Urologic Surgery, Asahikawa Medical University, Asahikawa, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Wada
authors.forename: Seiji
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kita
authors.forename: Kazumi
authors.initials: K
authors.lastname: Hashizume
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Kakizaki
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D001378:Azasteroids / Q000627:therapeutic use*; D015415:Biomarkers / Q000652:urine; D000068538:Dutasteride; D004797:Enzyme-Linked Immunosorbent Assay; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020932:Nerve Growth Factor / Q000652:urine*; D009929:Organ Size / Q000187:drug effects; D011446:Prospective Studies; D011467:Prostate / Q000000981:diagnostic imaging* / Q000187:drug effects; D011470:Prostatic Hyperplasia / Q000150:complications / Q000188:drug therapy* / Q000652:urine; D016896:Treatment Outcome; D014463:Ultrasonography; D001748:Urinary Bladder Neck Obstruction / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D014554:Urination
chemical_list: D058891:5-alpha Reductase Inhibitors; D001378:Azasteroids; D015415:Biomarkers; D020932:Nerve Growth Factor; D000068538:Dutasteride
keywords: benign prostatic hyperplasia; dutasteride; lower urinary tract symptoms; nerve growth factor