How do we make progress in phenotyping patients with lower urinary tract such as overactive bladder and underactive detrusor, including using urine markers and microbiome data, to personalize therapy? ICI-RS 2023-Part 2

Neurourol Urodyn. 2024 Aug;43(6):1272-1282. doi: 10.1002/nau.25379. Epub 2024 Jan 4.

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 using urodynamic tests, functional neuro-imaging, urinary markers, and microbiome.

Results and conclusions: The article emphasizes the critical significance of adopting a comprehensive yet tailored approach to phenotyping patients with lower urinary tract (LUT) symptoms, such as OAB and UAB. The intricate interplay between the LUT 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: functional neuro‐imaging; microbiome; overactive bladder; underactive bladder; urinary markers; urodynamic tests.

Publication types

  • Review

MeSH terms

  • Biomarkers* / urine
  • Humans
  • Lower Urinary Tract Symptoms / diagnosis
  • Lower Urinary Tract Symptoms / microbiology
  • Lower Urinary Tract Symptoms / physiopathology
  • Microbiota
  • Phenotype*
  • Precision Medicine*
  • Urinary Bladder, Overactive* / diagnosis
  • Urinary Bladder, Overactive* / microbiology
  • Urinary Bladder, Overactive* / physiopathology
  • Urinary Bladder, Underactive* / diagnosis
  • Urinary Bladder, Underactive* / physiopathology
  • Urodynamics

Substances

  • Biomarkers