ABSTRACT
ABSTRACT
Objective:
Bladder wall thickness (BWTh) measurements and
Nerve Growth Factor (
NGF) /
creatinine (Cr) values, as noninvasive tools, were found to predict daytime voiding problems in
children with
overactive bladder (OAB). The
goal of this
research was to examine if
bladder wall thickness together with
urine NGF/Cr could be a clinical utility in
treatment outcome of OAB in
children.
Patients and
Methods:
A total of 60
children with OAB, (Group 1; n=40) and healthy normal controls (Group 2; n=20),
aged 6-14 years old were involved in this
prospective study.
Children were evaluated with detailed
history and
physical examination, including
neurologic examination, and were asked to complete a
self-reported
questionnaire and a 3-day
bladder diary with the
aid of their
parents. Uroflowmetry was performed in all cases. Urinary
nerve growth factor levels were measured by the
ELISA and BWTh was measured trans-abdominally by one uro-
radiologist specialized in pediatric
ultrasonography. Urinary
NGF levels were normalized by urinary
creatinine levels and compared among all subgroups.
Children with OAB received urotherapy as first line
treatment at least for three months. 18
children refractory to urotherapy received
anticholinergic therapy defined as group 3.
Results:
The median age of the study group was 10 (range 6 to 16). After urotherapy, 22
children had
similar BWTh and
NGF/Cr values compared to controls. (2.75 ± 1.15; 2.40 ± 1.00 mm; p=0.86 and 1.02 ± 0.10; 0.78 ± 0.15; p=0.12, respectively). After
anticholinergic treatment, BWTh levels (2.25 ± 0.90; 2.40 ± 1.00 mm; p=0.94) and
NGF/Cr values (0.95 ± 0.10; 0.78 ± 0.15; p=0.42, respectively) had no significantly difference compared to controls (Group 2). In
receiver operating characteristic analysis,
bladder wall thickness was found to have
sensitivity of 85% and
specificity of 84.2% (3,20
AUC, 913; 95 %) and
NGF/Cr had
sensitivity of 90% and
specificity of 92.1% (1,595;
AUC, 947; 95 %) in predicting
treatment outcome in
children with OAB.
Conclusions:
Bladder wall thickness measurements and
NGF/Cr values, as noninvasive tools, could guide outcomes in the
treatment of
children with
overactive bladder.