Decrease of urinary nerve growth factor levels after antimuscarinic therapy in patients with overactive bladder

BJU Int. 2009 Jun;103(12):1668-72. doi: 10.1111/j.1464-410X.2009.08380.x. Epub 2009 Feb 11.


Objective: To determine urinary nerve growth factor (NGF) levels in patients with overactive bladder (OAB) and after treatment with antimuscarinics.

Patients and methods: Urinary NGF levels were measured in 38 'normal' controls and 70 patients with OAB. Patients were treated with tolterodine 4 mg once daily. Urinary NGF levels were measured by enzyme-linked immunosorbent assay method and normalized by urinary creatinine levels (NGF/Cr). The urinary NGF/Cr levels and urgency severity scale (USS) were compared at baseline, 1, 2 and 3 months after antimuscarinics, and 1 month after discontinuing treatment.

Results: The urinary NGF/Cr level was very low in normal controls with a mean (sem) of 0.005 (0.003). Patients with OAB had significantly higher baseline urinary NGF/Cr levels than the controls. Urinary NGF/Cr levels were significantly reduced at 3 months in 50 responders (1.10 [0.26] before vs 0.41 [0.09] after, P = 0.008) but not in the 20 non-responders (1.38 [0.54] before vs 1.30 [0.46] after, P = 0.879). However, after discontinuing antimuscarinic treatment for 1 month, the urinary NGF/Cr level was elevated in 23 responders at 0.83 (0.33) and in five non-responders at 2.72 (1.41). The USS scores significantly changed with the change of urinary NGF/Cr levels in responders at different time points. The voided volume increased but maximum urinary flow rate and postvoid residual volume did not increase in responders after 3-months of antimuscarinic treatment. The limitation of this study was the lack of a control arm for comparison.

Conclusions: Changes in the urinary NGF levels were associated with the changes of the USS scores after antimuscarinic treatment and discontinued medication. The urinary NGF level could be a potential biomarker for evaluating therapeutic results of antimuscarinics therapy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Benzhydryl Compounds / therapeutic use*
  • Biomarkers / urine
  • Case-Control Studies
  • Cresols / therapeutic use*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Male
  • Middle Aged
  • Muscarinic Antagonists / therapeutic use*
  • Nerve Growth Factor / urine*
  • Phenylpropanolamine / therapeutic use*
  • Prognosis
  • Severity of Illness Index
  • Tolterodine Tartrate
  • Treatment Outcome
  • Urinary Bladder, Overactive / drug therapy*
  • Urinary Bladder, Overactive / urine
  • Urodynamics / physiology


  • Benzhydryl Compounds
  • Biomarkers
  • Cresols
  • Muscarinic Antagonists
  • Phenylpropanolamine
  • Tolterodine Tartrate
  • Nerve Growth Factor