Romanzi et al. studied patients with persistent urinary frequency, urgency and/or UUI.They found that involuntary detrusor contractions were observed in 100% of the neurologically impaired patients, compared with 76% of the neurologically intact patients.21 Hashim and Abrams evaluatedadult patients with or without OAB symptoms by complete storage symptoms data and urodynamics. They found that patients with urgency had more DO than those without urgency (78.6% vs. 46.5%, p < 0.001), and patients with UUI had more DO than those without UUI (84.2% vs 59.8%, p < 0.001).7 In

the sub-analysis, they found that 69% of men and 44% of women with urgency (OAB dry) had DO, while 90% of men and 58% of women with urgency and urgency incontinence (OAB wet) had DO. GS-1101 solubility dmso We also found that the incidence of urodynamic DO in women with OAB was significantly

lower than that in men (74.4% vs 98%) and the incidence of IBS was higher GSK-3 signaling pathway than men (11.2% vs 1.5%). The gender difference in urodynamic DOin OAB patients could be due to anatomical difference between men and women, causing increased urge sensation during their daily life and mimicking OAB symptoms.18 In a recent study analyzing urodynamic results in OAB women with and without urodynamic DO, Guralnick et al. found patients with DO were more likely to have abnormal sensation, lower volume for strong desire and urgency and more UUI episodes.22 Haylen et al. found sensory urgency is a common symptom and until sensory urgency may be an earlier form of DO.12 Interestingly, Malone-Leeet al. demonstrated that the efficacy of combination of oxybutynin and bladder training for OAB symptoms was not different in groups with or without DO.23 Sensory urgency

or IBS might share the same pathophysiologies with DO, which include myogenic theories and myofibroblast activity, as well as an increasing appreciation of urothelial afferent function.24,25 Therefore, although urodynamic study is a well- established method for diagnosing the presence of DO, a less invasive way to diagnose OAB and assess therapeutic outcome in patients with OAB still needs to be found. OAB is a highly prevalent urinary dysfunction, with considerable economic and human costs. Clinical diagnosis of OAB is still based on subjective symptoms. A new accurate, objective and noninvasive test to diagnose OAB and assess therapeutic outcome is lacking. Recent studies in lower urinary tract dysfunction (LUTD), particularly in OAB patients, indicate that urinary proteins such as neurotrophins, prostaglandins and cytokines are altered, and such changes could be used as potential biomarkers of OAB. NGF is a small secreted protein which induces the differentiation and survival of particular target neurons (nerve cells).