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28
TH
CONGRESS OF THE ESPU
11:53–11:58
S24-2 (LO)
★
THE VALUE OF URINARY BDNF LEVELS
ON ASSESSMENT OF THE BOTULINUM TOXIN TYPE
A TREATMENT FOR NEUROGENIC DETRUSSOR
OVERACTIVITY IN CHILDREN WITH MYELODYSPLASIA
Cem AKBAL
1
, Cagri Akin SEKERCI
1
, Yiloren TANIDIR
1
, Tuncay TOP
1
, Banu ISBILEN
BASOK
2
, Ferruh ISMAN
3
, Ferruh SIMSEK
1
and Tufan TARCAN
4
1) Marmara University School of Medicine, Urology, Istanbul, TURKEY - 2) Tepecik Training and Research Hospital,
Biochemistry, Izmir, TURKEY - 3) Medeniyet University, Biochemistry, Istanbul, TURKEY - 4) Marmara University School
of Medicinechool of Medicine, UrMarmara Universitesi Egitim ve Arastirma Hastanesi Uroloji AD. Kat:4 Fevzi Cakmak
Mah. Mimar Sina, Istanbul, TURKEY
PURPOSE
Urodynamic studies are the gold standard method for assessment of treatment success following
intradetrusor BotulinumNeurotoxin TypeA(BoNTA) injections in children with myelodysplasia. In this
study we aimed to address the influence of BoNTA treatment on urine Brain Derived Neurotrophic
Factor (BDNF) levels in patients who have myelodysplasia due to neurogenic detrussor overactivity
(NDOA).
MATERIAL AND METHODS
23 patients with NDOA due to myelodysplasia and treated with intradetrusor BoNTA injection were
included in this prospective study. Urines of these patients were collected preoperatively and at
postoperative first and third month after BoNTA injection, samples stored at - 80
o
C after centrifuga-
tion (3000 rpm for 10 minutes). Urine BDNF levels were measured by using ELISA method with
commercial kit. Urodynamic findings were analyzed both before and after BoNTA injection.
RESULTS
Mean age of the childrens were 100,0 ±34,5 months (6 boys 33 % and 17 girls 66 %). Urinary
BDNF levels significantly declined after BoNTA treatment compared to preoperative levels (p <
0.05) (Table 1). Maximum cystometric capacity (155,0±105,0;246,1±110,3) and maximum detrus-
sor pressure (47,4±24,3; 29,8±17,0) improved significantly after BoNTA treatment compared to
preoperative levels (p < 0.05).
Table 1:
Before Treatment
Postoperative
1
st
Month
Postoperative
3
rd
Month
P Value
BDNF (ng/mg
Cr) ±Sd
(n:23)
1,0±1,0
0,6±1,1
0,4±0,3
0,006*
0,006**
0,333***
* Before and post 1
st
; ** Before and Postop 3
rd
; *** Postop 1
st
and Postop 3
rd
CONCLUSIONS
Urinary BDNF not only provide easy follow up of childrens with myelodysplasia and decrease the
need for further invasive and expensive procedures but also seem to predict urodynamic results of
BoNTA treatment. This can be used for evaluating the efficiency of the treatment.