Lower urinary tract disease and their objective and noninvasive biomarkers

Lower urinary tract diseases are highly prevalent among adults; this prevalence increases with age, and lower urinary tract diseases negatively impacts health-related quality of life. Given their chronic course, lower urinary tract diseases require an accurate diagnosis and persistent management. However, the diagnosis of and monitoring for lower urinary tract disease is challenging because of the lack of adequate biomarkers. Urodynamic studies, which are considered one of the most objective biomarkers for lower urinary tract dysfunction, are invasive, expensive, and time consuming. Therefore, new objective and noninvasive biomarkers for lower urinary tract disease are currently being studied. Imaging biomarkers such as the bladder wall thickness, bladder weight, intravesical prostatic protrusion, and resistive index of prostatic blood flow, as determined by ultrasonography, have been used to evaluate lower urinary tract disease. Among the urinary biomarkers, nerve growth factor, brain-derived neurotrophic factor, prostaglandin, and cytokine levels have been analyzed and evaluated. Among the serum biomarkers, sex hormone and C-reactive protein levels, which are related to the inflammatory pathophysiology of lower urinary tract disease, have been evaluated. The possibility of using genetic biomarker for lower urinary tract disease is also being explored. Although there are some limitations to the current applications of these biomarkers, these will be overcome by further research and investigation on noninvasive, objective, highly sensitive, and specific biomarkers for lower urinary tract disease in the near future.