Krishnan A, Sharma G, Devana SK, et al. - The study found higher levels of urinary nitric oxide (NO) and decreased levels of urinary adenosine triphosphate (ATP) in patients with underactive bladder (UAB). The results demonstrate that urinary NO/ATP levels can be considered as a noninvasive alternate test for diagnosing bladder underactivity.

• The results showed that compared with controls, the mean urinary ATP levels were significantly lower in cases (546.1 ± 37.3 pg/µl vs. 610.7 ± 24.9 pg/µl, p value < 0.001) and the mean NO levels were significantly higher in cases compared with controls (1233.4 ± 91.2 pg/µl vs. 1126.3 ± 91.3.4 pg/µl, p value < 0.001).

• Compared with controls, the mean NO/ATP ratio in cases was significantly higher (2.26 ± 0.2 vs. 1.84 ± 0.18, p value < 0.000).

• They noted the area under the curve (AUC) for NO/ATP ratio to be 0.91 in the diagnosis of cases using receiver operating curve (ROC) analysis.

• It was shown that a cut-off value of 2.06 for NO/ATP ratio had sensitivity, specificity, and diagnostic accuracy of 88.5%, 88.9%, and 88.6%, respectively, in diagnosing patients with UAB.