Hormonal replacement therapy and urinary problems as evaluated by ultrasound and color Doppler

Battaglia, Cesare; Salvatori, M.; Giulini, Simone; Primavera, M.R.; Gallinelli, Andrea; Volpe, Annibale

doi:10.1046/j.1469-0705.1999.13060420.x

Cited by 11 publications

(11 citation statements)

References 23 publications

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“…Although the mechanism by which estrogens modulate the bladder inflammation in menopause is unknown (30) estrogen hormones possess many functions by which they contribute to the urothelium homeostasis. Among those, they stimulate the cell division in the urothelium by activating cyclin D1 (31, 32) they maintain the protective glycosaminoglycans barrier (33) and stimulate the bladder vascularization (34), the absence of these stimuli being also involved in the decreased barrier capacity of urothelium. Thus, the effect of estrogen on bladder found in our study can be attributed to the decreased thickness of the urothelium followed by reduced barrier function of the urothelium against inflammatory factors in urine.…”

Section: Discussionmentioning

confidence: 99%

Changes in the Urinary Bladder Morphology, Mast Cell Population and Estrogen Receptor Alpha Expression Following Ovarectomy and Chronic Estrogen Replacement Therapy in Albino Rats

Lucan¹

2013

Acta Endo (Buc)

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Context. The inflammatory disorders of the urinary bladder represent one of the most frequent disorders associated with hormonal unbalances caused by menopause. The involvement of estrogens and mast cells in this complex mechanism mediated by neuro-hormonal pathway is well known, but the pathogenesis through which the hormonal deprivation is affecting the Estrogen Receptor expression and is predisposing to urinary bladder inflammatory changes is still argued.Objective. To determine the structural changes associated with surgically induced menopause, and the effect of estrogen replacement therapy (ERT) in the urinary bladder morphology, mast cell population and Estrogen Receptor (ERα) expression.Subjects and methods. The effect of ovariectomy and ERT was monitored by quantifying the number of mast cells and the structural changes that the urinary bladder suffers. By immunohistochemistry we assessed the changes of the Estrogen Receptor Alpha (ERα) expression in the urothelium and detrusor muscle.The study was carried out on ovariectomised female rats over a period of 42 days.Results. The main alterations associated with the hormonal deprivation were represented by the growth in number of the bladder mast cells, atrophy of the urothelium and amplification of the expression of ERα from the urothelium, but not from the detrusor muscle. ERT significantly decreased the tissue expression for ERα, reduced the severity of bladder atrophy and the number of mast cells.Conclusions. The estrogenic hormonal substitution can diminish the severity of the atrophic, inflammatory and ERα changes in bladder disorders associated with ovarectomy in rat.

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Section: Discussionmentioning

confidence: 99%

Changes in the Urinary Bladder Morphology, Mast Cell Population and Estrogen Receptor Alpha Expression Following Ovarectomy and Chronic Estrogen Replacement Therapy in Albino Rats

Lucan¹

2013

Acta Endo (Buc)

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“…Color flow images of the ascending branches of the uterine arteries were sampled lateral to the cervix in a longitudinal plane. Intramural bladder blood flow has been measured at the level of the antero-or posterolateral wall 14 . The internal carotid artery was examined on both sides within the first 1.5 cm of the bifurcation.…”

Section: Materias and Methodsmentioning

confidence: 99%

Transdermal hormone replacement therapy and Doppler findings in normal and overweight postmenopausal patients

Persico

Mancini

Artini³

et al. 2004

Gynecological Endocrinology

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The aim of this study was to evaluate the effects of transdermal hormone replacement therapy on some biological cardiovascular risk factors, specifically the thromboxane B2 levels, plasma viscosity and the lipid profile. Furthermore, we investigated the Doppler flow modifications at the level of the uterine artery, the internal carotid, the ophthalmic and the bladder wall arteries, and we finally evaluated whether there were significant differences in the examined parameters between normal and overweight postmenopausal women. Forty-five postmenopausal women (mean age+/-standard deviation, 53.5+/-3.8 years) participated in the study and were divided into two groups (27 with a body mass index of < 25 kg/m2 and 18 with a body mass index of > 25 kg/m2). Patients were treated with a continous estradiol transdermal supplement and a 12-day course of medroxyprogesterone acetate every 2 months, and were studied at baseline and after 6 months (in the estrogen-only phase of the second cycle). Our results showed a beneficial effect of hormone substitution on plasma viscosity, thromboxane B2 levels and lipid profile after 6 months of therapy and significant improvements of Doppler flow parameters in the examined vessels. Furthermore, we observed a lower impact of the treatment in overweight women. In conclusion, obesity represents an additional cardiovascular risk condition and it can only partially be modified by the administration of hormone replacement therapy.

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“…Despite such a risk, there is evidence to suggest that the bladder in postmenopausal women may not respond to inflammation as it does in young females. Thus postmenopausal women have been found to void with weaker detrusor contractions compared with premenopausal women (16), which may at least be partly due to a decreased intramural bladder thickness in postmenopausal women, which positively correlates with the circulating estradiol level (1). As the present results suggest, hormonal depletion may also lead to a decreased response of the bladder to bladder inflammation, possibly because of an abnormal relaxant response to hypogastric nerve activation.…”

Section: Discussionmentioning

confidence: 47%

Influence of estradiol on micturition thresholds in the rat: involvement of the hypogastric nerve

Dmitrieva

Berkley

2005

American Journal of Physiology-Regulatory, Integrative and Comp

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Studies have shown that the severity of bladder hyperreflexia induced by acute bladder inflammation varies with the ovarian cycle. These results suggest that the hyperreflexia is modulated by ovarian hormones. Other studies have suggested that such modulation involves the bladder's sympathetic innervation. These hypotheses were tested by assessing the development of bladder hyperreflexia in urethane-anesthetized rats subjected to different hormonal manipulations with or without bilateral hypogastric neurectomy (HYPX). The groups included sham ovariectomy (sham OVX), ovariectomy (OVX), OVX with estradiol replacement (OVX+E), OVX+HYPX, and OVX+HYPX+E. Assessments were performed using repeated cystometrograms (CMGs) to measure micturition thresholds (MT) before and hourly for 3 h after intravesicular treatment with 50% turpentine oil (or olive oil in an OVX+E control group). In the uninflamed bladder, treatment with estradiol increased MTs in the OVX+E group compared with the OVX group. As expected, bladder inflammation induced bladder hyperreflexia in sham OVX rats (studied in estrus). This hyperreflexia was eliminated by OVX and restored by either estradiol replacement or HYPX. Combining estradiol replacement and HYPX (i.e., OVX+E+HYPX) did not increase the severity of bladder hyperreflexia compared with either manipulation alone. These results indicate that the bladder hyperreflexia that is induced by bladder inflammation requires the presence of estradiol and suggest that this hormonal modulation is exerted via the sympathetic control of the bladder, possibly via an increase of beta-adrenergic inhibitory actions on the detrusor muscle. Similar mechanisms may contribute to bladder disorders in postmenopausal women.

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Hormonal replacement therapy and urinary problems as evaluated by ultrasound and color Doppler

Abstract: The study of bladder wall thickness and vascularization provides additional information regarding the beneficial effect of hormone replacement therapy on lower urinary tract symptoms in postmenopausal women.

Cited by 11 publications

References 23 publications

Changes in the Urinary Bladder Morphology, Mast Cell Population and Estrogen Receptor Alpha Expression Following Ovarectomy and Chronic Estrogen Replacement Therapy in Albino Rats

Changes in the Urinary Bladder Morphology, Mast Cell Population and Estrogen Receptor Alpha Expression Following Ovarectomy and Chronic Estrogen Replacement Therapy in Albino Rats

Transdermal hormone replacement therapy and Doppler findings in normal and overweight postmenopausal patients

Influence of estradiol on micturition thresholds in the rat: involvement of the hypogastric nerve

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