Morphological and Morphometric Studies of the Human Obstructed, Trabeculated Urinary Bladder

Gilpin, S. A.; Gosling, J. A.; Barnard, R.

doi:10.1111/j.1464-410x.1985.tb05860.x

Cited by 135 publications

(50 citation statements)

References 3 publications

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“…Gilpin et al (9) while studying the morphology and morphometry of detrusor muscle fibers from patients with obstruction, described structural changes of the vesical wall, represented by collagen deposit in muscular interstice, and by the increase in volume of muscle fibers, what is in accordance to our results.…”

Section: A B C Dsupporting

confidence: 82%

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Stereological study of collagen and elastic system in the detrusor muscle of bladders from controls and patients with infravesical obstruction

2007

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Objective: Compare detrusor muscle of normal and patients with infravesical obstruction, quantifying the collagen and elastic system fibers. Materials and Methods:We studied samples taken from bladders of 10 patients whose ages ranged from 45 to 75 years (mean = 60 years), who underwent transvesical prostatectomy for treatment of BPH. Control material was composed of 10 vesical specimens, removed during autopsies performed in cadavers of accident victims, with ages between 18 and 35 years (mean = 26 years). Results:The results of collagen and elastic fibers quantification (volumetric density) demonstrated the following results in percentage (mean +/-standard deviation): collagen in BPH patients = 4.89 +/-2.64 and 2.32 +/-1.25 in controls (p < 0.0001), elastin in BPH patients = 10.63% +/-2.00 and 8.94% +/-1.19 in controls (p < 0.0001). Conclusion:We found that the components of connective tissue, collagen and elastic system fibers are increased in the detrusor muscle of patients with infravesical obstruction, when compared to controls.

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Section: A B C Dsupporting

confidence: 82%

“…The vesical wall can accumulate connective tissue and evolve to a fibrotic process in consequence of a neurologic (myelomeningocele, spinal cord lesion) or obstructive (BPH) process. Such pathological conditions can result in low capacity, high pressure and low vesical compliance (9).…”

Section: Introductionmentioning

confidence: 99%

Stereological study of collagen and elastic system in the detrusor muscle of bladders from controls and patients with infravesical obstruction

2007

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“…The behaviour of detrusor smooth muscle secondary to the obstruction is often changed in a typical manner with the development of detrusor instability [1]. Structural adaptations might vary; in one study [2], the cross-sectional area of detrusor smooth muscle cells had increased suggesting hypertro phy, whereas an earlier study of the same group [3] showed subnormal cross-sectional cell areas. Connective tissue infiltration of the muscle bundles was found in both studies.…”

Section: Introductionmentioning

confidence: 92%

Collagen Content in the Rat Urinary Bladder following Removal of an Experimental Infravesical Outlet Obstruction

Uvelius¹,

Lindnér²,

Mattiasson³

1991

Urol Int

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A partial urethral obstruction was induced in female rats. After 6 weeks, detrusor weight had increased eightfold and collagen concentration had decreased to about 40% compared to controls. Due to the weight gain, the total amount of detrusor collagen had increased more than threefold. Removal of the obstruction led to a rapid decrease in detrusor weight to 70, 34 and 30%, 2, 4 and 6 weeks postobstruction, although control levels were not reached. Collagen content decreased more slowly than detrusor weight, and for the same groups was 97, 69 and 67% of the value in the obstructed detrusor. This led to a rapid increase in detrusor collagen concentration which already 4 weeks after removal of the obstruction had increased to a level that did not significantly differ from the control value. The discrepancy between decrease in detrusor weight and in collagen content after removal of the obstruction suggests that a large proportion of the collagen synthesized during the period of outlet obstruction remained. Changes in the ratio between muscle and nonmuscle tissue were limited between control, obstructed and nonobstructed bladders. This suggests that the collagen concentration following obstruction and removal of obstruction is to a large extent due to changes in collagen concentration in the interstitial connective tissue rich in collagen.

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“…Furthermore, ®brosis is present in the hypocompliant bladders of patients with myelomeningocele [10]. Similarly, there is connective tissue in®ltration into the muscle bundles of the obstructed unstable detrusor, which may show low compliance under conventional urodynamic conditions [11]. Indeed, it appears that any injury which results in a change in the connective tissue composition of any part of the bladder wall may result in a reduction in the compliance of that part.…”

Section: Discussionmentioning

confidence: 99%

The contribution of cholinergic detrusor excitation in a pig model of bladder hypocompliance

et al. 2000

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Objective To investigate the role of cholinergic excitation in mediating changes in detrusor compliance (manifested on conventional cystometry as an incremental rise in detrusor pressure as bladder volume increases) under conditions of propofol-sedation in the pig. Materials and methods Consecutive cystometrograms (CMGs) were obtained from eight female Large White pigs at a bladder ®lling rate of 50 mL/min. The ®rst CMG was obtained while the pig was awake and unsedated. Two subsequent CMGs were obtained after light to moderate sedation with propofol (2±8 mg/kg/ h) before and after the administration of intravenous atropine (0.02 mg/kg). Results All bladders were highly compliant over the volumes instilled (before sedation) with a maximum pressure during the ®lling phase of 0.9 cmH 2 O and a compliance of 943 mL/cmH 2 O. After sedation with propofol, the maximum pressure during the ®lling phase increased to 14 cmH 2 O with a compliance of 69 mL/cmH 2 O. Atropine antagonized this change in compliance; after sedation and atropine, the maximum pressure during the ®lling phase decreased to 4 cmH 2 O (P<0.05) and the compliance increased to 337 mL/cmH 2 O (P<0.05). Conclusion The decrease in compliance seen in the pig bladder after sedation with propofol is mediated via muscarinic excitation. This probably occurs as a result of low-level tonic release of acetylcholine by the efferent parasympathetic nerves. The existence of such efferent excitatory activity during the storage phase in the overactive human bladder might explain the ef®cacy of bladder-selective muscarinic antagonists in a proportion of patients with detrusor hyper-re¯exia and instability.

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Morphological and Morphometric Studies of the Human Obstructed, Trabeculated Urinary Bladder

Cited by 135 publications

References 3 publications

Stereological study of collagen and elastic system in the detrusor muscle of bladders from controls and patients with infravesical obstruction

Stereological study of collagen and elastic system in the detrusor muscle of bladders from controls and patients with infravesical obstruction

Collagen Content in the Rat Urinary Bladder following Removal of an Experimental Infravesical Outlet Obstruction

The contribution of cholinergic detrusor excitation in a pig model of bladder hypocompliance

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