Morphological reconstruction of the bladder in the process of age-related involution

Abstract

Objective - study of morphological rearrangements of the bladder and its vascular system in elderly and senile people.Material and methods. Autopsy material in the form of pieces of the bladder wall from 25 men aged 60-80 years was studied using a number of histological, morphometric and statistical techniques. As a control, we used material from 10 persons aged 20-30 years who died as a result of injuries.Results. It was shown that in men in the process of aging in the extraorganic arteries, atherosclerotic changes are revealed, leading to a narrowing of the lumen. In the intraorgan arteries, thickening of the media, hyperelastosis and hyalinosis are observed, which also lead to a reduction in blood flow and are markers of arterial hypertension. A reflection of the adaptation to hemodynamic disorders is the formation of the so-called "closing arteries" with a powerful intimate layer. Over time, in the media of the arteries, as well as in the intima of the "closing vessels", sclerosis grows. The veins of the bladder lose a powerful smooth muscle layer in the wall, undergo sclerosis, which leads to difficulty in blood outflow, aggravating chronic hypoxia. Remodeling of the vascular bed of the bladder leads to detrusor atrophy and degenerative-dysregenerative changes in the urothelium.Conclusion. In the vascular bed of the urinary bladder in elderly and senile men, atherosclerotic and angiotonic changes characteristic of arterial hypertension progress, followed by the development of detrusor atrophy and impaired urothelium regeneration.