Hongoh Y, Sakanaka M, Kitagawa Y, Magari S, Miyazaki S
Department of Urology, Osaka Medical College, Japan.
Urology. 1991 Jun;37(6):584-9. doi: 10.1016/0090-4295(91)80333-3.
The anterior bladder wall and actin- and myosin-like immunoreactivities within the detrusor muscles in patients with chronic obstruction of the lower urinary tract were examined by means of a MOP Videoplan image-processing system, electronmicroscopy, and light microscopic immunohistochemistry. The image-processing system demonstrated an excess of connective tissue elements between smooth muscle bundles in the anterior wall of the bladder similar to the results of previous studies dealing with the trabeculated posterior wall. Under electronmicroscopy, myofilaments were shown to be multidirectionally arranged in the smooth muscle cells in contrast to the regular arrangement in controls. Dense areas in the cytoplasm of the detrusor muscle also appeared to be abnormally distorted and/or elongated in the electronmicrographs. In support of these findings, actin- and myosin-like immunoreactivities in the muscle layer of the bladder were significantly less intense than in the controls. These results suggest that chronic obstruction of the lower urinary tract causes histopathologic alterations in both the intervening connective tissue and the detrusor muscle. This study raises the possibility that the aforementioned morphologic abnormalities are involved in the occurrence of uninhibited detrusor contraction and abnormal detrusor reflex in patients with lower urinary tract obstruction.
采用MOP Videoplan图像处理系统、电子显微镜和光学显微镜免疫组织化学方法，对下尿路慢性梗阻患者膀胱前壁及逼尿肌内肌动蛋白和肌球蛋白样免疫反应性进行了检测。图像处理系统显示，膀胱前壁平滑肌束之间的结缔组织成分过多，这与之前关于小梁化后壁的研究结果相似。在电子显微镜下，与对照组的规则排列相比，逼尿肌平滑肌细胞中的肌丝呈多方向排列。在电子显微镜照片中，逼尿肌细胞质中的致密区域也似乎异常扭曲和/或拉长。支持这些发现的是，膀胱肌层中肌动蛋白和肌球蛋白样免疫反应性明显低于对照组。这些结果表明，下尿路慢性梗阻会导致中间结缔组织和逼尿肌发生组织病理学改变。本研究提出了一种可能性，即上述形态学异常与下尿路梗阻患者逼尿肌无抑制性收缩和逼尿肌异常反射的发生有关。
