Kato K, Lin A T, Haugaard N, Longhurst P A, Wein A J, Levin R M
Division of Urology, University of Pennsylvania School of Medicine, Philadelphia Veterans Administration Medical Center.
J Urol. 1990 Apr;143(4):844-7. doi: 10.1016/s0022-5347(17)40114-5.
Bladder outlet obstruction has been shown to cause detrusor contractile dysfunction. To determine if alterations in bladder metabolism may in part underlie these functional defects, we investigated the effects of mild outlet obstruction on the glucose metabolism of the rabbit urinary bladder. Mild outlet obstruction was created in mature male rabbits by the surgical placement of a silicon sleeve around the bladder neck. Two weeks after surgery, the in vitro ability of the obstructed bladder tissues to metabolize glucose was compared to that of the controls. The results can be summarized as follows: 1) The bladder wet weight increased 2.3-fold following two weeks of obstruction. 2) Obstructed bladder tissues had a reduced glucose consumption as compared to the controls. 3) CO2 generation was significantly reduced by 31% in obstructed bladder tissues whereas lactate formation increased significantly by 22%. 4) Tissue concentrations of ATP, creatine phosphate, and glycogen before incubation showed no significant differences between control and obstructed bladder tissues. In summary, bladder tissues following two weeks obstruction showed a decrease in aerobic metabolism and an increase in anaerobic metabolism. Previous studies have indicated that the ability of the bladder to maintain a contraction and empty may be directly related to aerobic metabolism. Therefore, the decrease in aerobic metabolism (even in the presence of increased anaerobic metabolism) may in part explain the decreased ability of the obstructed bladder to empty.
膀胱出口梗阻已被证明会导致逼尿肌收缩功能障碍。为了确定膀胱代谢的改变是否可能部分是这些功能缺陷的基础,我们研究了轻度出口梗阻对兔膀胱葡萄糖代谢的影响。通过在膀胱颈部手术放置硅套管,在成年雄性兔中造成轻度出口梗阻。术后两周,将梗阻膀胱组织体外代谢葡萄糖的能力与对照组进行比较。结果总结如下:1)梗阻两周后,膀胱湿重增加了2.3倍。2)与对照组相比,梗阻膀胱组织的葡萄糖消耗减少。3)梗阻膀胱组织中的二氧化碳生成显著减少31%,而乳酸形成显著增加22%。4)孵育前,对照组和梗阻膀胱组织中ATP、磷酸肌酸和糖原的组织浓度无显著差异。总之,梗阻两周后的膀胱组织显示有氧代谢减少,无氧代谢增加。先前的研究表明,膀胱维持收缩和排空的能力可能与有氧代谢直接相关。因此,有氧代谢的减少(即使在无氧代谢增加的情况下)可能部分解释了梗阻膀胱排空能力的下降。