Bellucci Carlos H S, Ribeiro Wesley de O, Hemerly Thiago S, de Bessa José, Antunes Alberto A, Leite Katia R M, Bruschini Homero, Srougi Miguel, Gomes Cristiano M
Division of Urology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
Prostate Int. 2017 Jun;5(2):70-74. doi: 10.1016/j.prnil.2017.01.008. Epub 2017 Jan 25.
This study aimed to investigate the relationship between detrusor collagen content and urodynamic parameters in men with benign prostatic obstruction.
Nineteen consecutive patients undergoing open prostatectomy for bladder outlet obstruction (BOO) due to benign prostatic hyperplasia (BPH) were evaluated. Urodynamic tests were performed in all patients. BOO and detrusor contractility were assessed with the BOO index (BOOI) and the bladder contractility index (BCI), respectively. A bladder fragment was obtained during prostatectomy. Eight cadaveric organ donors composed the control group. Bladder sections were stained with picrosirius red and hematoxylin-eosin. The collagen to smooth muscle ratio (C/M) in the detrusor was measured and its relationship with urodynamic parameters was investigated.
Seven (36.8%) patients were operated on due to lower urinary tract symptoms and 12 (63.2%) had urinary retention. The mean prostate volume was 128.6 cm ± 32.3 cm, the mean BOOI was 76.4 ± 33.0, and the mean BCI was 116.1 ± 33.7. The mean C/M in BPH patients and controls were 0.43 ± 0.13 and 0.33 ± 0.09, respectively ( = 0.042). A negative correlation was shown between C/M and bladder compliance ( = -0.488, = 0.043). The C/M was increased in BPH patients with detrusor overactivity (DO) compared to those without DO (0.490 ± 0.110 and 0.360 ± 0.130, respectively; = 0.030) and also in patients with urinary retention ( = 0.002). No correlation was shown between C/M and maximum cystometric capacity, BOOI, or BCI.
Men with BOO/BPH have increased detrusor collagen content which is associated with decreased bladder compliance, detrusor overactivity, and urinary retention.
本研究旨在探讨良性前列腺梗阻男性患者逼尿肌胶原蛋白含量与尿动力学参数之间的关系。
对19例因良性前列腺增生（BPH）导致膀胱出口梗阻（BOO）而接受开放性前列腺切除术的连续患者进行评估。所有患者均进行了尿动力学检查。分别用BOO指数（BOOI）和膀胱收缩力指数（BCI）评估BOO和逼尿肌收缩力。在前列腺切除术中获取膀胱组织碎片。8例尸体器官捐献者组成对照组。膀胱切片用天狼星红和苏木精-伊红染色。测量逼尿肌中胶原蛋白与平滑肌的比例（C/M），并研究其与尿动力学参数的关系。
7例（36.8%）患者因下尿路症状接受手术，12例（63.2%）有尿潴留。平均前列腺体积为128.6 cm³±32.3 cm³，平均BOOI为76.4±33.0，平均BCI为116.1±33.7。BPH患者和对照组的平均C/M分别为0.43±0.13和0.33±0.09（P = 0.042）。C/M与膀胱顺应性呈负相关（r = -0.488，P = 0.043）。与无逼尿肌过度活动（DO）的BPH患者相比，有DO的BPH患者C/M升高（分别为0.490±0.110和0.360±0.130；P = 0.030），尿潴留患者的C/M也升高（P = 0.002）。C/M与最大膀胱测压容量、BOOI或BCI之间无相关性。
BOO/BPH男性患者逼尿肌胶原蛋白含量增加，这与膀胱顺应性降低、逼尿肌过度活动和尿潴留有关。
