Lais A, Paolocci N, Ferro F, Bosman C, Boldrini R, Caione P
Department of Pediatric Surgery, Bambino Gesù Children's Hospital, Rome, Italy.
J Urol. 1996 Aug;156(2 Pt 2):819-21. doi: 10.1097/00005392-199608001-00074.
In bladder exstrophy and to a lesser extent in epispadias the muscular tissue in the bladder wall may often be replaced by collagen. The aim of our study was to assess the relative changes of smooth muscle versus connective tissue in patients with the exstrophy-epispadias complex.
Nine full thickness detrusor biopsies from children with the exstrophy-epispadias complex were analyzed. Biopsies were stained with the Masson trichrome method to differentiate muscular tissue from collagen. At x50 magnification using image software for computerized morphometry the areas of smooth muscle and collagen were measured and expressed as a percent. As controls, detrusor biopsies from 8 children with unilateral obstructive megaureter or ectopic ureter were analyzed using the same method.
The average rates of smooth muscle in children with the exstrophy-epispadias complex were 7, 19.3 and 31.5%, respectively, in newborns, and before and after bladder neck reconstruction. In controls the rate averaged 56.5%.
The ratio of smooth muscle-to-connective tissue increases from the newborn period to puberty in the exstrophy-epispadias complex. After staged reconstruction is completed this ratio remains below normal, although it is increased. Such a change may represent a histological marker of the inadequate volume increase of some of these bladders.
在膀胱外翻患者中，膀胱壁的肌肉组织常被胶原组织替代，在尿道上裂患者中这种情况程度稍轻。本研究旨在评估膀胱外翻-尿道上裂综合征患者平滑肌与结缔组织的相对变化。
分析了9例膀胱外翻-尿道上裂综合征患儿的全层逼尿肌活检标本。活检标本采用马松三色染色法，以区分肌肉组织和胶原组织。在50倍放大倍数下，使用图像软件进行计算机形态测量，测量平滑肌和胶原的面积，并以百分比表示。作为对照，采用相同方法分析了8例单侧梗阻性巨输尿管或异位输尿管患儿的逼尿肌活检标本。
膀胱外翻-尿道上裂综合征患儿在新生儿期、膀胱颈重建术前及术后，平滑肌的平均比例分别为7%、19.3%和31.5%。对照组的平均比例为56.5%。
膀胱外翻-尿道上裂综合征患者从新生儿期到青春期，平滑肌与结缔组织的比例增加。分期重建完成后，该比例虽有所增加，但仍低于正常水平。这种变化可能是这些膀胱容量增加不足的组织学标志。
