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Urethral Diverticulum following Polypropylene Mesh Midurethral Slings: A Literature Review. BIOMED RESEARCH INTERNATIONAL 2020; 2020:6761581. [PMID: 32462011 PMCID: PMC7240659 DOI: 10.1155/2020/6761581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 04/09/2020] [Accepted: 04/30/2020] [Indexed: 11/28/2022]
Abstract
Aims It is currently unknown whether an association exists between polypropylene mesh and urethral diverticulum formation following placement of polypropylene midurethral slings (MUS) for the treatment of stress urinary incontinence (SUI). We aimed to examine the literature associating MUS with the occurrence of urethral diverticula. Methods Multiple online research databases, including PubMed, Google Scholar, EBSCOhost, and the Cochrane Library, were searched, from January 2019 to February 2019, for evidence related to the occurrence of urethral diverticula following polypropylene MUS procedures. Results Four case reports were published demonstrating the occurrence of urethral diverticula following the use of polypropylene mesh for surgical treatment of SUI. Subjects of these cases were menopausal and had an elevated body mass index (BMI), recurrent urinary tract infections (UTIs), autoimmune conditions, or prior pelvic floor surgeries. A thorough urologic workup, including imaging prior to sling placement, was not always performed. Conclusion No clear association exists between polypropylene MUS placement and subsequent urethral diverticulum formation. Factors that diminish polypropylene mesh biocompatibility include elevated BMI, menopause, recurrent UTIs, prior pelvic surgeries, and preexisting medical conditions. Symptoms associated with urethral diverticula should prompt a complete urologic workup prior to MUS placement.
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Bhanmeechao C, Srisuwatanasagul S, Ponglowhapan S. Age-related changes in interstitial fibrosis and germ cell degeneration of the canine testis. Reprod Domest Anim 2019; 53 Suppl 3:37-43. [PMID: 30474336 DOI: 10.1111/rda.13354] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Fifty-five healthy medium-sized dogs were divided into four groups; young (1-3 years old, n = 14), adult (>3 to 6 years old, n = 12), old (>6 to 9 years old, n = 14) and senile (>9 years old, n = 15). After routine orchiectomy, testes were collected, and the degree of white streak areas on cut surfaces was subjectively assessed. Later, testicular tissue sections were stained with haematoxylin and eosin and Masson's trichrome for evaluation of germ cell degeneration and the proportion of interstitial connective tissue, respectively. Semiquantitative severity scoring of germ cell degeneration and quantitative analysis of spermatogenic cells for spermatic index (SI) and Sertoli cell index (SEI) was performed. The score of white streak on cut surface area of the testes increased with age, being higher (p < 0.05) in senile dogs than other age groups; no difference was found between adult and old dogs. The proportion of testicular interstitial fibrosis was highest (p < 0.05) in senile dogs. Positive correlations between age and white streak area (rho = 0.77, p < 0.01) as well as age and interstitial fibrosis (rho = 0.63, p < 0.01) were observed. The severity of germ cell degeneration gradually increased with age and differed among age groups (p < 0.05). Age positively correlated with atrophy of seminiferous tubules (rho = 0.93, p < 0.01). The SI was lower (p < 0.05) in senile dogs compared to other age groups, and SI was not different among young, adult and old dogs. Conversely, SEI was significantly higher in senile dogs compared to young, adult and old dogs. A negative correlation between age and SI (rho = -0.69) and a positive correlation between age and SEI (rho = 0.68) were significant (p < 0.01). In conclusion, influence of age on testicular interstitial fibrosis and germ cell degeneration/depletion were pronounced in dogs over 9 years old.
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Affiliation(s)
- Cholayuth Bhanmeechao
- Department of Obstetrics, Gynaecology and Reproduction, Research unit of Obstetrics and Reproduction in Animals, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Sayamon Srisuwatanasagul
- Department of Anatomy, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Suppawiwat Ponglowhapan
- Department of Obstetrics, Gynaecology and Reproduction, Research unit of Obstetrics and Reproduction in Animals, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
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Ferreira FT, Dambros M, Bisogni S, Dambros MC, Scolfaro MR, Palma PCR. Effects of testosterone supplementation on prevention of age-related penile remodeling. Aging Male 2014; 17:12-7. [PMID: 24397689 DOI: 10.3109/13685538.2013.873784] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Erectile dysfunction develops among 46.2% of men between 40 and 70 years. Studies demonstrated substitution on detrusor muscle by collagen due testosterone deprivation. It is clear the correlation among aging and oxidative stress, accelerating apoptosis process in many tissues. This study aims to demonstrate the collagen substitution over the muscle fibers on muscle structure of rat's penis and the effects of testosterone supplementation. Sixteen senescent Wistar rats were divided into two groups: treatment (receiving standard supplementation testosterone dose) and control (receiving equivalent saline solution). Testosterone was dosed on D0 and D56 of study. All penises were prepared with picrosirius colored histology; stereology was applied to determine the volumetric density of collagen fibers (Vv). Analysis of variance demonstrated testosterone group's replacement therapy to be effective, while the androgenic decline continued by the time of experiment in control group (p < 0.05). Testosterone group had Vv of 20.6%, lower than control group (47.8%); t-test (p < 0.001). Pearson's correlation demonstrated an inverse correlation between the Vv and testosterone's levels (p < 0.001). This is a pioneer study on demonstration of structural alterations over the cavernous corpora muscle caused by deprivation of testosterone on elderly rat. These finding implicate that the testosterone levels can influence, not only the libido, but also the erectile function.
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Affiliation(s)
- Fabio Thadeu Ferreira
- Discipline of Urology, Department of General Surgery, Campinas State University , Campinas , Brazil
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Owen SJ, Massa HM, Rose'Meyer RB. Dietary phytoestrogen improves relaxant responses to 17-β-estradiol in aged but not ovariectomised rat bladders. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2013; 386:917-28. [PMID: 23793100 DOI: 10.1007/s00210-013-0892-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Accepted: 06/03/2013] [Indexed: 11/29/2022]
Abstract
This study examined the effect of age, ovariectomy and dietary phytoestrogen ingestion on 17-β-estradiol-mediated relaxant responses and messenger RNA (mRNA) and protein expression of oestrogen receptor subtypes in the rat isolated bladder. Female Wistar rats (8 weeks) were anaesthetised, and the ovaries were removed (ovx) or left intact (sham). Rats were fed either normal rat chow (soy, phytoestrogens) or a non-soy (phytoestrogen free) diet. Isolated bladder from rats aged 12, 24 or 52 weeks were pre-contracted with 3 μM carbachol prior to obtaining a concentration response curve to 17-β-estradiol. Protein and mRNA expression of the oestrogen receptor subtypes was completed using immunohistochemistry and real-time PCR, respectively. Relatively moderate relaxant responses to 17-β-estradiol were observed in bladders from all age and treatment groups. However, in soy-fed sham 52-week-old rats, the bladder exhibited enhanced relaxant responses to 17-β-estradiol when compared to tissues from other age-matched rat treatment groups (P < 0.05). In bladders from female rats, the mRNA and protein expression of oestrogen receptors β was significantly greater than the expression of the oestrogen receptor α. Oestrogen receptor α mRNA expression declined with age (P < 0.05), whereas oestrogen receptor β expression did not change in any of the treatment groups (P > 0.05). Diet, overiectomy or age did not alter the protein expression of either oestrogen receptor subtype in the bladder (P > 0.05). While a soy diet improved relaxant effects to the 17-β-estradiol with age, it did not alter relaxant responses in bladders from ovariectomised rats.
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Affiliation(s)
- Suzzanne J Owen
- School of Medical Sciences, Griffith University, Gold Coast Campus, Southport, QLD, 4222, Australia
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de Barros CAV, Lorenzetti F, Ortiz V, Dambros M. Testosterone supplementation's effects on age-related bladder remodeling - experimental study in rats. Aging Male 2013; 16:102-7. [PMID: 23803164 DOI: 10.3109/13685538.2013.807426] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study was designed to evaluate the effect of testosterone replacement on the fibrotic process of the detrusor bladder muscle during the normal aging process. METHODS 15 Wistar senile rats, aged between 18 and 20 months were divided into two groups: testosterone group - 11 animals submitted to the administration of testosterone undecanoate (50 mg/kg intramuscular), once per month; and, Control group - four animals underwent a sham procedure. At the end of eight weeks, animals from both groups were sacrificed; bladders were removed and subsequently stereologically evaluated to determine the volumetric density of collagen fibers. The success of testosterone administration was confirmed by the measurement of serum testosterone at the beginning and end of the experiment. RESULTS In the replacement group, testosterone average was 3.2 ng/ml, whereas in the control group, the mean testosterone at the end of the experiment was 0.64 ng/ml (p < 0.05). Analysis of stereological collagenous fiber showed higher density in the control group compared to the testosterone group I (56% versus 37.02%, respectively). The difference of volume concentration of collagen between both groups was statistically significant (p < 0.000). CONCLUSION Bladder wall fibrosis was reduced in senile rats subjected to testosterone replacement.
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Carvalho Junior AMD, Santos MM, Barkokébas BB, Aguiar JLDA, Lima SVC, Dambros M. Characterization of the deposition of collagen fibers and Lithogenic potential in bladder of rats submitted to a sugar cane biopolymer graft. Int Braz J Urol 2012; 38:544-51. [DOI: 10.1590/s1677-55382012000400015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2012] [Indexed: 11/21/2022] Open
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Owen SJ, Rose'Meyer RB, Massa HM. Dietary phytoestrogens maintain contractile responses to carbachol with age in the female rat isolated bladder. Life Sci 2011; 89:213-20. [PMID: 21718707 DOI: 10.1016/j.lfs.2011.05.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Revised: 05/08/2011] [Accepted: 05/19/2011] [Indexed: 11/26/2022]
Abstract
AIMS Development of urinary incontinence, for many women, occurs following menopause. Dietary phytoestrogens consumed over the long term may affect the contractile function and maintenance of the urinary bladder in post menopausal women. This study examined the muscarinic receptor mediated contractile responses in the rat isolated bladder in response to ovariectomy and long term dietary phytoestrogen consumption. MAIN METHODS Ovariectomised or sham-operated female Wistar rats (8 weeks) were fed either normal rat chow (soy, phytoestrogens) or a non-soy (phytoestrogen free) diet. Bladders were dissected from rats at 12, 24 and 52 weeks of age and placed in 25 ml organ baths filled with McEwans solution. KEY FINDINGS The contractile response to carbachol, in 12 week old female rats did not change as a result of dietary phytoestrogens or ovariectomy (P>0.05). At 24 weeks of age, detrusor muscle strip responses to carbachol from non-soy fed ovariectomised rats were attenuated (P<0.05). At 52 weeks, bladder detrusor strip responses to carbachol were reduced in all treatment groups with the exception of the soy-fed sham operated rats. SIGNIFICANCE These results suggest an age-related reduction in the contractile response of the detrusor to the muscarinic receptor agonist carbachol, which may be prevented by long term dietary phytoestrogen intake.
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Affiliation(s)
- Suzzanne J Owen
- School of Medical Sciences, Griffith University, Gold Coast Campus, Queensland, 4222, Australia
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de Fraga R, Palma P, Dambros M, Riccetto CLZ, Mandarim-de-Lacerda C, Miyaoka R. Estrogen replacement avoids the decrease of bladder innervations in ovariectomized adult virgin rats: in vivo stereological study. Int Urogynecol J 2009; 20:591-5. [DOI: 10.1007/s00192-009-0811-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2008] [Accepted: 01/11/2009] [Indexed: 11/28/2022]
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Ponglowhapan S, Church D, Khalid M. Differences in the proportion of collagen and muscle in the canine lower urinary tract with regard to gonadal status and gender. Theriogenology 2008; 70:1516-24. [DOI: 10.1016/j.theriogenology.2008.06.099] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2008] [Revised: 06/14/2008] [Accepted: 06/18/2008] [Indexed: 11/26/2022]
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Cayan F, Tek M, Balli E, Oztuna S, Karazindiyanoğlu S, Cayan S. The effect of testosterone alone and testosterone + estradiol therapy on bladder functions and smooth muscle/collagen content in surgically menopause induced rats. Maturitas 2008; 60:248-52. [PMID: 18774243 DOI: 10.1016/j.maturitas.2008.07.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2008] [Revised: 07/03/2008] [Accepted: 07/22/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The aim of the study was to investigate the effect of testosterone alone and testosterone+estradiol therapy on bladder functions and smooth muscle/collagen content in surgically menopause induced rat model. METHODS The study included 34 female Sprague-Dawley rats, and the rats were divided into four groups. After bilateral oophorectomy, during a 60 days period, six rats received IM saline injection for one time, as a control group, and nine rats received testosterone undecanoate 100mg/kg IM for one time, and nine rats received testosterone undecanoate 100mg/kg IM for one time + daily 0.50mg nasal spray of 17beta estradiol. Ten rats were taken as sham group. Urodynamic studies were performed in all groups before and after the study. The rats were sacrificed after 60 days, and cystometric findings and smooth muscle/collagen ratio of the bladders were compared between the groups. RESULTS Increase in maximal bladder capacity and compliance were significantly higher in the testosterone treatment group and testosterone + estradiol treatment group than in the control group (p = 0.01 and p = 0.002, respectively for bladder capacity; p = 0.04 and p = 0.005, respectively for bladder compliance). Smooth muscle/collagen ratio of the bladders was significantly higher in the testosterone and testosterone + estradiol treatment groups than in the control group (p = 0.04 and p = 0.008, respectively). CONCLUSIONS This study shows that bladder functions may deteriorate in postmenopausal period. In addition to estrogen replacement therapy, testosterone has a significant role to increase bladder smooth muscle, leading to improvement in bladder functions in postmenopausal women with urogenital system dysfunction.
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Affiliation(s)
- Filiz Cayan
- Department of Obstetrics and Gynecology, University of Mersin School of Medicine, Mersin, Turkey
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de Almeida SHM, Rodrigues MAF, Gregório E, Crespígio J, Moreira HA. Influence of sling material on inflammation and collagen deposit in an animal model. Int J Urol 2008; 14:1040-3. [PMID: 17956533 DOI: 10.1111/j.1442-2042.2007.01888.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM Compare inflammation and collagen production induced by four sling materials in female rats. METHODS Adult female rats (n=144) were submitted to a urinary incontinence model and neutering. After four weeks they were randomized in 5 groups: Sham; autologous sling; Marlex; swine intestinal submucosa (SIS), and polypropylene mesh (TVT). Animals were killed at 7, 30 and 90 days. The inflammatory infiltrated area was rated from 0 to 3 (0=area smaller than 25%, 1=between 25% and 50%, 2 between 50% and 75%, and 3 for areas greater than 75%). The presence of granuloma and necrosis was noted. Penetration in the vesical wall was evaluated employing a system of scores from 0 to 3. The amount of collagen I and III, and the total was assessed using the Picro-Sirius staining technique. RESULTS The Sham group presented lower inflammatory parameters at 7 days. On the 30th day, the autologous fascia presented inflammatory reactions similar to the Sham group, and lower than the remaining groups. The synthetic materials demonstrated greater inflammatory reactions at 60 days. No differences between groups were observed other than those concerning collagen production, except at 60 days, when TVT and SIS differed from Fascia and Sham in the production of collagen III. CONCLUSION Autologous fascia produced less inflammatory reaction and collagen. TVT and Marlex caused more intense and longer-lasting inflammatory reaction with greater visceral penetration. When TVT was used, this process resulted in a higher quantity of collagen III. The presence of SIS, although presenting a less intense inflammatory reaction than the synthetics, also caused greater collagen III production at 60 days.
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de Fraga R, Dambros M, Miyaoka R, Riccetto CLZ, Palma PCR. Role of 17 beta-estradiol on type IV collagen fibers volumetric density in the basement membrane of bladder wall. Int Urogynecol J 2007; 18:1185-90. [PMID: 17347794 DOI: 10.1007/s00192-006-0294-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2006] [Accepted: 12/12/2006] [Indexed: 10/23/2022]
Abstract
The authors quantified the type IV collagen fibers volumetric density in the basement membrane of bladder wall of ovariectomized rats with and without estradiol replacement. This study was conducted on 40 Wistar rats (3 months old) randomly divided in 4 groups: group 1, remained intact (control); group 2, submitted to bilateral oophorectomy and daily replacement 4 weeks later of 17 beta-estradiol for 12 weeks; group 3, sham operated and daily replacement 4 weeks later of sesame oil for 12 weeks; and group 4, submitted to bilateral oophorectomy and killed after 12 weeks. It was used in immunohistochemistry evaluation using type IV collagen polyclonal antibody to stain the fibers on paraffin rat bladder sections. The M-42 stereological grid system was used to analyze the fibers. Ovariectomy had an increase effect on the volumetric density of the type IV collagen fibers in the basement membrane of rat bladder wall. Estradiol replacement in castrated animals demonstrated a significative difference in the stereological parameters when compared to the castrated group without hormonal replacement. Surgical castration performed on rats induced an increasing volumetric density of type IV collagen fibers in the basement membrane of rats bladder wall and the estradiol treatment had a significant effect in keeping a low volumetric density of type IV collagen fibers in the basement membrane of rats bladder wall.
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