COMPARATIVE MORPHOMETRIC STUDY OF BLADDER DETRUSOR BETWEEN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA AND CONTROLS:

Upregulation of heme oxygenase and collagen type III in the rat bladder after partial bladder outlet obstruction

The objective of the study was to evaluate possible changes of the gene expression and localization of the enzymes, heme oxygenase and nitric oxide synthase (NOS), with reference to increase of collagen type III in response to the partial obstruction of the bladder. Following initial obstruction, whole rat bladders were removed for real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry. Real-time RT-PCR demonstrated significantly enhanced expression of HO (p < 0.01) and collagen type III (p < 0.001) gene on postoperative day 14. Enhanced expression of NOS gene was seen only on postoperative day 4 (p < 0.01). Immunohistochemistry revealed that immunoreactivity to HO-1 had much in common in neural cells and fibers, although immunoreactivity to HO-2 and iNOS was relatively weak. This study suggested gene expression of HO, especially HO-1, was more dramatically changed than NOS, and was upregulated simultaneously with increase of collagen type III after obstruction. HO systems could be involved in the pathogenesis of bladder dysfunction related to increase of collagen type III after obstruction.

Effects of Selective Alpha-1-Adrenergic Receptor Blockers on Bladder Weight

INTRODUCTION

This study was undertaken to investigate the effects of two different alpha(1)-adrenergic blockers on bladder hypertrophy using ultrasound-estimated bladder weight (UEBW) and to assess the relation between changes in UEBW and other objective and subjective parameters of disease severity in patients with benign prostatic hyperplasia (BPH).

MATERIALS AND METHODS

41 men were enrolled in the study and they were subjected to either watchful waiting (group 1) or alpha(1)-adrenergic receptor blocker therapy (group 2 with alfuzosin; group 3 with tamsulosin). The patients were investigated by symptom evaluation using the International Prostate Symptom Score (IPSS) and quality of life score (QOL), uroflowmetry and UEBW. The parameters were assessed again 3 months after initiation of treatment and compared with the initial values.

RESULTS

While the mean UEBW increased in group 1 (42.2 +/- 10.3 to 52.5 +/- 12.2 g), it decreased in both the other groups that received alpha-blocker therapy (61.3 +/- 18.7 to 41.1 +/- 13.2 and 59.4 +/- 17.2 to 43.5 +/- 17.6 g, respectively). In groups 2 and 3, the mean UEBW, post-void residual urine, IPSS and QOL values decreased, and the mean maximum flow rate increased. All of the changes in group 2 and all except QOL in group 3 were statistically significant (p < 0.05). The changes correlated well with each other with regard to treatment success. The highest decreases in UEBW were encountered in patients with heavier bladders.

CONCLUSIONS

UEBW decreases with alpha(1)-adrenergic receptor blockers. When used together with the other objective and subjective parameters, UEBW is a promising quantitative parameter as a follow-up tool and can be useful in monitoring the therapeutic effects of alpha(1)-adrenergic receptor blockers.