Correlation between intravesical pressure and prostatic obstruction grade using computational fluid dynamics in benign prostatic hyperplasia

Urethral meatus stricture BOO stimulates bladder smooth muscle cell proliferation and pyroptosis via IL‑1β and the SGK1‑NFAT2 signaling pathway

Bladder outlet obstruction (BOO), which is primarily caused by benign prostatic hyperplasia, is a common chronic disease. However, previous studies have most commonly investigated BOO using the acute obstruction model. In the present study, a chronic obstruction model was established to investigate the different pathological alterations in the bladder between acute and chronic obstruction. Compared with chronic obstruction, acute obstruction led to increased expression of proliferating cell nuclear antigen and interleukin-1β, which are markers of proliferation and inflammation, respectively. Furthermore, increased fibrosis in the bladder at week 2 was observed. Low pressure promoted mice bladder smooth muscle cell (MBSMC) proliferation, and pressure overload inhibited cell proliferation and increased the proportion of dead MBSMCs. Further investigation using serum/glucocorticoid regulated kinase 1 (SGK1) small interfering RNAs indicated that low pressure may promote MBSMC proliferation by upregulating SGK1 and nuclear factor of activated T-cell expression levels. Therefore, the present study suggested that acute obstruction led to faster decompensation of bladder function and chronic bladder obstruction displayed an enhanced ability to progress to BOO.

Role for intravesical prostatic protrusion in lower urinary tract symptom: a fluid structural interaction analysis study

BACKGROUND

Numerous studies indicated that Intravesical prostatic protrusion is relevant to prognosis of LUTS, however, the confounding effect that is brought about by prostate volume, urethra anterior curvature angle and other factors makes it hard to evaluate the role of intravesical prostatic protrusion in clinical observation.

METHODS

We proposed a fluid structural interaction analysis approach. 3D models were constructed based on MRI images, and prostatic urethra diameters were calibrated with urodynamic data. Comparisons of urine flow dynamics were made between models with various degree of intravesical prostatic protrusion, while the intravesical pressure, anterior urethra curvature angle and diameter of prostatic urethra were same among all models to rule out their confounding effects.

RESULTS

Simulation result showed that the decrement of diameter and increment of variation in cross-sectional area for prostatic urethra were related to the degree of intravesical prostatic protrusion. Such deformation would lead to deterioration of flow efficiency and could compromise the effect of bladder outlet obstruction alleviation treatment.

CONCLUSIONS

These results provided further evidence for intravesical prostatic protrusion being an independent risk factor for bladder outlet obstruction severity and demonstrated that intravesical prostatic protrusion would be a promising marker in clinical decision making.