ABSTRACT
To study the effect of bladder outlet obstruction due to benign prostatic hyperplasia [BPH] on type III collagen deposition in bladder wall and it's correlation with the clinical outcome. 33 patients with benign prostatic hyperplasia planned for intervention were included in this study. Patients age ranged from 58-72y [average 66y], patients were divided into 3 groups representing spectrum of condition. Group I included 9 patients who failed medical therapy with moderate IPSS 8-18 and <100 ml residual urine. Group 2 included 18 patients with moderate to high IPSS 20-35 and 100 ml residual urine. Group 3 included 6 patients with chronic urinary retention. All patients had interventions, TURP in 28 and surgical adenectomy in 7 during which bladder biopsies were taken for immunohistochemical studies to determine type III collagen content within the bladder wall. 3 control biopsies were taken from nonobstructed bladders in patients undergoing ureterovesical implantation. Group 1 showed mild to moderate type III collagen deposition in bladder wall, they had the most favorable outcome following relief of obstruction. Qmax 18-25 ml/sec and no residual urine. Group 2 showed moderate to severe type III collagen deposition in bladder wall, they voided adequately postoperatively, Qmax 15-20 ml sec and insignificant residual urine. Group 3 showed extreme form of type III collagen deposition, they had the least favorable outcome with high residual urine. Bladder outlet obstruction increases deposition of type III collagen in the bladder wall. Severe and extensive deposition of type III collagen is associated with pathological bladder function that may affect the outcome of surgery