Electron microscopic changes of detrusor in benign enlargement of prostate and its clinical correlation

ABSTRACT Aims: To study the ultra structural changes in bladder musculature in cases of BPE and their clinical relevance. Material and Methods: In this descriptive longitudinal, controlled, observational study patients were enrolled into three groups, group 1, group 2A and group 2B. Control group (group-1) consisted of age matched normal male patients, who underwent surveillance or diagnostic cystoscopy for microscopic hematuria or irritative symptoms. Case group (group-2) comprised of patients with BPE, undergoing TURP. Case group (group-2) was further classified into: Category 2A (patients not on catheter) and category 2B (patients on catheter). All relevant clinical parameters like IPSS, prostate size, Qmax, PVR were recorded. Cystoscopy and bladder biopsy were performed in all patients. Various ultrastructural parameters like myocytes, fascicular pattern, interstitial tissue, nerve hypertrophy and cell junction pattern were analyzed under electron microscope and they were clinically correlated using appropriate statistical tests. Results: Control group had significant difference as compared to case group in terms of baseline parameters like IPSS, flow rate and prostate size, both preoperatively and postoperatively, except for PVR, which was seen only preoperatively. There was statistically significant difference in ultrastructural patterns between case and control group in all five electron microscopic patterns. However, no significant difference was found between the subcategories of case groups. Conclusions: BPE is responsible for ultra structural changes in detrusor muscle and these changes remain persistent even after TURP. Nerve hypertrophy, which was not thoroughly discussed in previous studies, is also one of the salient feature of this study.

Effect of different durations of overdistention on rat bladder function and morphology

We investigated the contribution of the duration of overdistention (DOD) to rat bladder function and morphology and explored its possible molecular mechanisms. Bladder overdistention was induced in male Sprague-Dawley rats (200-250 g) by an infusion of saline. Forty rats were divided into 5 groups submitted to different DOD, i.e., 1, 2, 4, and 8 h, and control. Bladder function was evaluated by cystometry. Morphological changes were observed by light and transmission electron microscopy. Compared to control (44.567 ± 3.472 cmH2O), the maximum detrusor pressure of groups with 2-, 4- and 8-h DOD decreased significantly (means ± SEM): 32.774 ± 3.726, 31.321 ± 2.847, and 29.238 ± 3.724 cmH2O. With the increase of DOD, inflammatory infiltration and impairment of ultrastructure were more obvious in bladder tissue. Compared to control (1.90 ± 0.77), the apoptotic indexes of groups with 1-, 2-, 4-, and 8-h DOD increased significantly (6.47 ± 2.10, 10.66 ± 1.97, 13.91 ± 2.69, and 18.33 ± 3.28%). Compared to control (0.147 ± 0.031/0.234 ± 0.038 caspase 3/β-actin and Bax/Bcl-2 ratios), both caspase 3/β-actin and Bax/Bcl-2 ratios of 1-, 2-, 4-, and 8-h DOD increased significantly (0.292 ± 0.037/0.508 ± 0.174, 0.723 ± 0.173/1.745 ± 0.471, 1.104 ± 0.245/4.000 ± 1.048, and 1.345 ± 0.409/8.398 ± 3.332). DOD plays an important role in impairment of vesical function and structure. With DOD, pro-apoptotic factors increase and anti-apoptotic factors decrease, possibly contributing to the functional deterioration and morphological changes of the bladder.

Streptozotocin-induced diabetic cystopathy in albino rat. An ultrastructural and immunohistochemical study

It was suggested that urinary bladder dysfunction can be considered as one of the most common complications of diabetes. Therefore, this study was designed to clarify the ultrastructural changes in the smooth muscles of the urinary bladder in diabetic rats and to ascertain the role of iNOS, in an attempt to investigate the possible mechanism of these histopathological changes. Thirty adult male albino rats were used in this study. The animals were divided into three equal groups; A served as sham-injected control, while the animals of group B were intraperitoneally injected with a single dose of streptozotocin [50 mg/kg body weight/ rat] and left under observation tor 8 weeks. The rats of group C were intraperitoneally-injected with the same dose of streptozotocin and left for 18 weeks. Specimens from the urinary of the animals of all groups were to obtain paraffin blocks which were cut and immunohistochamically stained for demonstration of iNOS activity. In addition, small specimens were processed and prepared for electron microscopic study. The smooth muscles cells showed progressive ultrastructural changes in the form of degenerated mitochondria, apparent increase in of the pinocytotic vesicles which were relatively electron lucent and degenerated in the cytoplasm that were devoid of actin and myosin filaments, in addition, corrugated cell membranes and widened gap junctions were observed. These myocytes showed strong positive reactions for iNOS as compared with the control group. The connective tissue stroma between adjacent cells showed degenerated nerve fibres forming myelin body-like structures, activated fibro-blasts with dilated endoplasmic reticulum cisternae and increased collagen deposition. These changes were more marked in the animals of the third group. Therefore, urinary bladder biopsy may be of value in early diagnosis of diabetic cystopathy with a more positive impact on management. Moreover, the increased iNOS expression can be considered as an indicator of oxidative stress and thus the use of antioxidants might have a role in better management of such condition

Evaluation of time dependent structural changes of rat urinary bladder in experimentally induced diabetes mellitus light and electron microscopic study

Diabetes Mellitus [DM] is a chronic disease that requires a long-term medical attention. Diabetic bladder dysfunction is among the most common consequences of DM. This work aimed to evaluate the histological changes in the urinaly bladder of the rats in streptozotocin induced- DM. It also aimed to study the influence of duration of diabetes on these changes. Thirty male albino rats were used in the present study. They were divided into three groups. Group I consisted of six rats and constituted the control group. Group II consisted of twelve rats which was equally divided into two subgroups III-A and Il-B. They included the rats which were killed four and eight weeks respectively after a single injection of citrate buffer. Group III consisted of twelve rats which was further subdivided into two equal subgroups III- A and Ill-B. They included the diabetic rats which were sacrificed four and eight weeks after diabetes induction respectively. After the end of the experiment the urinary bladder was dissected and the specimens were prepared fir light, electron microscopic and morphometric study. In subgroup Ill-A, there were focal areas where the suffice cells of the urothelium appeared widely separated and shrunken. In subgroup Ill-B, there were multiple areas of denuded urothelium. Collagen fibers and residues of degenerated nerve fibers were seen between the myocytes. Frequent mast cells could be detected in the urothelium and in the connective tissue beneath the urothelium. The morphometric and statistical study revealed a significant increase in thickness of the urothelium and the muscle layer as well as in the area percentage of the collagen content after four weeks of diabetes induction and became a highly significant increase after eight weeks when compared with the control group. It was concluded that diabetes. induced time-dependent structural changes in the urinaly bladders of rats that might account for bladder dysfunction

Efeito do extrato de Passiflora edulis (maracujá) na cicatrização de bexiga em ratos: estudo morfológico / Effect of Passiflora edulis (passion fruit) extract on rats bladder wound healing: morphological study

OBJETIVO: Avaliar o efeito do extrato das folhas de Passiflora edulis na cicatrização de bexiga em ratos, sob aspectos histológico. MÉTODOS: Quarenta ratos da linhagem Wistar, machos foram submetidos à incisão longitudinal na bexiga e síntese em plano único. Após este procedimento comum, os animais foram distribuídos aleatoriamente em dois grupos, Passiflora e Controle. No grupo Passiflora utilizou-se dose única intra-peritoneal do extrato hidroalcoólico das folhas de Passiflora edulis e no grupo controle utilizou-se dose única intraperitoneal de água destilada. Cada grupo foi dividido em dois subgrupos, conforme o dia de morte dos animais, subgrupos Controle três e sete dias e subgrupos Passiflora três e sete dias. Após a morte dos animais, foi feito o inventário da cavidade abdominal e a retirada da bexiga. Uma análise comparativa entre os dois grupos, utilizando-se parâmetros microscópicos da cicatrização, foi realizada. RESULTADOS: Houve menor inflamação aguda (p=0,008), maior colagenização (p=0,001) e maior neoformação capilar (0,000) no subgrupo Passiflora do terceiro dia, quando comparado com o subgrupo Controle do terceiro dia. Encontrou-se menor inflamação aguda (p=0,001), maior proliferação fibroblástica (p=0,011) e maior presença de colágeno (p=0,001) no subgrupo Passiflora do sétimo dia quando comparado ao subgrupo Controle do sétimo dia. CONCLUSÃO: O extrato das folhas de Passiflora edulis diminuiu a inflamação aguda e aumentou a proliferação fibroblástica, a colagenização e a neoformação capilar na cicatrização da bexiga de ratos.

PURPOSE: To evaluate the effects of hydroalcoholic extract of Passiflora edulis leaves in the healing of urinary bladder in rats from histological aspects. METHODS: Forty Wistar male rats were submitted to a longitudinal incision of the bladder followed by a stetching in only one level. After this common procedure, animals were divided at random two groups: Passiflora and Control. In the Passiflora group the only dosage used was administered by intraperitonial injection of hydoalcoholic extract of Passiflora edulis leaves while in the Control group distilled water was injected. Each subgroup was then divided in two subgroups according to the death of these animals: Control, three and seven days, Passiflora, three and seven days. After the death of these animals, an inventory of the abdominal cavity was performed and the bladder was removed. A comparative analysis was done between the two groups with microscopic evaluation of the healing. There was less acute inflammation (p=0.008), greater colagenous formation (p=0.001) and greater capillary neo-formation (p=0.000) in the third day Passiflora subgroup when compared to the Control subgroup of the third day. RESULTS: There was less acute inflammation (p=0.001), greater fibroblastic proliferation (p=0.011) and greater colagenous formation (p=0.001) in the Passiflora subgroup of seventh day when compared with the Control seventh day subgroup. CONCLUSION: The use of Passiflora edulis leaves extract resulted in less acute inflammation, greater fibroblastic proliferation, colagenous formation and capillary neo-formation on rats bladder wound healing.

Estudo da cicatrização de suturas na bexiga urinária de ratos com e sem a utilização de extrato bruto de Jatropha gossypiifolia L. intraperitoneal / Healing process in bladder suture of rats with and without the administration of intraperitoneal Jatropha gossypiifolia L. gross extract

INTRODUÇÃO: A sutura dos tecidos e sua cicatrização é um dos fundamentos básicos da cirurgia e a procura de substâncias que melhorem este processo é desafio constante. O uso de substâncias retiradas de plantas tem sido testado há muitos anos, contudo sem ainda terem comprovação científica consolidada. OBJETIVO: Comparar as alterações macroscópicas e histológicas proporcionadas pelo uso do extrato bruto da Jatropha gossypiifolia L. intraperitonial, na cicatrização de suturas realizadas na bexiga urinária de ratos. MÉTODOS: Quarenta ratos da linhagem wistar, adultos, machos foram distribuídos em dois grupos, experimento e controle. Incisão longitudinal de 1cm na parede ventral da bexiga e síntese em plano único com pontos separados de poliglactina 910 5-0 (ethicon) foi realizada nos dois grupos. No controle, instilou-se na cavidade peritoneal água destilada na proporção de 1ml/kg de peso, enquanto no grupo Jatropha utilizou-se o extrato bruto de Jatropha gossypiifolia L. na proporção de 1ml/kg, que representava 200mg/kg de peso do fitoterápico. Cada grupo foi subdividido em dois subgrupos de 10 animais, sendo estes submetidos à eutanásia no 3° e 7° dia pós-operatório. Foi feita análise macroscópica e histológica comparativa entre os subgrupos. RESULTADOS: No 3° dia foi observada diferença estatisticamente significante nas variáveis inflamação aguda, neoformação vascular e colagenização, sendo a primeira, maior no grupo controle e as duas últimas no grupo Jatropha; no 7° dia as variáveis inflamação aguda e proliferação fibroblástica apresentaram-se mais intensas, com significado estatístico, no grupo controle. CONCLUSÃO: Não se observou efeito favorecedor cicatrizante do extrato bruto da Jatropha gossypiifolia L., intraperitonealmente aplicado, na bexiga urinária de ratos.

INTRODUCTION: The suture of tissues and their healing process is one of the basic fundamentals of surgery, and the research on substances which could improve the process is an ongoing challenge. The use of plants has been tested but till nowadays without scientific demonstration. PURPOSE: To compare the macroscopic and histological alterations done by the use of intraperitoneal Jatropha gossypiifolia L. gross extract, in the healing process of sutures performed on the bladder of rats. METHODS: Forty adult, male, Wister rats were distributed into two animal groups. One centimeter longitudinal incision on the bladder ventral wall, and single plane synthesis with separated polyglactine 910 5-0 (Ethicon) stitches was done in all the animals. In the control group an intraperitoneal cavity instillation of distilled water at a ratio of 1ml/kg/weight, and a 1ml/kg/weight of Jatropha gossypiifolia L. extract for the Jatropha group was done representing 200 mg of the substance. Each group was subdivided into two with 10 animals in each, being submitted to euthanasia on 3th and 7th post-operative days. Comparative histological, macroscopic and statistical analysis were undertaken between the subgroups. RESULTS: Statistical significant difference was observed in the acute inflammation changes, vascular neoformation and bonding on day 3; the first one was greater in the control group, and the latter two greater in the Jatropha group; acute inflammation variables and fibroblastic proliferation presented to be more intense on day 7, with statistical significance favoring the control group. CONCLUSION: No favorable healing effect was observed with the administration of single intraperitoneal dose of Jatropha gossypiifolia L. gross extract on the sutures of bladder in rats.

Scanning electron microscopic study of carcinoma of the urinary bladder

The urinary bladder of 30 patients with histologically proven carcinoma of the urinary bladder was studied by scanning electron microscopy [SEM]. Specimens were taken from the tumor as well as from the normal looking mucosa. The SEM characteristics of the various types of bladder cancer have been verified. In addition, the apparently normal mucosa showed precancerous surface changes that were not always evident by light microscopic examination. These findings lend a further support to concept of multicentricity of bladder cancer. This concept should be taken in consideration in planning the management of patients with carcinoma of the urinary bladder, partial cystectomy is not a suitable operation for such patients