Effect of Stress on the Expression of Rho-Kinase and Collagen in Rat Bladder Tissue

PURPOSE: We examined the effect of stress on the pathophysiology of bladder stability in terms of enzyme levels, Rho-kinase, and bladder relaxation. MATERIALS AND METHODS: A total of 48 female Sprague-Dawley rats were studied in scheduled stress environments for 7, 14, and 28 days; 24 rats were in the control group and 24 rats were in the test (stressed) group. RESULTS: Estrogen decreased significantly whereas testosterone and dopamine increased significantly in the stress group (p<0.05). Rho-kinase was significantly increased in the rats exposed to stress stimuli for 14 days (p<0.05). Collagen types I and III in the bladder tissue were significantly higher in rats exposed to stress for 14 days and 28 days (collagen type I in the 14-day group, p<0.01; collagen type I in the 28-day group, p<0.05; collagen type III in the 14-day and 28-day groups, p<0.05). Voiding frequency increased significantly as the duration of stress exposure was prolonged, in addition to a significant decrease in volume per voiding (p<0.05). CONCLUSIONS: The changes observed in micturition pattern, factors that contribute to smooth muscle contraction, and relaxation in the female rat bladder support the hypothesis that stress affects bladder stability.

Clinical Use of High-Sensitivity C-Reactive Protein (hs-CRP) in Chronic Pelvic Pain Syndrome

PURPOSE: The cause of chronic pelvic pain syndrome (CPPS) has traditionally been regarded as inflammation of the pelvis and pelvic organs. C-reactive protein (CRP) is an indicator of acute and chronic inflammation. We aimed to determine the clinical significance and use of high-sensitivity C-reactive protein (hs-CRP) in patients with CPPS. MATERIALS AND METHODS: From January 2005 to December 2006, we retrospectively reviewed 70 patients diagnosed as having CPPS (mean age, 45.4+/-10.09 years old). The variables we assessed in these patients were white blood cell count in the third voided urine specimen (VB3), scores on the NIH-Chronic Prostatitis Symptom Index (NIH-CPSI), peak flow rate (Qmax), postvoid residual urine (PVR), and hs-CRP level. Items were checked again after 8 weeks of treatment with antibiotics and anti-inflammatory agents. Patients who showed improvement in symptom scores were regarded as being in the positive response group. We analyzed correlations of hs-CRP with the other CPPS items. RESULTS: The hs-CRP level was statistically significantly correlated with other CPPS items in both the NIH category IIIa and IIIb groups. In the positive response group, there were statistically significant changes in the hs-CRP level, WBC count in VB3, and scores on the NIH-CPSI after treatment (p<0.05). In the negative response group, there were no significant changes in CPPS items. CONCLUSIONS: The hs-CRP level had a clinically significant correlation with other CPPS items. In the positive response group especially, the hs-CRP level decreased after treatment. Measuring hs-CRP may have benefits in determining the severity of CPPS and in predicting the response to treatment.