[Consequences of intravesical obstruction on detrusor muscle energy metabolism]

Alteration of the emptying function of the bladder observed during the natural history of benign prostatic hyperplasia may be related to a biochemical disorder, more specifically a disorder of energy metabolism. Under conditions of obstruction, the bladder is no longer able to contract effectively as it is unable to produce a sufficient quantity of energy. This energy dysfunction is induced by anaerobic diversion of glucose metabolism. The key element of this disturbance is the mitochondrion. Morphological studies have demonstrated degeneration of this organelle controlling energy metabolism. This intracellular alteration is also reflected by functional changes. Disturbances of the various mitochondrial energy producing cycles appear to be responsible for detrusor dysfunction. Further investigations are necessary, especially clinical studies to corroborate these experimental findings. A better knowledge of the pathophysiology of vesical functional consequences of BPH would allow the use of new therapeutic categories of drugs.