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The effect of obstruction on the developing bladder.

C A Peters1, S Vasavada, D Dator

  • 1Department of Surgery, Children's Hospital, Harvard Medical School, Boston, Massachusetts.

The Journal of Urology
|August 1, 1992
PubMed
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Fetal bladder obstruction in sheep causes significant bladder growth, primarily through cell enlargement (hypertrophy), and impairs bladder function. This study demonstrates a viable in utero model for investigating congenital bladder obstruction effects.

Area of Science:

  • Urology
  • Developmental Biology
  • Physiology

Background:

  • Congenital bladder obstruction has severe consequences but its underlying mechanisms are not fully understood.
  • Studying fetal development is crucial for understanding congenital abnormalities.

Purpose of the Study:

  • To develop and utilize a fetal sheep model to investigate the pathophysiology of congenital bladder obstruction.
  • To analyze the structural, biochemical, and functional responses of the developing bladder to obstruction.

Main Methods:

  • Congenital bladder obstruction was surgically created in fetal sheep at 60 days of gestation.
  • Bladders were analyzed at 95 days gestation or term using stereology, biochemical assays, and cystometry.
  • Comparisons were made against age-matched control sheep.

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Main Results:

  • Obstruction led to a 4.6-fold increase in bladder weight and a 5.8-fold increase in smooth muscle mass, mainly via cellular hypertrophy.
  • Muscarinic cholinergic receptor number per cell increased 3.2-fold, and myosin heavy chain isoform ratios were altered, suggesting disrupted smooth muscle development.
  • In vivo cystometry revealed significantly reduced bladder compliance in obstructed fetuses.

Conclusions:

  • An in utero model for studying congenital bladder obstruction is feasible in sheep.
  • Congenital bladder obstruction induces substantial structural, biochemical, and functional changes in the developing bladder.
  • These changes indicate significant alterations in the regulation of bladder growth and differentiation in utero.