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Related Experiment Videos

Structural basis of geriatric voiding dysfunction. III. Detrusor overactivity

A Elbadawi1, S V Yalla, N M Resnick

  • 1Department of Pathology, State University of New York, Syracuse 13210.

The Journal of Urology
|November 1, 1993
PubMed
Summary
This summary is machine-generated.

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Detrusor overactivity in elderly individuals shows a unique "dysjunction" pattern in muscle cells, not hypertrophy. This structural change may explain involuntary contractions and impaired contractility in aging bladders.

Area of Science:

  • Urology
  • Gerontology
  • Cell Biology

Background:

  • Detrusor overactivity (DO) is common in the elderly, often without bladder outlet obstruction.
  • Previous research on DO ultrastructure focused mainly on detrusor innervation.
  • Understanding detrusor muscle cell structure is crucial for explaining voiding dysfunction in older adults.

Purpose of the Study:

  • To investigate the ultrastructure of detrusor muscle cells, interstitium, and nerves in elderly subjects.
  • To identify structural correlates of urodynamically defined voiding dysfunction.
  • To elucidate the structural basis of detrusor overactivity and impaired contractility.

Main Methods:

  • Prospective study involving 35 elderly subjects undergoing detrusor biopsies.
  • Blind ultrastructural analysis of muscle cells, intercellular spaces, and junctions.

Related Experiment Videos

  • Correlation of structural findings with urodynamic evaluations and clinical presentation.

    • Main Results:

    • A distinct
    • dysjunction
    • pattern was identified in 15 biopsies from patients with DO.
    • This pattern includes widened intercellular spaces, reduced intermediate junctions, and increased protrusion junctions.
    • Superimposed muscle cell and axonal degeneration was observed in patients with impaired detrusor contractility.

    Conclusions:

    • The
    • dysjunction
    • pattern, characterized by altered cell junctions, may underlie detrusor overactivity in aging.
    • Protrusion junctions might facilitate electrical coupling, compensating for reduced mechanical coupling.
    • Muscle cell degeneration is proposed as the structural basis for impaired detrusor contractility in this population.