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Related Experiment Videos

Structural basis of geriatric voiding dysfunction. IV. Bladder outlet obstruction

A Elbadawi1, S V Yalla, N M Resnick

  • 1Department of Pathology, SUNY-Health Sciences Center, Syracuse 13210.

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

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Bladder outlet obstruction causes voiding dysfunction through specific detrusor muscle structural changes. These changes, including myohypertrophy and collagenosis, explain weakened or overactive bladders in elderly patients.

Area of Science:

  • Urology
  • Pathology
  • Geriatrics

Background:

  • Voiding dysfunction in bladder outlet obstruction is not fully understood.
  • Structural changes in the detrusor muscle are implicated but require detailed investigation.

Purpose of the Study:

  • To investigate the ultrastructural basis of voiding dysfunction in elderly patients with bladder outlet obstruction.
  • To correlate specific detrusor muscle structural patterns with urodynamic findings.

Main Methods:

  • Prospective ultrastructural and urodynamic study of 35 elderly subjects.
  • Electron microscopy of detrusor specimens with blinded clinical and urodynamic data analysis.

Main Results:

  • A distinct myohypertrophy pattern (widely separated muscle cells, collagenosis, hypertrophic cells) was identified in obstructed patients.

Related Experiment Videos

  • Superimposed muscle and axon degeneration correlated with impaired detrusor contractility.
  • Protrusion junctions and abutments were associated with detrusor overactivity in obstructed bladders.
  • Hyperelastosis contributed to increased bladder distensibility and chronic retention.

    • Conclusions:

    • Bladder outlet obstruction induces specific detrusor structural changes that explain voiding dysfunction.
    • Myohypertrophy with degeneration accounts for detrusor weakness.
    • Specialized junctions may mediate involuntary contractions in overactive bladders.
    • Excessive elastic fibers likely cause increased bladder distensibility and retention.