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Morphometric analysis of smooth muscle in the exstrophy-epispadias complex
1Department of Pediatric Surgery, Bambino Gesù Children's Hospital, Rome, Italy.
The Journal of Urology
|August 1, 1996
Summary
Bladder exstrophy patients show increased collagen and decreased smooth muscle in bladder tissue. This ratio improves with age and reconstruction but remains below normal, potentially impacting bladder volume.
Area of Science:
- Urology
- Pediatric Surgery
- Histopathology
Background:
- Bladder exstrophy and epispadias involve abnormal bladder development.
- Collagen often replaces smooth muscle in the bladder wall of affected patients.
Purpose of the Study:
- To quantify the ratio of smooth muscle to connective tissue in the bladder walls of patients with the exstrophy-epispadias complex.
- To compare these ratios to healthy controls.
Main Methods:
- Analysis of nine detrusor biopsies from children with exstrophy-epispadias complex.
- Masson trichrome staining to differentiate muscle and collagen.
- Computerized morphometry to measure tissue areas.
- Comparison with eight control biopsies.
Main Results:
- Smooth muscle content in exstrophy-epispadias patients averaged 7% (newborns), 19.3% (pre-reconstruction), and 31.5% (post-reconstruction).
- Control bladders averaged 56.5% smooth muscle.
- A significant increase in smooth muscle ratio was observed with age and after reconstruction.
Conclusions:
- The smooth muscle-to-connective tissue ratio increases with age in the exstrophy-epispadias complex.
- Post-reconstruction ratios remain subnormal, suggesting a potential histological marker for inadequate bladder volume.
- Findings highlight tissue composition changes impacting bladder function.