Morphologic changes in detrusor muscles of patients with chronic obstruction of lower urinary tract. Electronmicroscopic and immunohistochemical findings.
The anterior bladder wall and actin- and myosin-like immunoreactivities within the detrusor muscles in patients with chronic obstruction of the lower urinary tract were examined by means of a MOP Videoplan image-processing system, electronmicroscopy, and light microscopic immunohistochemistry. The image-processing system demonstrated an excess of connective tissue elements between smooth muscle bundles in the anterior wall of the bladder similar to the results of previous studies dealing with the trabeculated posterior wall. Under electronmicroscopy, myofilaments were shown to be multidirectionally arranged in the smooth muscle cells in contrast to the regular arrangement in controls. Dense areas in the cytoplasm of the detrusor muscle also appeared to be abnormally distorted and/or elongated in the electronmicrographs. In support of these findings, actin- and myosin-like immunoreactivities in the muscle layer of the bladder were significantly less intense than in the controls. These results suggest that chronic obstruction of the lower urinary tract causes histopathologic alterations in both the intervening connective tissue and the detrusor muscle. This study raises the possibility that the aforementioned morphologic abnormalities are involved in the occurrence of uninhibited detrusor contraction and abnormal detrusor reflex in patients with lower urinary tract obstruction.
Hongoh
Y
Y
Department of Urology, Osaka Medical College, Japan.
Sakanaka
M
M
Kitagawa
Y
Y
Magari
S
S
Miyazaki
S
S
D008841:Actin Cytoskeleton / Q000648:ultrastructure; D000199:Actins / Q000032:analysis; D000328:Adult; D000368:Aged; D003238:Connective Tissue / Q000473:pathology; D003593:Cytoplasm / Q000648:ultrastructure; D005260:Female; D006003:Glycogen / Q000032:analysis; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007150:Immunohistochemistry; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D009130:Muscle, Smooth / Q000473:pathology*; D009218:Myosins / Q000032:analysis; D001743:Urinary Bladder / Q000473:pathology*; D014555:Urination Disorders / Q000209:etiology*
D000199:Actins; D006003:Glycogen; D009218:Myosins