title: Correlation between detrusor collagen content and urinary symptoms in patients with prostatic obstruction.
abstract: OBJECTIVE
  We used computerized imaging analysis to compare the collagen content of detrusor specimens between patients affected with symptomatic obstructive benign prostatic hyperplasia (BPH) and asymptomatic controls.
  
  
  METHODS
  In our study we enrolled 36 patients with symptomatic urodynamically obstructed BPH undergoing transurethral resection of the prostate. We also enrolled 28 men (mean age 61.3, range 55 to 70) undergoing transurethral resection of the bladder for primitive, singular Ta bladder cancer, with no significant urinary symptoms, as the control group. During the transurethral surgical procedure in controls and in patients with BPH, a biopsy was performed deep through the muscular layer from either of the lateral bladder walls. Computerized morphometric analysis of the stained sections was performed with an image analysis system, and a percentage of collagen fibers was extracted through morphological filtering and expressed as a mean percentage of the total bioptic area.
  
  
  RESULTS
  Collagen content in bladder detrusor specimens was significantly higher in patients with BPH compared to controls (48% and 17% of bioptic area, respectively, p <0.001). Mean detrusor collagen content was clearly higher in patients with severe symptoms than in patients with moderate symptoms (50.45 +/- 8.22% and 43.09% +/- 7.05%, respectively).
  
  
  CONCLUSIONS
  Our study supports the important role of detrusor collagen neo-deposition in determining lower urinary tract symptoms in obstructive BPH. Detrusor collagen content correlates with urodynamic obstruction, the presence and severity of symptoms and, given that collagen neoformation is irreversible could probably have a role in the postoperative persistence of lower urinary tract symptoms in patients undergoing surgery for BPH.
authors.affiliation: Urology Department, University Federico II, Naples, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Mirone
authors.forename: Ciro
authors.initials: C
authors.lastname: Imbimbo
authors.forename: Gaetano
authors.initials: G
authors.lastname: Sessa
authors.forename: Alessandro
authors.initials: A
authors.lastname: Palmieri
authors.forename: Nicola
authors.initials: N
authors.lastname: Longo
authors.forename: Antonio M
authors.initials: AM
authors.lastname: Granata
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Fusco
mesh_terms: D000368:Aged; D003094:Collagen / Q000032:analysis*; D004724:Endoscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009122:Muscle Hypertonia / Q000473:pathology* / Q000601:surgery; D011470:Prostatic Hyperplasia / Q000473:pathology* / Q000601:surgery; D013223:Statistics as Topic; D014521:Urethra / Q000473:pathology / Q000601:surgery; D001748:Urinary Bladder Neck Obstruction / Q000473:pathology* / Q000601:surgery
chemical_list: D003094:Collagen