Immunohistochemical estimation of hypoxia in human obstructed bladder and correlation with clinical variables.
OBJECTIVE
To investigate the tissue distribution of ischaemia in human detrusor in patients with bladder outlet obstruction (BOO) and to correlate the results with clinical variables, as clinical BOO is a common problem in ageing men and ischaemia might be important in detrusor dysfunction.


METHODS
From September 2004 to October 2006, 70 patients were recruited, comprising 60 scheduled for surgery to treat benign prostatic hyperplasia (the study group) and 10 as controls. Detrusor tissue was retrieved and stained for hypoxia-inducible factor (HIF)-1alpha, a cellular marker of hypoxia.


RESULTS
The mean (sd) total number of cells immunoreactive to HIF-1alpha in the study group was 93.3 (48.09), and in the specimens from the control group only few rare cells showed weak immunoreactivity to HIF-1alpha (0-2). Positive cells were in different proportions between muscle bundles and submucosa, expressed mainly in stromal cells. The urothelium and detrusor muscle showed no immunoreactivity to HIF-1alpha. There was strong immunoreactivity in patients with prolonged BOO (<10 years), declining thereafter, and in those patients with urinary retention.


CONCLUSIONS
The urothelium and detrusor seem to be more resistant to hypoxic stress, while stromal cells perceive low oxygen tension. The bladder response to chronic hypoxia through HIF-1alpha expression is limited in time and might depend on the functional status of the detrusor.
Koritsiadis
George
G
1st Urology Department, Athens Medical School, Laiko Hospital, Greece.
Stravodimos
Konstantinos
K
Koutalellis
George
G
Agrogiannis
Georgios
G
Koritsiadis
Sotirios
S
Lazaris
Andreas
A
Constantinides
Constantinos
C
D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015687:Cell Hypoxia; D002908:Chronic Disease; D006801:Humans; D051795:Hypoxia-Inducible Factor 1, alpha Subunit / Q000378:metabolism*; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D011470:Prostatic Hyperplasia / Q000473:pathology / Q000503:physiopathology*; D053448:Prostatism / Q000473:pathology / Q000503:physiopathology*; D001743:Urinary Bladder / Q000098:blood supply*; D001748:Urinary Bladder Neck Obstruction / Q000473:pathology / Q000503:physiopathology*
D051795:Hypoxia-Inducible Factor 1, alpha Subunit