title: Functional consequences of chronic bladder ischemia.
abstract: The pathophysiology of lower urinary tract symptoms (LUTS), particularly in the elderly, seems to be multifactorial. One of the factors involved may be chronic ischemia of the bladder caused by bladder outflow obstruction (male) or atherosclerosis (male/female). The mechanisms by which chronic ischemia initiates and causes LUTS and progressive bladder dysfunction, and the time course of the effects, are incompletely known. Bladder ischemia and repeated ischemia/reperfusion during a micturition cycle may produce oxidative stress, leading to denervation of the bladder and the expression of tissue damaging molecules in the bladder wall. This may be responsible for the development of detrusor overactivity progressing to detrusor underactivity and inability to empty the bladder. The extent of bladder dysfunction in chronic bladder ischemia may depend on the degree and duration of ischemia. To prevent chronic bladder ischemia caused by atherosclerosis and to treat its consequences, more pathophysiological knowledge is needed. Several animal models of atherosclerosis-induced chronic bladder ischemia are available and should be useful tools for further research.
authors.affiliation: Division of Bioengineering and LUTD Research, Nihon University College of Engineering, Koriyama, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Yamaguchi
authors.forename: Masanori
authors.initials: M
authors.lastname: Nomiya
authors.forename: Karl-Erik
authors.initials: KE
authors.lastname: Andersson
mesh_terms: D000818:Animals; D050197:Atherosclerosis / Q000150:complications; D002908:Chronic Disease; D004195:Disease Models, Animal; D005260:Female; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology*; D059411:Lower Urinary Tract Symptoms / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D018384:Oxidative Stress; D012039:Regional Blood Flow; D001743:Urinary Bladder / Q000098:blood supply* / Q000378:metabolism / Q000503:physiopathology*; D001748:Urinary Bladder Neck Obstruction / Q000150:complications; D014554:Urination
keywords: aging; atherosclerosis; bladder dysfunction; bladder ischemia; detrusor overactivity; detrusor underactivity; lower urinary tract symptoms; oxidative stress