Changes in bladder wall blood oxygen saturation in the overactive obstructed bladder.

Department of Urology and Pediatric Urology, Erasmus Medical Centre, Sophia Children's Hospital, Rotterdam, The Netherlands.
The Journal of urology (Impact Factor: 3.75). 09/2011; 186(3):1128-33. DOI: 10.1016/j.juro.2011.04.111
Source: PubMed

ABSTRACT Several studies suggest that hypoxia of the bladder wall contributes to bladder dysfunction but the exact relation between bladder function and blood oxygen saturation, a surrogate marker for hypoxia, is not known. We determined bladder wall blood oxygen saturation in vivo in an animal model of bladder outlet obstruction to establish the exact relation between blood oxygen saturation and bladder function.
In 8 sham operated and 8 urethrally obstructed guinea pigs we measured blood oxygen saturation of the bladder wall by differential path length spectroscopy before surgery and 8 weeks postoperatively. Urodynamic investigations performed during the whole 8-week period provided data on bladder function.
Before surgery and 8 weeks after sham surgery blood oxygen saturation in the bladder wall was between 88% and 95% during filling. It decreased during voiding and returned to greater than 90% within 30 seconds. Eight weeks after obstruction saturation was significantly lower than in the sham operated group during filling and voiding. The decrease was positively related to bladder pressure during filling and voiding, and was more pronounced when overactivity was present. Local bladder contractions occurred without a measurable increase in bladder pressure but were associated with a decrease in saturation.
A normal bladder maintains a high oxygen saturation level during filling. Bladder obstruction compromises this ability, especially when it involves overactivity. Local bladder contractions without a measurable increase in bladder pressure were associated with a decrease in blood saturation.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Ischemia and the accompanied hypoxia significantly impair the function of the urinary bladder, which is further damaged by ischemia/reperfusion (I/R) injury following the re-establishment of the blood supply. Current evidences have confirmed that blood flow of the bladder is decreased by bladder outlet obstruction (BOO) and acute overdistention and that functional impairment of the urinary bladder following chronic BOO and acute overdistention might partly come from tissue ischemia and ischemia/reperfusion injury. Antioxidants, free radical scavengers or substances inhibiting I/R injury may reduce bladder damages caused by BOO or overdistention.
    Lower urinary tract symptoms 03/2012; 4(s1). · 0.33 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Benign prostatic hyperplasia (BPH)-related lower urinary tract symptoms (LUTS) and erectile dysfunction commonly coexist, and both respond to phosphodiesterase (PDE) 5 inhibitors, suggesting a shared pathophysiological mechanism. We propose that both BPH-LUTS and erectile dysfunction are caused by microvascular dysfunction within the pelvic organs, and we present an overview of preclinical and clinical studies supporting the hypothesis that, within both the penis and the lower urinary tract, a combination of endothelial and neural dysfunction leads to a vicious cycle of hypoxia, vasoconstriction, altered smooth muscle contractility, and degeneration of autonomic neurons and ganglia. This hypothesis explains much of the preclinical and clinical research relating to these two conditions, and provides a rationale for further investigation into the effects of PDE5 inhibitors on the pathophysiology and symptoms of BPH-LUTS.
    Nature Reviews Urology 03/2014; · 4.79 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Blood oxygen saturation (BOS) is decreased in a low-compliant, overactive obstructed bladder. The objective of this study is to determine the effect of Sildenafil (SC) on bladder function and BOS) in an in vivo animal model of bladder outlet obstruction.
    BMC Urology 05/2014; 14(1):44. · 1.69 Impact Factor