Bladder outlet obstruction: Progression from inflammation to fibrosis.

摘要

Introduction. Partial bladder outlet obstruction (pBOO) is a ubiquitous problem that results in renal damage. We hypothesize that change in the bladder progresses over time.;Results. Urodynamics demonstrated an increased capacity and deterioration into highpressure. H+E demonstrated an initial inflammatory response, and increased mRNA levels of TGF-beta, CTGF, HIF-1alpha, and PDGF. Muscle hypertrophy was evident on H+E and increased bladder mass and thickness. Masson's Trichrome and mass spectrometry showed an increase in collagen.;Conclusion. We believe that this represents distinct phases of bladder decompensation: inflammation, hypertrophy, and fibrosis. This could lead to improved preventative strategies, with respect to biochemical pathways and the time course of their initiation.;Methods. Fischer rats underwent surgical pBOO for 2, 4, 8, or 13 weeks and were compared to shams. Urodynamic measurements were taken, bladders weight and thickness recorded, and tissue analyzed with microscopy. RT-PCR was performed for inflammatory mediators and spectrometry used to quantify collagen.