Functional consequences of chronic bladder ischemia

Authors

  • Osamu Yamaguchi,

    Corresponding author
    1. Division of Bioengineering and LUTD Research, Nihon University College of Engineering, Koriyama, Japan
    • Correspondence to: Osamu Yamaguchi, Division of Bioengineering and LUTD Research, Nihon University College of Engineering, Koriyama, Japan. E-mail: yamaosa@ee.ce.nihon-u.ac.jp

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  • Masanori Nomiya,

    1. Division of Bioengineering and LUTD Research, Nihon University College of Engineering, Koriyama, Japan
    2. Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
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  • Karl-Erik Andersson

    1. Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
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  • Lori Birder led the peer-review process as the Associate Editor responsible for the paper.
  • Conflict of Interest: Potential conflicts of interest include: Consulting agreements with Ferring Pharma, Inc. and Taiho Pharmaceutical Co.; Speaker honoraria from Hisamitsu Pharmaceutical Co., Astellas Pharma, Inc., and Pfizer. This article was written totally independent of any commercial organisation.

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. Neurourol. Urodynam. 33:54–58, 2014. © 2013 Wiley Periodicals, Inc.

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