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Open Access 01-12-2018 | Research article

Progressive bladder remodeling due to bladder outlet obstruction: a systematic review of morphological and molecular evidences in humans

Authors: Ferdinando Fusco, Massimiliano Creta, Cosimo De Nunzio, Valerio Iacovelli, Francesco Mangiapia, Vincenzo Li Marzi, Enrico Finazzi Agrò

Published in: BMC Urology | Issue 1/2018

Abstract

Background

Bladder outlet obstruction is a common urological condition. We aimed to summarize available evidences about bladder outlet obstruction-induced molecular and morphological alterations occurring in human bladder.

Methods

We performed a literature search up to December 2017 including clinical and preclinical basic research studies on humans. The following search terms were combined: angiogenesis, apoptosis, bladder outlet obstruction, collagen, electron microscopy, extracellular matrix, fibrosis, hypoxia, histology, inflammation, innervation, ischemia, pressure, proliferation, remodeling, suburothelium, smooth muscle cells, stretch, urothelium.

Results

We identified 36 relevant studies. A three-stages model of bladder wall remodeling can be hypothesized involving an initial hypertrophy phase, a subsequent compensation phase and a later decompensation. Histological and molecular alterations occur in the following compartments: urothelium, suburothelium, detrusor smooth muscle cells, detrusor extracellular matrix, nerves. Cyclic stretch, increased hydrostatic and cyclic hydrodynamic pressure and hypoxia are stimuli capable of modulating multiple signaling pathways involved in this remodeling process.

Conclusions

Bladder outlet obstruction leads to progressive bladder tissue remodeling in humans. Multiple signaling pathways are involved.

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Title: Progressive bladder remodeling due to bladder outlet obstruction: a systematic review of morphological and molecular evidences in humans
Authors: Ferdinando Fusco
Massimiliano Creta
Cosimo De Nunzio
Valerio Iacovelli
Francesco Mangiapia
Vincenzo Li Marzi
Enrico Finazzi Agrò
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Urology / Issue 1/2018
Electronic ISSN: 1471-2490
DOI: https://doi.org/10.1186/s12894-018-0329-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Progressive bladder remodeling due to bladder outlet obstruction: a systematic review of morphological and molecular evidences in humans

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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