Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Mar 9;18(1):15.
doi: 10.1186/s12894-018-0329-4.

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

Ferdinando Fusco  1 , Massimiliano Creta  2 , Cosimo De Nunzio  3 , Valerio Iacovelli  4 , Francesco Mangiapia  2 , Vincenzo Li Marzi  5 , Enrico Finazzi Agrò  4
Affiliations

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

Ferdinando Fusco et al. BMC Urol. .

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.

Keywords: Bladder outlet obstruction; Bladder remodeling; Systematic review.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

Ferdinando Fusco: Speaker and Consultant for Recordati, Bayer, Lilly, Pierre-Fabre.

Massimiliano Creta: Consultant and medical writer for Recordati.

Vincenzo Li Marzi: Invited speaker from Wellspect and Allergan.

Enrico Finazzi Agrò: Consultat for Laborie, Wellspect, Allergan; Speaker honorarium from: Astellas, Coloplast, Glaxo Smith Kline, Wellspect.

Cosimo De Nunzio (SE) and Enrico Finazzi Agrò (AE) are members of the editorial board of BMC Urology.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) flowchart
Fig. 2
Fig. 2
Proposed three-stage model for BOO-induced bladder remodeling in humans
See this image and copyright information in PMC

References

    1. Fusco F, Creta M, Imperatore V, Longo N, Imbimbo C, Lepor H, et al. Benign prostatic obstruction relief in patients with lower urinary tract symptoms suggestive of benign prostatic enlargement undergoing endoscopic surgical procedures or therapy with alpha-blockers: a review of urodynamic studies. Adv Ther. 2017;34(4):773–783. doi: 10.1007/s12325-017-0504-0. - DOI - PubMed
    1. Fusco F, Palmieri A, Ficarra V, Giannarini G, Novara G, Longo N, et al. α1-blockers improve benign prostatic obstruction in men with lower urinary tract symptoms: a systematic review and meta-analysis of urodynamic studies. Eur Urol. 2016;69(6):1091–1101. doi: 10.1016/j.eururo.2015.12.034. - DOI - PubMed
    1. Creta M, Bottone F, Sannino S, Maisto E, Franco M, Mangiapia F, et al. Effects of alpha1-blockers on urodynamic parameters of bladder outlet obstruction in patients with lower urinary tract symptoms suggestive of benign prostatic enlargement: a review. Minerva Urol Nefrol. 2016;68(2):209–221. - PubMed
    1. Mirone V, Imbimbo C, Longo N, Fusco F. The detrusor muscle: an innocent victim of bladder outlet obstruction. Eur Urol. 2007;51(1):57–66. doi: 10.1016/j.eururo.2006.07.050. - DOI - PubMed
    1. Komninos C, Mitsogiannis I. Obstruction-induced alterations within the urinary bladder and their role in the pathophysiologyof lower urinary tract symptomatology. Can Urol Assoc J. 2014;8(7–8):E524–E530. doi: 10.5489/cuaj.1636. - DOI - PMC - PubMed

Publication types

MeSH terms