Tiago Antunes-Lopes1, Alice Vasconcelos2, Daniel Costa3, Ana Charrua4, João Neves5, João Silva6, Francisco Cruz6, Carlos Silva6. 1. Department of Urology, Hospital de São João, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal; Instituto de Investigação e Inovação em Saúde, Translational Neuro-Urology Group, University of Porto, Porto, Portugal; Instituto de Biologia Molecular e Celular, University of Porto, Porto, Portugal. Electronic address: tantuneslopes@med.up.pt. 2. Faculty of Medicine, University of Porto, Porto, Portugal. 3. Department of Urology, Hospital de São João, Porto, Portugal. 4. Instituto de Investigação e Inovação em Saúde, Translational Neuro-Urology Group, University of Porto, Porto, Portugal; Instituto de Biologia Molecular e Celular, University of Porto, Porto, Portugal; Experimental Biology Department, Faculty of Medicine, University of Porto, Porto, Portugal. 5. Faculty of Medicine, University of Porto, Porto, Portugal; Department of Vascular Surgery, Hospital de São João, Porto, Portugal. 6. Department of Urology, Hospital de São João, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal; Instituto de Investigação e Inovação em Saúde, Translational Neuro-Urology Group, University of Porto, Porto, Portugal; Instituto de Biologia Molecular e Celular, University of Porto, Porto, Portugal.
Abstract
OBJECTIVE: To investigate lower urinary tract symptoms (LUTS) and urinary levels of neuroinflammatory, inflammatory, and oxidative stress markers in elderly men with chronic pelvic ischemia (CPI) caused by significant aortoiliac disease. MATERIALS AND METHODS: Thirteen men aged over 60 years, with aorta, unilateral or bilateral common/internal iliac artery occlusion documented by computed tomography angiography or angiography, were enrolled from the vascular surgery department. Twelve sex- and age-matched controls without significant aortoiliac disease were used for comparison. Exclusion criteria included neurogenic bladder dysfunction, bladder or prostate cancer, prostatic surgery, pelvic radiotherapy, or chronic treatment for LUTS. Participants underwent urological examination, including assessment of International Prostate Symptom Score (IPSS), uroflowmetry, postvoid residual (PVR), and prostate volume. Urine samples were collected, and levels of neuroinflammatory (nerve growth factor, NGF), inflammatory (cytokines), and oxidative stress markers (8-hydroxy-2'-deoxyguanosine) were determined by enzyme-linked immunosorbent assay. RESULTS: Groups were similar for age, PVR, prostate volume, and most cardiovascular risk factors. IPSS was higher in patients with CPI (11 ± 3 vs 8 ± 2, P = .02), with a significant mean difference between groups of three points. Urinary NGF was significantly higher in men with CPI (3.7 ± 0.8 vs 2.9 ± 0.7, P = .02), but no differences were found in inflammatory and oxidative biomarkers among groups. CONCLUSION: Severe CPI in elderly men is associated with a significant increase in LUTS and bladder neurogenic inflammation, as suggested by the increase of NGF release in urine, sensitizing bladder afferents. These findings confirm the relevance of ischemia in bladder function and appear to validate animal models of bilateral iliac artery occlusion.
OBJECTIVE: To investigate lower urinary tract symptoms (LUTS) and urinary levels of neuroinflammatory, inflammatory, and oxidative stress markers in elderly men with chronic pelvic ischemia (CPI) caused by significant aortoiliac disease. MATERIALS AND METHODS: Thirteen men aged over 60 years, with aorta, unilateral or bilateral common/internal iliac artery occlusion documented by computed tomography angiography or angiography, were enrolled from the vascular surgery department. Twelve sex- and age-matched controls without significant aortoiliac disease were used for comparison. Exclusion criteria included neurogenic bladder dysfunction, bladder or prostate cancer, prostatic surgery, pelvic radiotherapy, or chronic treatment for LUTS. Participants underwent urological examination, including assessment of International Prostate Symptom Score (IPSS), uroflowmetry, postvoid residual (PVR), and prostate volume. Urine samples were collected, and levels of neuroinflammatory (nerve growth factor, NGF), inflammatory (cytokines), and oxidative stress markers (8-hydroxy-2'-deoxyguanosine) were determined by enzyme-linked immunosorbent assay. RESULTS: Groups were similar for age, PVR, prostate volume, and most cardiovascular risk factors. IPSS was higher in patients with CPI (11 ± 3 vs 8 ± 2, P = .02), with a significant mean difference between groups of three points. Urinary NGF was significantly higher in men with CPI (3.7 ± 0.8 vs 2.9 ± 0.7, P = .02), but no differences were found in inflammatory and oxidative biomarkers among groups. CONCLUSION: Severe CPI in elderly men is associated with a significant increase in LUTS and bladder neurogenic inflammation, as suggested by the increase of NGF release in urine, sensitizing bladder afferents. These findings confirm the relevance of ischemia in bladder function and appear to validate animal models of bilateral iliac artery occlusion.
Authors: Stefanie N Foster; Theresa M Spitznagle; Lori J Tuttle; Jerry L Lowder; Siobhan Sutcliffe; Karen Steger-May; Chiara Ghetti; Jinli Wang; Taylor Burlis; Melanie R Meister; Michael J Mueller; Marcie Harris-Hayes Journal: J Womens Health Phys Therap Date: 2022 Apr-Jun