Ultrastructural observations on detrusor musculature in areflexia neurogenic bladders
- VernacularTitle:神经原性膀胱逼尿肌超微结构的变化
- Author:
Jimao ZHAO
;
Yuhai ZHANG
;
Lindong DU
;
- Publication Type:Journal Article
- Keywords:
Bladder,neurogenic;
Detrusor;
Ultrastructure
- From:
Chinese Journal of Urology
2001;0(10):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To understand the ultrastructure of detrusor musculature in areflexia neurogenic bladders. Methods The detrusor secured from the anterior wall of bladders was studied and compared by means of transmission electron microscope in 11 patients with areflexia neurogenic bladder during cystomyoplasty with musculus rectus abdominis and in 7 accidentally deceased young men in autopsy. Results Ultrastructural changes of de differentiation of detrusor cells were observed in areflexia neurogenic bladders,such as inconsistent contours,malalignment and disarray.Wide separation between muscle cells with reduction of intermediate cell junction and with abundant collagen fibrils and irregular dense structures between individual cells were noted.There were also such changes as reduction of pinocytotic vesicle and mitochondria,disarray of myofilaments and malalignment of dense body,etc.,in detrusor cells.By contrast normal detrusor cells were well arranged and well distributed with consistent contours and size.The distance between muscle cells was much smaller than the abnormal specimens with proper intermediate junction.Caveolae and dense area were evenly distributed among the sarcoplasm.Organelles,myofilament and dense body were well organized in the smooth muscle cells. Conclusions The ultrastructural changes of detrusor in areflexia neurogenic bladders may be associated with relative increment of bladder outlet obstruction,which is probably due to detrusor debility from diseased nerve and sequential disequilibrium between normal detrusor and sphincter muscle of the urethra.Prophylactic management of lower intra bladder pressure may be beneficial to the prevention of ultrastructural deterioration in detrusor cells.
