Bladder function in obstructed men - does age matter?

AIM: The high prevalence of diseases and disabilities in the elderly will therefore impose major future challenges for governments, particularly in social security, health system and social care. METHODS: Nine hundred and seventy-one men, 40 years or older referred for low urinary tract symptoms (LUTS) evaluation who underwent full urodynamic investigation, were reviewed. Urodynamic parameters were obtained, such as Uroflowmetry, those of Filling Cystometry and those of pressure flow study (PFS). RESULTS: Mean age was of 66.1 years old. Most the patients included in the analysis were categorized as Schafer score 2-4. Correlation analysis of uroflowmetry parameters revealed statistically significant decrease in voided volume (p = 0.013), Qmax (p = 0.023) with aging. Cystometric parameters revealed significant age-related decrease in bladder capacity (p < 0.001) and bladder compliance (p = 0.004). PFS revealed significant decrease in voiding efficiency (p = 0.029), voided volume (p < 0.001), Qave (p = 0.008) and Qmax (p = 0.048) with progressing age. Age subgroup analyses showed significant differences in voiding efficiency (KW, p = 0.032), voided volume (KW, p < 0.001) and Qave (KW, p = 0.036). CONCLUSIONS: Age-related changes in voiding function might not be a result of impaired detrusor contractility or increased outflow obstruction, intrinsic causes must be suspected. Changes in the storage function of the bladder represent specific pathophysiological mechanisms influenced by aging.

Relation between glycemic levels and low tract urinary symptoms in elderly.

INTRODUCTION: Due the low mortality attributed to BPH, the evaluation of the impacts of LUTS on quality of life of the patients has great importance, especially on the concern of therapeutic choices, except on cases of formal surgery indication. This increase is directly related with difficulties to perform ordinary tasks and a normal living in community. OBJECTIVES: Determinate an association among Diabetes mellitus II and BPH symptoms in a group of elder men. METHODOLOGY: This is an observational clinic trial, comparative. About 62 male subjects, 60 years old or more have been active interviewed. They were divided in two similarly groups. First was composed by men without diabetes and the second with diabetic men. For the evaluation of prostatic symptoms, it was utilized the IPSS. RESULTS: Mean age on Group I was 67.6 years old, while on Group II was 68.7 years old (p = 0.1521). After questionnaire, 51.5% of participants on Group I and 54.2% on Group II presented Systemic Arterial Hypertension (p = 0.099). IPSS was higher on group II (p < 0.0005). DISCUSSION: Diabetes mellitus was positively associated with the increasing of the LUTS, especially NOCTÚRIA. Patients on group I had a media of 14.2 points on IPSS questionnaire, while those on group II reached the media of 7 points. This pattern was the same even after the age, corporal mass and social/economic adjustment. CONCLUSION: There is a statistically association between DM and LUTS on Elder men, evaluated through a specific questionnaire.

Effects of testosterone supplementation on prevention of age-related penile remodeling.

Erectile dysfunction develops among 46.2% of men between 40 and 70 years. Studies demonstrated substitution on detrusor muscle by collagen due testosterone deprivation. It is clear the correlation among aging and oxidative stress, accelerating apoptosis process in many tissues. This study aims to demonstrate the collagen substitution over the muscle fibers on muscle structure of rat's penis and the effects of testosterone supplementation. Sixteen senescent Wistar rats were divided into two groups: treatment (receiving standard supplementation testosterone dose) and control (receiving equivalent saline solution). Testosterone was dosed on D0 and D56 of study. All penises were prepared with picrosirius colored histology; stereology was applied to determine the volumetric density of collagen fibers (Vv). Analysis of variance demonstrated testosterone group's replacement therapy to be effective, while the androgenic decline continued by the time of experiment in control group (p < 0.05). Testosterone group had Vv of 20.6%, lower than control group (47.8%); t-test (p < 0.001). Pearson's correlation demonstrated an inverse correlation between the Vv and testosterone's levels (p < 0.001). This is a pioneer study on demonstration of structural alterations over the cavernous corpora muscle caused by deprivation of testosterone on elderly rat. These finding implicate that the testosterone levels can influence, not only the libido, but also the erectile function.

Influence of oxidative stress on inducing micturition dysfunction following chronic infravesical obstruction and the protective role of an antioxidant diet - association of in vivo and in vitro studies in rats.

OBJECTIVE: This study was developed to determine whether the generation of free radicals, induced by ischemia followed by reperfusion in a model of chronic intravesical obstruction in rats, would lead to damage in the detrusor. It also investigates the possible protective action of the flavonoid galangin on the tissue lesion induced by lipid peroxidation. MATERIALS AND METHODS: Twenty-one male rats were divided into three groups of seven animals each. Group A was subjected to a sham procedure; group B to partial obstruction of the bladder neck; and group C to partial obstruction of the bladder neck, but also received a diet rich in the flavonoid galangin. All the animals were subjected to urodynamic evaluation and then sacrificed. The bladders were sent for enzymatic tests. RESULTS: The urodynamic showed that group B developed significantly greater numbers of involuntary contractions of the detrusor, greater post-micturition residue and lower compliance. The group A presented TEAC levels greater than to the group B. Comparative analysis of group A, B and C demonstrated significantly greater malondialdehyde levels in group B in relation to groups A and C. The group B presented smaller contraction amplitudes than did groups A and C, in electrically stimulated contractions. CONCLUSIONS: That oxidative stress is implicated in the damage to the detrusor musculature following a period of chronic intravesical obstruction. We show, for the first time, that administration of an antioxidant prior to and following the start of chronic obstruction makes it possible to avoid the cellular lesions that cause detrusor dysfunction.

Structural abnormalities are similar in familial and nonfamilial mesial temporal lobe epilepsy.

BACKGROUND/OBJECTIVE: Diffuse temporal lobe abnormalities can be observed on MRI of patients with mesial temporal lobe epilepsy (MTLE). Our objective was to perform qualitative and quantitative analyses of temporal lobe structures in patients with familial MTLE (FMTLE) and nonfamilial MTLE. METHODS: Two groups of patients were ascertained: 67 FMTLE patients (14 with refractory seizures) and 30 patients with nonfamilial refractory MTLE. We performed qualitative analyses of MRI (with multiplanar reconstruction) and volumes of hippocampi and anterior temporal lobes in all patients, and in a normal control group of 23 individuals. We used the Chi-square test and ANOVA for statistical analyses. RESULTS: We identified anterior temporal lobe abnormalities by visual analysis in only 4% of FMTLE patients and atrophy of the anterior temporal lobe by volumetric analysis in 19%. In the group of nonfamilial MTLE patients we found anterior temporal lobe abnormalities by visual analysis in 17% of patients and anterior temporal lobe atrophy in 13%. Hippocampal atrophy was present in 90% of FMTLE and in 83% of nonfamilial MTLE. No signs of cortical dysplasia were observed. CONCLUSION: Anterior temporal lobe atrophy and other abnormalities outside the mesial portion of temporal lobes were infrequent in both familial and nonfamilial MTLE patients. Despite the genetic basis, hippocampal atrophy in FMTLE is not associated with other abnormalities outside the mesial temporal regions.

Influence of oxidative stress on inducing micturition dysfunction following chronic infravesical obstruction and the protective role of an antioxidant diet - association of in vivo and in vitro studies in rats

OBJECTIVE: This study was developed to determine whether the generation of free radicals, induced by ischemia followed by reperfusion in a model of chronic intravesical obstruction in rats, would lead to damage in the detrusor. It also investigates the possible protective action of the flavonoid galangin on the tissue lesion induced by lipid peroxidation. MATERIALS AND METHODS: Twenty-one male rats were divided into three groups of seven animals each. Group A was subjected to a sham procedure; group B to partial obstruction of the bladder neck; and group C to partial obstruction of the bladder neck, but also received a diet rich in the flavonoid galangin. All the animals were subjected to urodynamic evaluation and then sacrificed. The bladders were sent for enzymatic tests. RESULTS: The urodynamic showed that group B developed significantly greater numbers of involuntary contractions of the detrusor, greater post-micturition residue and lower compliance. The group A presented TEAC levels greater than to the group B. Comparative analysis of group A, B and C demonstrated significantly greater malondialdehyde levels in group B in relation to groups A and C. The group B presented smaller contraction amplitudes than did groups A and C, in electrically stimulated contractions. CONCLUSIONS: That oxidative stress is implicated in the damage to the detrusor musculature following a period of chronic intravesical obstruction. We show, for the first time, that administration of an antioxidant prior to and following the start of chronic obstruction makes it possible to avoid the cellular lesions that cause detrusor dysfunction.