Collagen-1 Membrane for Replacing the Bladder Wall.

We studied the possibility of using membrane fabricated from type 1 collagen isolated from cattle tissues (group 1) or porcine tissues (group 2) for replacement of the resected bladder wall defect in rabbits in order to retain functional volume of the organ. Satisfactory take of both types of collagen membranes with formation of competent anastomosis was observed. Histological studies revealed inflammatory process in the bladder wall at the site of contact with the implanted membrane (more pronounced in case of membranes from cattle tissues) that decreased by day 21 of the experiment. Bladder tissue ingrowth into the implant from was observed starting from day 14. The bladder capacity decreased in 7 days after surgery in both groups, presumably because of increasing tone of the organ wall resulting from surgical trauma and inflammation. In group 2, the bladder volume increased by day 14 after surgery and returned to normal by day 21, whereas in group 1 it remained below the control despite a trend to increase. These findings confirm good prospects of using collagen-1 membranes for plastic repair of the urinary bladder, the membranes from porcine collagen being more preferable.

Effect of Doxazosin on Autonomic Nervous Control and Urodynamics of Rat Urinary Bladder during Modeled Infravesical Obstruction.

The therapeutic effect of doxazosin (40 µg/kg/day over one month) on urinary bladder was examined in female rats with modeled chronic infravesical obstruction (IVO) produced by graduated mechanical constriction of the proximal urethral segment. In one month, IVO induced a pronounced vesical hypertrophy both in treated and untreated rats that manifested in increased bladder weight and capacity, the latter increment being pronouncedly greater in treated rats. In untreated IVO rats, infusion cystometry revealed elevated basal intravesical pressure of void bladder P0, markedly increased maximal (premicturitional) pressure Pmax, and increased amplitude of spontaneous oscillations of intravesical pressure ΔPdet in filled bladder. Doxazosin produced no significant effect on Pmax rise during IVO, but prevented elevation of P0 and increment of ΔPdet in filled bladder. During gradual filling of urinary bladder in control (intact) rats, the parasympathetic vesical influences increased progressively, while in untreated IVO rats, the adrenergic influences prevailed even at maximal filling of the bladder. In IVO rats, doxazosin prevented the bias of the sympathetic-parasympathetic balance in the filled bladder in favor of sympathetic influences, but did not prevent this bias in a void bladder. It is hypothesized that α-adrenoblockers improve micturition during IVO caused by benign prostatic hyperplasia not only by decreasing the urethral resistance to urine flow due to down-regulation of prostate smooth muscle tone, but also by a direct action of these blockers on detrusor adrenergic receptors and central structures involved in urinary bladder control.

Electrical Rhythms Revealed by Harmonic Analysis of a High-Resolution Cardiogram.

The front-end low-noise electronic amplifiers and high-throughput computing systems made it possible to record ECG with a high resolution in the low-frequency range including the respiration and Mayer frequencies and to analyze ECG with digital filtering technique and harmonic analysis. These tools yielded ECG spectra of narcotized rats, which contained the characteristic pulsatile triplets and pentaplets with splitting constant equal to respiration rate, as well as the peaks at respiration and Mayer frequencies. The harmonic analysis of ECG determined the frequency parameters employed to tune the software bandpass filters, which revealed the respiratory (R) and Mayer (M) waves in the time domain with the amplitudes of 20-30 µV amounting to 5% ECG amplitude. The depolarizing myorelaxant succinylcholine chloride capable to trigger various types of arrhythmias, transiently increased R-wave, inhibited M-wave, and provoked a negative U-wave within a heartbeat ECG cycle synchronously with inspiration. It is hypothesized that M-, R-, and U-waves in ECG reflect cardiotropic activity of autonomic nervous system. The respective spectral peaks in ECG can be employed to assess intensity of sympathetic and parasympathetic cardiotropic influences, their balance, and the risk of arrhythmias.

Ischemia in pelvic organs as an independent pathogenic factor in the development of benign prostatic hyperplasia and urinary bladder dysfunction.

Blood supply to the pelvic organs of outbred male rats was diminished by graduated constriction of the distal part of the inferior vena cava. Deficiency of intramural blood supply in prostate and urinary bladder was revealed by bioimpedance harmonic analysis according to the magnitude of first cardiac peak in the bioimpedance spectrogram. In 1-1.5 months, the histological examination revealed the glandular-stromal form of progressive benign prostatic hyperplasia in all ischemic rats. The development of hyperplasia was not accompanied by the changes in testosterone, dihydrotestosterone, or estradiol in blood and prostatic tissue. Assessment of vesical functional status by recording the intravesical pressure during infusion cystometry revealed an increase in the amplitude of spontaneous fluctuations of detrusor tone and intravesical pressure during bladder filling, which can be considered as indicator of detrusor hyperactivity. The data conclude that chronic ischemia of pelvic organs is an individual pathogenic factor in the development of benign prostatic hyperplasia and associated urinary disorders.

Efficiency assessment of shock wave therapy in patients with pelvic pain employing harmonic analysis of penile bioimpedance.

In searching for novel objective methods to diagnosticate pelvic pain and assess efficiency of analgesic therapy, 37 male patients were examined prior to and after the course of extracorporeal shock wave therapy (5-10 sessions) with the waves directed to projections of prostate and/or crura and shaft of the penis. The repetition rate of mechanical pulses was 3-5 Hz. The range of energy pulse density was 0.09-0.45 mJ/mm(2). The overall number of pulses in a session was 1500-3000 in any treated zone with total energy smaller than 60 J. The applicator was relocated every other series of 300-500 pulses. Effect of the shock wave therapy was assessed according to subjective symptomatic scales: International Prostate Symptom Score, International Index of Erectile Function, Quality of Life, and nociceptive Visual Analog Scale. The objective assessment of shock wave therapy was performed with harmonic analysis of penile bioimpedance variability, which quantitatively evaluated the low-frequency rhythmic and asynchronous activities at rest as well as the total pulsatile activity of the penis. The magnitude of spectrum components of bioimpedance variations was assessed with a novel parameter, the effective impedance. The spectral parameters were measured in 16 patients prior to and after the treatment course. The corresponding control values were measured in the group of healthy patients. Prior to the shock wave therapy course, all spectrum parameters of penile bioimpedance significantly differed from the control (p<0.05). After this course, low-frequency rhythmic and the total pulsatile activity decreased to normal, while asynchronous activity remained significantly different from the normal. The novel objective physiological criteria of pelvic pain diagnostics and efficiency of its treatment reflecting the regional features of circulation and neural activity corresponded to the clinical symptom scaling prior to and after the shock wave course, and on the whole, these criteria corroborated improvement of the patient state after this therapy.

Role of oxidative stress and mitochondria in onset of urinary bladder dysfunction under acute urine retention.

Acute urine retention is a frequent complication in patients with benign hyperplasia of the prostate gland. According to studies made on experimental animals and people, it is accompanied by the deterioration of the bladder blood supply. This study attempts to explore the relationship of intramural blood flow, production of reactive oxygen species, and functional state of the bladder detrusor in modeling of acute urine retention in rats, as well as the impact of mitochondria-targeted antioxidants (which are supposed to alleviate the effects of oxidative stress induced by experimental ischemia) on these parameters. The study showed beneficial effects of mitochondria-targeted antioxidant SkQR1 in preventing damage of the bladder caused by acute urinary retention, which suggests the therapeutic use of this type of compounds for the treatment of ischemic abnormalities of the urinary bladder.

Assessment of intramural blood flow and neurogenic control in intact and hypertrophic urinary bladder with harmonic analysis of bioimpedance in rats.

High-resolution impedancometry and harmonic (Fourier) analysis of variable component of bioimpedance revealed rhythmic oscillations of urinary bladder bioimpedance at the Mayer wave, respiration, and heartbeat frequencies. The power values of the corresponding Mayer, respiratory, and cardiac peaks were calculated to assess circulation in the urinary bladder wall and its autonomic nervous control at various stages of infusion cystometry in intact rats and in the rats with preliminary formed infravesical obstruction (IVO). In intact rats, filling of the bladder with physiological saline diminished the power of the first (fundamental) cardiac peak attesting to a decrease of the blood flow in the bladder wall. Simultaneously, the power of low-frequency Mayer peak reflecting sympathetic activity increased, while the power of respiratory peak decreased supposedly reflecting abatement of the parasympathetic influences. Bladder voiding was accompanied by a decrease of Mayer peak and increase of the respiratory one. Prior to infusion cystometry, the intravesical pressure in IVO rats was elevated while the power of fundamental cardiac peak was below the control value. Filling the bladder in these rats was accompanied by further decrease of the cardiac peak reflecting still greater drop in blood supply. In control rats, voiding the bladder normalized the vesical circulation assessed by the cardiac peak, while in IVO rats this peak remained decreased. The reciprocal changes of Mayer and respiratory peaks observed during infusion cystometry in the norm were replaced by unidirectional decrease in the power of both peaks in IVO rats, which probably attest to disturbance of autonomic nervous control in the hypertrophic urinary bladder in these rats.

Bioimpedance harmonic analysis as a tool to simultaneously assess circulation and nervous control.

Multicycle harmonic (Fourier) analysis of bioimpedance was employed to simultaneously assess circulation and neural activity in visceral (rat urinary bladder) and somatic (human finger) organs. The informative value of the first cardiac harmonic of the bladder impedance as an index of bladder circulation is demonstrated. The individual reactions of normal and obstructive bladders in response to infusion cystometry were recorded. The potency of multicycle harmonic analysis of bioimpedance to assess sympathetic and parasympathetic neural control in urinary bladder is discussed. In the human finger, bioimpedance harmonic analysis revealed three periodic components at the rate of the heart beat, respiration and Mayer wave (0.1 Hz), which were observed under normal conditions and during blood flow arrest in the hand. The revealed spectrum peaks were explained by the changes in systemic blood pressure and in regional vascular tone resulting from neural vasomotor control. During normal respiration and circulation, two side cardiac peaks were revealed in a bioimpedance amplitude spectrum, whose amplitude reflected the depth of amplitude respiratory modulation of the cardiac output. During normal breathing, the peaks corresponding to the second and third cardiac harmonics were split, reflecting frequency respiratory modulation of the heart rate. Multicycle harmonic analysis of bioimpedance is a novel potent tool to examine the interaction between the respiratory and cardiovascular system and to simultaneously assess regional circulation and neural influences in visceral and somatic organs.

Rhythmic oscillations of human penile bioimpedance in healthy individuals and in patients with vascular erectile dysfunction.

Small variations of electric impedance (bioimpedance) of human penis were examined in healthy volunteers and in patients with vascular erectile dysfunction (ED). The harmonic analysis revealed rhythmic oscillations of penile bioimpedance at frequencies corresponding to the heart and respiration rates and Mayer wave (0.1 Hz) and to multiple frequencies (harmonics) of the respiratory and cardiac oscillations. In normal penile bioimpedance spectrum, the Mayer and respiratory peaks were several times higher than the first cardiac (pulsatile) harmonic indicating neurogenic origin of rhythmic bioimpedance variations in the whole penis. The most of healthy individuals (78%) demonstrated the cardiac harmonics at the frequency range of 4-7 Hz that violated the monotone decrement of the pulsatile harmonic series suggesting the resonant character of oscillations of the penile arteries at this "near" frequency range. In contrast to stable 1-4 cardiac harmonics, the amplitudes of the near-range resonant harmonics could vary during few minutes suggesting a causal relation of the corresponding bioimpedance oscillations with the varying vascular tone in penile arteries. The most patients (89%) with vascular ED demonstrated not only the first 1-4 monotonically decrementing harmonics and the near-resonant ones, but also the stable cardiac harmonics at the "far" frequency range of 8-14 Hz that also disturbed the monotonic character of the cardiac harmonic series indicating the sclerotic alterations in regional arteries. In ED patients, insignificant decrease of the initial cardiac harmonics C1-C3 in comparison with the norm was accompanied by pronounced and significant decrease of the respiratory R1 and Mayer M1 peaks. The study showed that the far-frequency bioimpedance resonances at the range of 8-14 Hz and dramatic drop of Mayer and respiratory peaks are the diagnostic signs of vascular ED independent on the accompanying hormonal or neurogenic disorders.

Fourier analysis of human finger bioimpedance variances.

Fourier analysis was employed to determine the amplitudes of spectrum components of small variations of electrical resistance (bioimpedance) in human finger recorded using an original hardware-software complex. It revealed periodic bioimpedance oscillations at the frequencies of heartbeats, respiration, and Mayer wave (0.1 Hz). These periodic variations were observed under normal conditions and during circulation arrest in the arm. It is concluded that the spectrum peaks of bioimpedance variations in the phalanx of human finger reflect periodic blood pressure changes in the major vessels and rhythmic neural control of the regional vascular tone. During normal blood flow, the greatest amplitude of rhythmic changes in bioimpedance was observed at the heart rate; it surpassed by an order of magnitude the amplitudes of respiratory oscillations and Mayer wave. In contrast, the largest amplitude of rhythmical changes of the impedance during circulation arrest corresponded to the oscillations at respiration rate, while the amplitude of variations at the heart rate was the smallest. Under circulation arrest, the maximum frequency of bioimpedance variations was approximately 1.4 Hz (the third respiratory harmonic), which indicates the upper limit of frequency range of neural modulation of vascular tone in human finger. During normal respiration and circulation, two side cardiac peaks were revealed in bioimpedance amplitude spectrum, whose amplitude reflected the depth of the respiratory amplitude modulation of pumping action of the heart. During normal breathing, the second and the third harmonics of the cardiac bioimpedance variations were split reflecting respiratory frequency modulation of the heart rate.

Heterogeneity of morphological and functional changes in various compartments of rat urinary bladder in infravesical obstruction of the urinary tract.

Infravesical obstruction of the lower urinary tract was simulated in rats by dosed constriction of the prevesical portion of the urethra. The functional and morphological changes in various urinary bladder compartments were evaluated after 1 week and 3 months. The development of compensatory hypertrophy of the detrusor was associated with an increase in the number of hypertrophic, atrophic, and young leiomyocyte forms and their transformation into myofibroblasts, with the formation of connective tissue laminae between myofibril bundles mainly in the zone of urinary urinary bladder neck. Specific contractility of the detrusor strips decreased with increasing their tone, which was most pronounced in the neck zone. The relaxing effect of norepinephrine was significantly lower after 3 months of obstruction and virtually disappeared in the zone of the urinary bladder body and neck. Blockade of a-adrenoceptors after adrenostimulation with norepinephrine stimulated contractions of the hypertrophic detrusor against the background of reduced tone of the urinary bladder neck, in contrast to intact urinary bladder where this treatment reduced contractions.

Contractile function of the smooth-muscle wall and its adrenergic regulation in megaureter.

We demonstrated disordered contractile capacity of megaureters formed against the background of reflux, organic or functional obstruction. The rhythmic and tonic contractions were suppressed in the megaureters with organic obstruction in comparison with megaureters caused by reflux. Norepinephrine stimulation induced pronounced pressor responses in obstructive megaureters. The state of the smooth-muscle walls of megaureters with functional obstruction was characterized by high tone, weak phase contractions, and increased capacity to pressor tonic reactions induced by norepinephrine.

Contractile function of upper urinary tract after indwelling ureteral prosthesis: experimental investigation.

BACKGROUND: Ureteral endoprostheses are used for dilatation of strictures in order to maintain upper urinary tract (UUT) function for a longer period. MATERIALS AND METHODS: Three kinds of short (3-4-cm) endoprostheses were inserted into the ureter of mongrel dogs with intact UUT or experimental ureter strictures. The UUT function was evaluated by means of radiographic examinations and in terms of following measures of contractility: intraluminal pressure, electroureterography (EUG), and multichannel impedance ureterography (MIUG). Studies were performed 1, 3 to 6 months, and 1 to 3 years after prostheses implantation. RESULTS: Similar urodynamic changes were registered in prosthetically treated ureters of dogs with initially intact UUTs and those with ureteral strictures. These disorders consisted of increased UUT intraluminal pressure and different functioning of the upper and lower regions of the ureter. The bioelectric and contractile activity of the upper UUT regions was reinforced, accelerated, and dysrhythmic, while peristaltic ureter wall function below the endoprosthesis was rare and weak. CONCLUSIONS: The changes observed are typical for ureteral prosthetics. The UUT urodynamic alterations could be attributable entirely to the excluding of the ureteral segment from active contraction and were the result of the local absence of the ureteral wall closing mechanism. One must keep in mind that UUT endoprostheses produce a high load on the ureter wall. The transition from UUT hyperfunction to contractile function decompensation may depend on the intrinsic compensatory reserves of the ureter.