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The fine structure of the human fetal urinary bladder. Development and maturation. A light, transmission and scanning electron microscopic study.

The urinary bladders of 27 human fetuses, aged 7 weeks to full term, were studied by light, transmission and scanning electron microscopy to establish the sequence of events in the development and maturation of the organ during fetal life. In the early specimens, 7-12 weeks old, the urinary bladder was lined by a bilayered, cuboidal and glycogen-rich epithelium. During the 13-17th weeks the epithelium thickened, a third layer developed and by light microscopy it now resembled urothelium. By 21 weeks this had evolved into a 3-4 layer thick epithelium with typical ultrastructural urothelial characteristics. Smooth muscle cells emerged from the condensed mesenchyme of the bladder wall by the 12th week of gestation, initially in the cephalic part of the organ but spreading within a week into the caudal end. Our findings indicate that the human fetal bladder undergoes a series of vital developmental changes during 13-21 weeks of gestation finally acquiring the typical urothelial lining and a well-developed muscular coat.

Embryonic and Fetal Development↗

Positron emission tomography in the diagnosis and staging of urinary bladder cancer.

PURPOSE: Evaluation of positron emission tomography (PET) using (18)fl 18F-2-fluoro-2-deoxy-D-glucose (18FDG) and L-methyl-11C-methionine in the diagnosis and staging of urinary bladder carcinoma. MATERIAL AND METHODS: Twenty-three patients with biopsy-proven urinary bladder carcinoma were examined with PET after intravenous injection of 11C-methionine; 2 were also examined with 18FDG. The results from the PET investigations were compared with CT or MR findings and TNM classification before and after treatment. RESULTS: The urinary excretion of 18FDG prevented distinction of the primary tumour from the surrounding tracer. With 11C-methionine it was possible to detect 18/23 primary tumours. A trend was seen, suggesting that the higher the uptake values of 11C-methionine in the tumour, the greater the tumour stage. CONCLUSION: It is possible to visualize urinary bladder tumours larger than 1 cm in diameter with PET using (11)C-methionine, but the value of the method in the staging of the lesions is not superior to conventional methods.

Aged↗

[Subtypes of alpha 1-adrenoceptors in urinary bladder and urethral smooth muscle and prostatic adenoma].

Two alpha 1-adrenoceptor subtypes (alpha 1A and alpha 1B) have been distinguished by competitive antagonists and alkylating agent chloroethylclonidine (CEC). The CEC-insensitive subtype (alpha 1A) had been suggested to selectively activate Ca2+ influx through Ca-channels in smooth muscle cell membrane. We examined the effects of WBC4101, CEC and verapamil on contractile responses to phenylephrine in rabbit aorta, urinary bladder and urethral smooth muscle and in human prostatic adenoma to examine the alpha 1-adrenoceptor subtypes in these tissue. Pretreatment with WB4101 caused a large shift to the right for phenylephrine-induced dose response curves and verapamil decreased the phenylephrine-induced contractions of rabbit aorta, urinary bladder and urethral smooth muscles and human prostatic adenomas. CEC inhibited only phenylephrine induced contractions of human prostatic adenomas. The pA2 value for WB4101 was significantly lower in human prostate than in rabbit aorta, urinary bladder and urethra. These results suggest that functional alpha 1-adrenoceptor subtypes involve alpha 1A and alpha 1B in human prostatic adenoma, while only alpha 1A in rabbit aorta, urinary bladder and urethral smooth muscles.

Aged↗

Confocal microscopic analysis of fluorescein compartmentation within crab urinary bladder cells.

Fluorescein (FL), a fluorescent organic anion, is compartmentalized in cells of organic anion-secreting epithelia, e.g., OK cells, teleost proximal tubule, and crab (Cancer borealis) urinary bladder, a proximal tubule analogue. To further examine the processes involved, FL uptake and distribution were studied in C. borealis urinary bladder cells using epifluorescence and laser confocal microscopy combined with video-image analysis. Intracellular FL was about evenly split between diffuse and punctate compartments after in vitro or in vivo loading. Treatments that affected FL transport into cells (incubation with p-aminohippuric acid or glutarate) altered the FL content of both compartments. However, nocodazole, a microtubule inhibitor, did not affect diffuse FL but significantly reduced punctate FL. Finally, confocal analysis indicated that individual sites of punctate FL accumulation moved in the secretory direction at 0.83 micron/min. Nocodazole nearly abolished this movement and significantly reduced transepithelial organic anion secretion. Thus, in crab urinary bladder, a substantial fraction of total cellular FL is sequestered in vesicles, and these vesicles move in the secretory direction, by a microtubule-dependent process.

Animals↗

Frequency urgency syndrome following urinary bladder suspension.

Bladder suspension for urinary incontinence secondary to bladder neck hypermobility is highly successful. Of those who fail, however, a subset will develop new onset or markedly worsened irritative voiding symptoms. A series of such patients were identified to study the associated urodynamic abnormalities of this symptom complex. The charts of female patients presenting for incontinence from 1992-94 were reviewed. Forty-six patients with a mean age of 59.4 (range 28-79) fulfilled the inclusion criteria of developing new onset or markedly worsened post-operative frequency, urgency and urge incontinence within two years of undergoing bladder suspension. All had been evaluated with thorough history, physical examination, and urodynamic testing. Seventeen patients were found to have recurrent hypermobility. Eighteen had a diagnosis of intrinsic sphincter deficiency (ISD), including six that also had another diagnosis. Four patients were diagnosed with detrusor overactivity and seven with other miscellaneous diagnoses. Patients presenting with this symptom complex should be evaluated so that treatment can be tailored appropriately.

Adult↗

[Pheochromocytoma of the urinary bladder. Diagnosis and therapy based on a case report].

Micturition difficulties associated with unstable hypertension, tachycardia and profuse sweating could be a sign of pheochromocytoma of the urinary bladder. Of all pheochromocytomas, 10-36% are located extradrenally, in which case they are also referred to as paragangliomas, and 1-3% are found in the urinary bladder. The case history of a 44-year-old female patient with typical symptoms is described. Diagnosis required not only CT, NMR, excretory urography and MIBG scintigraphy, but also hormonal analyses. Histology reveals malignancy in up to 20%; it is thought that focal invasions of tumor into vessels and destruction of connective tissue might be pathognomonic. A precise history and careful diagnosis are necessary before a pheochromocytoma of the bladder can be disclosed and treated.

Adult↗

Distribution and changes with age of nitric oxide synthase-immunoreactive nerves of the rat urinary bladder, ureter and in lumbosacral sensory neurons.

In the distal parts of the urinary tract, nerves containing nitric oxide (NO) are either postganglionic parasympathetic nerves, with cell bodies in the major pelvic ganglia, or sensory nerves with cell bodies in the lumbosacral dorsal root ganglia. We have used indirect immunohistochemical techniques to examine the distribution and regional variation of nerves immunoreactive for neuronal nitric oxide synthase (NOS) in the urinary bladder, distal ureter and in neurons in lumbosacral dorsal root ganglia (L1-L2 & L6-S1) of young adult (3 months) and aged (24 months) male rats. Semi-quantitative estimations of nerve densities were made of NOS fibres innervating the dome, body and base of the urinary bladder and distal ureter. Quantitative studies were also used to examine the effects of age on the percentage of dorsal root ganglion neurons immunoreactive for NOS. The dome and the body regions, in both age groups, contained no NOS-immunoreactive axons. The bladder base and distal ureter in young adults showed sparse to moderate numbers of fibres immunoreactive to NOS within the urothelium and in the subepithelium and muscle coat. In the aged rat there were slight reductions in the densities of NOS-immunoreactive nerves in all three regions. In the lumbosacral dorsal root ganglia, the percentage of NOS-immunoreactive neuronal profiles showed a significant reduction from 4.6 +/- 0.2% in young adult to 2.7 +/- 0.2% (means +/- S.E.M) in aged rats. These findings suggest that the effects of NO on the bladder and distal ureteric musculature and also its expression in dorsal root ganglion neurons are affected in aged rats and that the micturition reflex may be perturbed as a result.

Age Factors↗

Aberrant expression of E-cadherin and beta-catenin in association with transforming growth factor-beta1 in urinary bladder lesions in humans after the Chernobyl accident.

This study examines the molecular pathways of cell-cell communication in chronic inflammatory processes associated with long-term low-dose urinary bladder exposure to ionizing radiation in people without major disease living more than 19 years in radio-contaminated areas of Ukraine after the Chernobyl accident. Patterns of components of the E-cadherin/beta-catenin complex, and transforming growth factor-beta1 (TGF-beta1) and inducible nitric oxide synthase (iNOS) expression were immunohistochemically evaluated in urinary bladder biopsies from 52 males with benign prostate hyperplasia and 8 females with chronic cystitis (group 1). For comparison, 25 males and 6 females living in non-contaminated areas of Ukraine were also investigated (group 2). Fourteen patients with primary urothelial carcinomas, which were operated on before the Chernobyl accident, were included as a carcinoma group. Chronic proliferative atypical cystitis ('Chernobyl cystitis') was observed in group 1 patients. Foci of dysplasia and carcinoma in situ were found in 51 (85%) and 34 (57%) of the 60 cases, respectively. Chronic cystitis with areas of dysplasia was detected in only 4 (13%) cases of 31 group 2 patients. Statistically significant differences in immunohistochemical scores for TGF-beta1 in the urothelium and lamina propria, iNOS in the urothelium and both beta-catenin and E-cadherin in the cytoplasm were observed between groups 1 and 2 with marked expression in group 1. Furthermore, TGF-beta1 overexpression and alteration in E-cadherin/beta-catenin complexes in bladder urothelium might play a crucial role in urinary bladder carcinogenesis in humans exposed to long-term low-dose ionizing radiation.

Adult↗

Muscularis mucosa of urinary bladder. Importance for staging and treatment.

We report the results of a histologic evaluation of muscle (muscularis mucosa) in the lamina propria of the urinary bladder performed on 100 consecutive cystectomy specimens. Muscle fibers were found in the lamina propria lying parallel to the mucosa and forming a distinct muscularis mucosa in three cases; they were interrupted or discontinuous in 20 cases, and dispersed or scattered, forming thin bundles, in 71 cases. In six cases, there were no muscle fibers in the lamina propria. In addition, we noticed that the lamina propria contains large vessels that run along the length of the lamina propria in a continuous or interrupted fashion. When muscle fibers are present, they are associated with these vessels. Since prognosis and management of muscle invasive carcinomas (stage B) is different from that of lamina propria-invasive tumors (stage A), pathologists and urologists should be aware of the presence of a muscularis mucosa in the urinary bladder.

Biopsy↗

Reabsorption of water and electrolytes in the urinary bladder of intact frogs (genus Rana).

1. Water and electrolyte reabsorption of the urinary bladder epithelia has been studied in intact, fully hydrated frogs (Rana temporaria, R. lessonae, R. ridibunda). 2. The rates of water reabsorption were lower in frogs on wet soil than in those on dry soil and related to the degree of terrestrialism: R. temporaria greater than R. lessonae greater than R. ridibunda. 3. Samples of urine stored up to 24 hr within the urinary bladder were analysed for osmolality and the concentration of urea, ammonia, sodium, potassium, magnesium and calcium. 4. Selective reabsorption of sodium was detected in all species, that of calcium only in R. ridibunda. The efficiency of electrolyte reabsorption was also related to the degree of terrestrialism. 5. In conclusion, in fully hydrated frogs reabsorption by the bladder epithelia contributes significantly to the water and electrolyte conservation.

Absorption↗

[Effects of gosha-jinki-gan on urinary bladder contraction in dogs].

The effects of Gosha-Jinki-Gan on the urinary bladder contraction in anesthetized dogs were studied to elucidate the mode of action. The bladder contraction was induced by electrical stimulation of the left distal end of the pelvic nerve under the bilateral pelvic nerve and hypogastric nerve transections, or by the infusion of acetylcholine (200 micrograms) in to the abdominal aorta. The bladder contraction induced by pelvic nerve stimulation was significantly inhibited by 10 and 100 mg/kg of intravenous Gosha-Jinki-Gan administration. A similar phenomenon was observed by the administration of atropine sulfate (0.1 mg). The acetylcholine-induced contraction was significantly inhibited by administration of 100 mg/kg of Gosha-Jinki-Gan. These findings suggested that Gosha-Jinki-Gan inhibits the urinary bladder contraction induced by the stimulation of cholinergic nerve.

Animals↗

Vesicoureteral reflux induced by manual compression of the urinary bladder of dogs and cats.

Vesicoureteral reflux caused by manual compression of the urinary bladder performed to obtain urine samples was evaluated by contrast radiography in 10 sedated, clinically normal male and female dogs and in 10 sedated, clinically normal male and female cats. Vesicoureteral reflux occurred in 50% of the dogs and in 40% of the cats. Application of digital pressure to the urinary bladder for a prolonged period to initiate urine voiding was associated with a greater occurrence of reflux than was application of digital pressure for a transient period. Contrast material refluxed into the prostate gland of 3 of 6 male dogs.

Animals↗

Severe urinary bladder involvement in systemic sclerosis. Case report and review of the literature.

Lower urinary tract involvement is an uncommon manifestation of systemic sclerosis; however, it may represent a troublesome disturbance affecting the quality of life in systemic sclerosis patients. Here we report the case of a middle-aged woman with a 5-year history of systemic sclerosis, who developed severe and progressive urinary bladder sclerosis. This report is particularly interesting because of the severity of the bladder involvement, which required surgical treatment.

Female↗

Comparative study of the contractile activity evoked by ATP and diadenosine tetraphosphate in isolated rat urinary bladder.

The present study was designed to investigate the effect and possible mechanism(s) of action of ATP and diadenosine tetraphosphate (AP(4)A) on the isolated rat urinary bladder rings. ATP ( 0.1- 1 x 10(-3)M) or AP(4)A ( 0.01- 0.1 x 10(-3)M) produced contractions of the isolated bladder rings in a concentration-dependent manner. The contraction-induced by AP(4)A in the bladder rings was approximately ten times more potent than that produced by ATP. Addition of ATP prior to addition of AP(4)A or vice versa desensitized bladder tissue to the second agonist with great reduction in the contraction produced. Electrical field stimulation (EFS, 40 V, 0.5 ms, 2 Hz) produced contraction (79.8 +/-7.1 g tension x g(-1)tissue) in the bladder rings that can be greatly reduced by prior addition of ATP or AP(4)A. Theophylline, a P(1)-purinoceptor antagonist, significantly reduced the contraction-induced by AP(4)A and did altered that produced by ATP in bladder rings. Atropine, a non-selective muscarinic receptor antagonist, or indomethacin, a cyclo-oxygenase inhibitor, significantly suppressed the contractions of the bladder rings to ATP or AP(4)A. Similarly, nifedipine, an l -type Ca(2+)channel blocker, significantly attenuate the contractions induced by ATP and AP(4)A in the isolated rat urinary bladder rings. In conclusion, the results of the present study show that ATP, AP(4)A, and EFS evoked contractions in the rat urinary bladder rings and that the contractions induced by AP(4)A was more potent than that produced by ATP. Furthermore, the contractions evoked by ATP or AP(4)A were Ca(2+)-dependent and mediated at least in part through one of the cyclo-oxygenase products. Also, the present results suggested the involvement of the P(1)-purinoceptor in mediating the contractions evoked by AP(4)A but not ATP in the bladder rings.

Adenosine Triphosphate↗

Detection of human papillomavirus DNA sequences in cancer of the urinary bladder by in situ hybridisation and polymerase chain reaction.

OBJECTIVE: To evaluate the prevalence of "high risk" human papillomavirus type 16 (HPV 16) in transitional cell carcinoma of the urinary bladder. MATERIALS AND METHODS: The study included 10 biopsy specimens from male patients of transitional cell carcinoma of the urinary bladder for the detection of HPV DNA sequences. Specimens were collected from the Urology Clinic of the K.G. Medical College Hospital, Lucknow, India. Detection of HPV DNA was carried out by tissue in situ hybridisation (a single copy gene localisation method) using 3H-labelled HPV DNA probe and also by polymerase chain reaction (PCR) techniques using primers to HPV 16 upstream regulatory region (URR). RESULTS: Out of 10 cases of transitional cell carcinoma of the urinary bladder, "high risk" HPV 16 DNA was detected only in one (10%) by using in situ hybridisation whereas two cases (20%) were found to be positive by polymerase chain reaction. CONCLUSION: Our results suggest that the rare occurrence of HPV in bladder carcinoma may not have a causal relation with the viral infection.

Base Sequence↗

The effect of indomethacin and adenosine 5'-triphosphate on the excitatory innervation of the rate urinary bladder.

Adenosine 5'-triphosphate (ATP) (20-400 microM) contracted 48% of isolated rat urinary bladder preparations but induced no response in the remainder. The response to ATP never exceeded 25% of the response to electrical stimulation in the presence of indomethacin (50 microM) plus hyoscine (25 microM) and usually developed more slowly than that to electrical stimulation. Autoinhibition could be produced to ATP by incubating the tissue with ATP (200 microM) for 20 min. Incubation of the tissue with ATP (200 microM) for 60 min in the presence of indomethacin (50 microM) and either hyoscine (25 microM) or hemicholinium-3 (500 microM) reduced but failed to abolish responses to electrical stimulation. Responses to acetylcholine were not affected by ATP (200 microM) in the presence of indomethacin and the output of acetylcholine induced by neuronal stimulation at 10 Hz was not inhibited by ATP (200 microM) or by indomethacin (50 microM). The results suggest a possible modulatory role for ATP in the excitatory innervation of the rat urinary bladder.

Acetylcholine↗

Diagnostic considerations in urinary bladder wall calcification.

Though a relatively uncommon finding in general radiologic practice, urinary bladder wall calcification has relatively few etiologies. A series of 19 patients with radiographically visible bladder wall calcification encompassing most of the known causes is presented and other reported causes are discussed. Eight patients had schistosomiasis, six had primary carcinoma of the bladder, two had encrustation cystitis, and one each had amyloidosis, cyclophosphamide-induced cystitis, and tuberculosis. While a correct diagnosis is often not possible solely on the basis of the appearance of the calcification, such a diagnosis can usually be obtained expediently from a combination of history, clinical examination, appropriate laboratory studies, and radiographic evaluation of the bladder calcification and remaining urinary tract. Cystoscopy with biopsy of involved tissues is almost necessary, however, for confirmation and to rule out bladder neoplasia.

Calcinosis↗

Metabolic and contractile effects of anoxia on the rabbit urinary bladder.

The in vitro metabolic and contractile effects of anoxia and glucose deprivation on the rabbit urinary bladder were studied. The exposure of isolated strips of rabbit urinary bladder to a glucose deficient medium equilibrated with nitrogen rather than with oxygen resulted in 1) a rapid decrease in baseline tension, 2) a progressive decrease in the intracellular concentration of adenosine 5'-triphosphate (ATP) and progressive increases in the concentrations of adenosine 5'-monophosphate and adenosine 5'-diphosphate, 3) a rapid decrease in the ability of bethanechol to stimulate contractility, and 4) the inability of bethanechol to maintain a sustained increase in contractile force. Recovery from a 60-minute exposure of bladder strips to anoxia was characterized by a rapid recovery of the ability of the bladder to respond to bethanechol (50 per cent recovery occurring within 15 minutes) and a slightly slower recovery of the intracellular ATP level. Both the contractile response to bethanechol and the intracellular concentration of ATP returned to control levels within 60 minutes after the termination of anoxia.

Adenosine Diphosphate↗