Presentation Authors: Marcio Averbeck*, Nelson de Lima, Gabriela Motta, Lauro Beltrao, Nury Abboud Filho, Clarice Rigotti, William dos Santos, Steven dos Santos, Luiz da Silva, Ernani Rhoden, Porto Alegre, Brazil
Introduction: To evaluate the link between preoperative lower urinary tract (LUT) ultrasound and oxidative stress (OS) markers in the bladder wall of men undergoing open prostate surgery.
Methods: From July 2014 to August 2016, men presenting with LUTS, aged â‰¥ 50 years, prostate volume â‰¥ 40 mL, undergoing prostate surgery in a single university hospital were enrolled. Preoperative LUT ultrasound (US) measurements were performed transabdominally by a single trained researcher, using a high frequency transducer (7.5 MHz) with the device Siemens Sonoline G50Â® (Siemens AG, Munich, Germany). Full-thickness fragments of the bladder wall were obtained from the anterior bladder wall during open prostatectomy for determination of OS markers, including catalase, superoxide dismutase (SOD) and malondialdehyde (MDA), using spectrophotometry. Increased OS was defined by increased concentration of malondialdehyde (MDA) and/or decreased concentration of antioxidant enzymes (SOD/catalase). The level of significance was P < 0.05.
Results: Thirty-eight consecutive patients (mean age: 66.36 Â± 6.44 ys) were included. Mean IPSS was 11.05 Â± 8.72 points. Mean PV was 77.7 Â± 20.63 cm3 and mean BWT was 3.99 Â±1.39 mm. Seventeen patients (44.7%) presented with IPP, with a mean of 1.54 Â± 0.64 cm. MDA concentration was higher in patients with BWT â‰¥ 3 mm compared to those with BWT < 3 mm (342.03 Â± 317.03 vs. 157.97 Â± 107.47 pmoL / mg, respectively; p = 0.015). Increased prostate volume (PV) was associated with higher concentrations of MDA: 236.43 Â± 217.75 vs. 130.33 Â± 66.44 pmoL / mg in patients with PV â‰¥ 80 cm3 and PV < 80cm3, respectively (p = 0.048). However, IPP was not associated with increased OS in the bladder wall (p > 0.05). Increased MDA concentration and reduced activity of antioxidant enzymes (both catalase and SOD) were observed in the bladder wall of patients with post - void residual urine (PVR) â‰¥ 50 mL: MDA: 270 Â± 197.06 vs. 143.96 Â± 154.91 pmoL / mg (p = 0.045); SOD: 0.48 Â± 0.29 vs. 0.97 Â± 0.67 Usod / mg (p = 0.005); Catalase: 212.71 Â± 99.32 vs. 344.61 Â± 154.01 pmoL / mg (p = 0.003).
Conclusions: LUT US parameters, including increased bladder wall thickness, prostate volume and post-void residual urine, were associated with increased OS in the bladder wall of men with LUTS undergoing open prostatectomy. Identification of such factors may have clinical relevance, as there might be a relationship between increased OS and bladder dysfunction. Future research should focus on non-invasive OS biomarkers.