723 URODYNAMIC IMPROVEMENTS AFTER MEDICAL TREATMENT OF PARTIAL BLADDER OUTLET OBSTRUCTION IN AN ANIMAL MODEL

Abstract

You have accessJournal of UrologyPediatrics: Basic Research1 Apr 2012723 URODYNAMIC IMPROVEMENTS AFTER MEDICAL TREATMENT OF PARTIAL BLADDER OUTLET OBSTRUCTION IN AN ANIMAL MODEL Conrad Maciejewski, Edward Tredget, and Peter Metcalfe Conrad MaciejewskiConrad Maciejewski Edmonton, Canada More articles by this author , Edward TredgetEdward Tredget Edmonton, Canada More articles by this author , and Peter MetcalfePeter Metcalfe Edmonton, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.808AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Partial bladder outlet obstruction (pBOO) is a significant problem in both adult and pediatric urology. Anticholinergic medication remains the gold standard for symptomatic treatment, however its efficacy in prevention of deterioration to end-stage bladder fibrosis has never been proven in an experimental model. Furthermore, a great deal of in-vitro work has demonstrated the involvement of numerous novel signaling pathways, including mTOR / MAPK pathway. Rapamycin is a commonly used immunosuppressant due to its potent suppression of the mTOR pathway. Therefore, we wish to assess the long-term urodynamic effects of oxybutinin and compare it to rapamycin in an animal model. METHODS Following approval from the University of Alberta Animal Care & Use Committee, female Sprague-Dawley rats underwent surgical induction of pBOO. Three experimental groups were used: including control, daily oral oxybutynin (3mg/kg) and daily oral rapamycin (2mg/kg). The rats were maintained and monitored for a period of 12 weeks at which point urodynamics were performed, and organs harvested. RESULTS All animals survived to experimental end points. Treatment with oxybutynin resulted in a 10-fold increase in bladder capacity compared to controls, (3.36 +/- 0.53 cc vs 0.36 +/- 0.08 cc (p<0.01). Similar changes were seen in maximum detrusor pressure with oxybutynin treated animals having a pressure of 46.5 +/- 7.8 cm H2O compared to controls with a mean of 17.3 cm H2O+/- 4.04 (p<0.01). However, no statistically significant differences in bladder capacity or pressure were seen with rapamycin. Bladder weights were significantly different between the groups, with controls weighing 326 +/- 30.5 mg, oxybutynin treated animals weighing 875 +/- 318 mg (p=0.04), and rapamycin treated animals weighing 227 +/- 70 mg (p=0.08). CONCLUSIONS We demonstrate that urodynamic changes after bladder outlet obstruction leading to fibrosis is a pharmacologically alterable process. Daily treatment with oxybutinin results in a huge increase in bladder capacity but pressures remain elevated. Treatment with Rapamycin does not seem to alter urodynamic parameters after 3 months, but results in signicicantly smaller bladders. Further work will determine if this data is related to deterioration to fibrotic changes and progression to the end-stage bladder. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e297 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Conrad Maciejewski Edmonton, Canada More articles by this author Edward Tredget Edmonton, Canada More articles by this author Peter Metcalfe Edmonton, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...