Prune Belly Bladder Wall: Histological study and Adrenergic Receptor Expression

Abstract

PURPOSE Prune Belly syndrome (PB) curses with large bladder capacity, urachal diverticulum, lower sensibility, hypocontractility and post voiding residue. We evaluated the muscle|connective tissue ratio and the detrusor adrenergic receptors concentration in patients with Prune Belly Syndrome comparing with normal bladder (immunohistochemistry). MATERIAL AND METHODS Thirty six patients with Prune Belly syndrome were undergone to a surgical treatment. Fourteen PB- specimens and 18 18 control-specimens were studied (13 from radical prostatectomy with normal urodynamic- GC1 5 and children-detrusor – GC2 - from autopsy). Paraffin blocks were stained with Van Gieson and immunohistochemistry reaction with antibodies to adrenergic receptors. Images were acquired and analysed with Photoshop. The muscle|connective tissue ratio and the immunohistochemically positiv area (adrenoreceptors) ratio were calculated. The statistic test Mann-Whitney was employed (p < 0,05). RESULTS The mean age in PB group was 1.2 years, 64 years in GC1 and 1.41 in GC2. The muscle|connective tissue ratio in Prune Belly was 1.08, in GC2 1,59 and 1.28 in normal bladders from childrens – GC2 (p = >0.05). Considering a1a, the median of pixels proportion receptor/muscle calculated was 0.06 in group PB, 0.16 in group GC1 and 0.14 in group GC2 (p = 0.027). Ther were no difference in this median for a1b (p = 0.781), a1d (p = 0.618) and b3 (p = 0.378). CONCLUSIONS There is a hypoexpression from the adrenoreceptor a1a in this disease, but no change in the receptors a1b, a1d and b3, and no change in the muscle|connective tissue ratio.This finding can contribute to develop future therapies.