Averbeck MA, et al. - An inquiry was set up of the collagen content in the bladder wall of men undergoing open prostate surgery. The findings unveiled a link between diabetes mellitus (DM2) and urodynamic parameters, such as increased PVR and reduced bladder compliance, with higher collagen content in the bladder wall of men with LUTS.

Methods

• This trial recruited men aged ≥ 50 years, presenting LUTS and undergoing open prostate surgery due to benign prostatic enlargement (BPE) or prostate cancer, from July 2014 to August 2016.
• Preoperative analysis comprised validated questionnaires (IPSS and OAB-V8), lower urinary tract ultrasound, and urodynamics.
• Bladder biopsies were extracted during open prostatectomy for the detection of collagen content (sirius red-picric acid stain; polarized light analysis).
• An estimation was performed of the collagen to smooth muscle ratio (C/M) in the detrusor and its association with preoperative parameters was inspected.
• The level of significance was P < 0.05.

Results

• Thirty-eight consecutive patients were eligible for this research.
• Mean age was 66.36 ± 6.44 years and mean IPSS was 11.05 ± 8.72 points.
• Men diagnosed with diabetes mellitus (DM2) reported higher collagen content in the bladder wall than the non-diabetic patients (17.71 ± 6.82% vs 12.46 ± 5.2%, respectively; P = 0.024).
• Moreover, reduced bladder compliance served as a marker for higher collagen content (P = 0.042).
• It was noted that bladder outlet obstruction (BOO) was not a predictor of increased collagen deposition in the bladder wall (P = 0.75).
• A higher collagen to smooth muscle ratio in the bladder wall (P = 0.036), was illustrated in patients with PVR ≥ 200 mL.