Is there a correlation between structural changes of the bladder wall and its dysfunction? A Prospective Study

Abstract

The aim of the study was to evaluate the microscopic structure of the bladder wall in children with a neurogenic bladder to find a correlation between changes in the microscopic structure of the bladder wall and functional disorders. The study group consisted of 42 children who underwent bladder augmentation. Full-thickness fragments of the bladder wall were collected during operation, photographed for evaluation with a morphometric analysis. The proportion of muscle and connective tissue was determined. Results were correlated with the results of urodynamic tests. The analysis showed a progressive increase in connective/muscle tissue ratio with a decrease in the number of nerve trunks with a correlation between the connective/muscle tissue ratio and the deterioration of lower urinary tract in urodynamic investigations. Dysfunctions of the bladder are associated with histological abnormalities of the bladder wall, particularly increases in the amount of connective tissue and reduction of the number of nerve trunks. The increase in the percentage of the connective tissue correlates positively with deterioration of bladder function, reduced compliance of the bladder wall, and changes in the structure of the bladder wall and deterioration of the upper urinary tract.