Analysis of metalloproteinases expression and their tissue inhibitors in the detrusor muscle of patients with benign prostatic hyperplasia

Abstract

The benign prostatic hyperplasia (BPH) is the main cause of urinary symptoms in adult men. These symptoms have three pathophysiological components: mechanical component, in which the volumetric increase causes a decrease in prostate size and increased urethral resistance, dynamic component, represented by alpha-adrenergic activity increased in this region due to the presence in the capsule and the prostatic stroma bladder neck for high levels of these receptors; Component bladder, resulting from the changes produced by obstruction secondary to BPH in the detrusor muscle. The urological community has emerged to investigate the concern fisiodinâmica bladder decompensation component and that patients with similar levels of obstruction evolve differently. Objective. To determine the expression profile of matrix metalloproteinases 1, 2, and 9, their tissue inhibitors TIMP1, TIMP2, and RECK and collagen type I, III, and IV in the detrusor muscle of patients with BPH. Material and methods: Patients with BPH and bladder outlet obstruction (n = 20), patients with BPH and the presence of bladder diverticulum (n = 20) Control: Patients with early bladder cancer <2 cm without bladder outlet obstruction (n = 20). Variables. Primary variables: Patients with BPH (ultrasound, prostate weight, findings of the bladder wall, post-voiding residue), Indices urodynamic (urine flow, intravesical pressure, bladder capacity filling, complacency, the contraction is not inhibited, vesico-sphincter dyssynergia) of patients with low intravesical voiding pressure, presence of diverticula, international prostatic symptoms score (I-PSS). Secondary variables: Age, physical activity, diabetes mellitus, hypercholesterolemia, smoking, alcoholism, neurological sequel, voiding habits, duration of symptoms prostate, urinary calculi, history of urinary retention, history of urinary tract infection, hematuria, body mass index body, urinary calculi, previous medication for BPH. Statistical methods. Sampling adequacy test by literature review and statistical results of descriptive analysis.(AU)