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Table 1 Summary of studies describing BOO-induced detrusor morphological alterations

From: Progressive bladder remodeling due to bladder outlet obstruction: a systematic review of morphological and molecular evidences in humans

Author, year Study design Subjects in the case group (n) Main findings
Gosling, 1980 [15] Case control 9 • ↑ intrafascicular and interfascicular collagen
• ↓ SMCs diameter
Gilpin, 1985 [10] Case control 14 • ↑connective tissue infiltration of some smooth muscle bundles in 12/14 patients
• ↑ SMCs mean profile area
Elbadawi, 1993 [12] Case control 7 • ↓ intermediate cell junctions
• ↑intrafascicular collagen and elastic fibers
• ↑ SMCs hypertrophy
• ↑ SMCs and axons degeneration in patients with impaired detrusor contractility
Inui, 1999 [19] Case control 26 • Significant positive linear relationship between C/M and estimated bladder weight in patients with bladder weight ≥ 60 g
• ↑ C/M in patients with bladder weight ≥ 60 g
Tse, 2000 [13] Case control 9 • Myohypertrophy pattern in all cases
Brierly, 2003 [14] Case control 12 • Myohypertrophy pattern in 8/10 BOO patients.
• Degenerative pattern in 4/10 BOO patients.
Holm, 2003 [22] Case control 25 • Significant correlation between intra- and interfascicular elastin and BOO degree
Mirone, 2004 [15] Case control 36 • ↑collagen content in BPO patients with respect to controls
• ↑collagen content in patients with severe symptoms
Horn, 2004 [44] Observational 54 • Correlation between abnormal morphology and impaired bladder compliance and decreased capacity
Collado, 2006 [11] Case control 33 • ↑ intrafascicular and interfascicular collagen
• ↑ intrafascicular fibrosis in BOO patients with history of AUR
• ↑ SMCs diameter in BOO patients with respect to controls
• Not significant differences in terms of SMCs diameter between BOO patients with and without AUR history
• Positive correlation between SMCs diameter and symptoms duration
Rubinstein, 2007 [18] Case control 10 • ↑ collagen and elastic fibers
Blatt, 2012 [16] Case control 17 • Poor post-TURP voiding outcome in patients with detrusor ultrastructural pattern characterized by variable muscle cell size, muscle cell shape, abnormal fascicle arrangement and collagenosis.
Bellucci, 2017 [21] Case control 19 • ↑ C/M
• Significant negative correlation between C/M and bladder compliance
• Significant correlation between the probability of urinary retention and C/M
Averbeck, 2017 [20] Observational 38 • ↑ C/M in patients with PVR ≥ 200 mL and in those with reduced bladder compliance
  1. AUR acute urinary retention, BOO bladder outlet obstruction, C/M connective tissue-to-smooth muscle ratio, PVR post void residual volume, SMCs smooth muscle cells, TURP trans urethral resection of the prostate