Vol. 44 (6): 1182-1193, November – December, 2018
Marcio Augusto Averbeck 1, 2, 3, Nelson Gianni de Lima 4, Gabriela Almeida Motta 1, Lauro Beltrão 2, Nury Jafar Abboud Filho 2, Clarice Pereira Rigotti 2, William Nascimento dos Santos 2, Steven Kitzberger Jaeger dos Santos 2, Luis Fernando Batista da Silva 2, Ernani Luis Rhoden 2, 3, 5
1 Departamento Pós-graduação em Ciências da Saúde da Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil; 2 Serviço de Urologia, Complexo Hospitalar Santa Casa, Porto Alegre, RS, Brasil; 3 Serviço de Urologia, Hospital Moinhos de Vento, Porto Alegre, RS, Brasil; 4 Serviço de Urologia, Hospital de Nossa Senhora dos Navegantes, Torres, RS, Brasil; 5 Disciplina de Urologia, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil
Purpose: This study aims to evaluate the link between preoperative parameters and oxidative stress (OS) markers in the bladder wall of men undergoing open prostatectomy.
Materials and Methods: From July 2014 to August 2016, men aged ≥ 50 years and presenting with LUTS were prospectively enrolled. Preoperative assessment included validated questionnaires (IPSS and OAB – V8), lower urinary tract ultrasound and urodynamics. Bladder biopsies were taken during open prostatectomy for determination of OS markers. Increased OS was defined by increased concentration of malondialdehyde (MDA) and / or decreased concentration of antioxidant enzymes (superoxide dismutase and / or catalase). P<0.05 was regarded as statistically significant.
Results: Thirty – eight consecutive patients were included. Mean age was 66.36 ± 6.44 years, mean prostate volume was 77.7 ± 20.63 cm3, and mean IPSS was 11.05 ± 8.72 points. MDA concentration was increased in men with severe bladder outlet obstruction (BOO grade V – VI according to the Schaefer’s nomogram) in comparison with BOO grade III – IV (p = 0.022). Patients with severe LUTS also had higher MDA concentration when compared to those with mild LUTS (p = 0.031). There was a statistically significant association between increased post – void residual urine (cut off ≥ 50 mL) and not only higher levels of MDA, but also reduced activity of SOD and catalase (p < 0.05).
Conclusions: This pilot study showed that severity of LUTS and BOO were associated with increased MDA concentration in the bladder wall of men undergoing open prostatectomy. Further studies are still needed to assess the role of non – invasive biomarkers of OS in predicting bladder dysfunction in men with LUTS.
Keywords: Urinary Bladder; Lower Urinary Tract Symptoms; Urinary Bladder Neck Obstruction; Oxidative Stress