Morphological reconstruction of the bladder in the process of age-related involution

Abstract

BACKGROUND: Population aging has caused a steady increase in morbidity associated with gerontological pathology with lesions of various organs and systems, including those associated with structural changes in the bladder.

AIM: To study morphological rearrangements of the bladder and its vascular system in elderly and senile people.

MATERIAL AND METHODS: Autopsy material of the bladder wall from 25 men aged 60–80 years was studied using histological, morphometric, and statistical techniques. As a control, we used material from 10 persons aged 20–30 years who died from injuries.

RESULTS: Our results show that, in men in the process of aging, atherosclerotic changes occur in the extra-organic arteries,, leading to a narrowing of the lumen. In the intra-organ arteries, thickening of the media, hyperelastosis, and hyalinosis are observed, leading to a reduction in blood flow and are markers of arterial hypertension. The formation of the so-called closing arteries with a powerful intimate layer indicates adaptation to hemodynamic disorders. Over time, sclerosis grows in the media of arteries and in the intima of the closing vessels. The veins of the bladder lose a powerful smooth muscle layer in the wall and undergo sclerosis, making blood outflow difficult, and aggravating chronic hypoxia. Remodeling of the vascular bed of the bladder leads to detrusor atrophy and degenerative-dysregenerative changes in the urothelium.

CONCLUSIONS: In the vascular bed of the urinary bladder in elderly and senile men, atherosclerotic and angiotonic changes characteristic of arterial hypertension progress occur, followed by the development of detrusor atrophy and impaired urothelium regeneration.

Keywords

older men / age-related involution / urinary bladder / blood vessels / bladder wall / age-related structural changes / morphometry

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