Надточий О.Н.

This review is dedicated to the analysis of recently published data related to the influence of metabolic syndrome (MS) on the development and progression of benign prostate hyperplasia (BPH) and urination disorders, which are denoted as lower urinary tract symptoms (LUTS). It has been shown that patients with MS are diagnosed with BPH significantly more often than men of the same age, who do not suffer from metabolic disorders. At the same time, the volume of the prostate was larger in patients with MS, who have recently been diagnosed with BPH, in comparison with patients without MS.

Acute and chronical experiments were carried out using 30 white inbreed male rats. Blood circulation and neurogenic vegetative regulation of the bladder and prostate were studied in the normal conditions at the different filling of the bladder (full, empty) and also in the models of pathologic conditions (acute urinary retention, benign prostatic hyperplasia). Overfilling the bladder influenced the blood supply both to the bladder itself and to the prostate.

The pathogenetic importance of chronic ischemia of the pelvic organs in the development of benign prostate hyperplasia (BPH) and concurrent bladder dysfunction was investigated in chronic experiments on 18 male rats. Chronic ischemia was induced by the contraction of the inferior vena cava (1st series). In the second series BPH was induced with the use of androgen therapy (once a week Sustanon for 1 month). Intact rats were used as controls. In both series the development of BPH was evident.

In narcotized dogs, electrical impedances of prostate and urinary bladder were recorded simultaneously with vesical pressure to assess neural control and circulation in these organs in vivo with the method of bioimpedance harmonic analysis. Regional sympathetic and parasympathetic activities were assessed by the magnitude of Mayer (M) and respiratory (R) peaks, correspondingly. Circulation in these organs was evaluated according to the magnitude of the first pulsatile (cardiac) harmonic C1.

In experiment on 15 male rats of different age it was shown, that old rats in the age of 2 years have definitive age-related changes in the prostate, analogous to the benign prostatic hyperplasia (BPH), in a form of increase in the prostatic mass and typical histological picture.

The experiments were made using 20 mature male rats (line “August”) with a mass of 280-320 g. In 10 rats metabolic changes typical for metabolic syndrome (MS) were induced using high-calorie diet (adding of 20% margarine to standard diet and 20% of fructose to the water during 3 months), bilateral orchiectomy (to create androgen deficiency) and stress (immobilization stress during 1 day in the end of the observation period).

In this literature review we examine the current data on the physiological roles and mechanisms of spontaneous rhythmic contractile activity of the urinary system and prostate. The data shows that in the upper urinary tract the spontaneous rhythmic activity mainly provides transportation of urine, whereas in the lower urinary tract and prostate gland it is associated with regulation of the tonus of these organs.

In experiment on 20 rats we studied the effect of a 4-hour acute urinary retention (AUR) on the functional state of the bladder and the change in activity of some enzymes (AST and ALT transaminases, lactate dehydrogenase - LDH, alkaline phosphatase - ALP, y-glutamyltranspeptidase-GGTP, N-acetyl -p-glycosidase - NAG and cholinesterase - CE) in the urine and the bladder wall, comparing them with the changes after 2-hour total ischemia of the bladder caused by pelvic clamping of the aorta.

In rat model perspective of two novel trends of preventing and treatment of acute post-ischemic renal failure (ARF) was investigated, in particular application of two drugs referred to novel class of antioxidants, which are selectively accumulated in mitochondria of renal tubular epithelium, which conditionally denoted as SkQ1 and SkQR, as well as administration of cultured human bone marrow-derived mesenchymal stem cells (BM-MSC) and cultured fetal renal cells (CRC).