Reconstructive urology

Abstract

735Urological Survey the clinical setting for these proposes. Nevertheless, the mechanism of finasteride action in stopping bleeding is still unknown.The authors of the present paper used male beagle dogs to assess dynamic contrast enhanced magnetic resonance imaging as a biological marker of in vivo changes in microcirculation in the prostatic suburethral region. They found that subjects in the finasteride group had decreased microcirculation, as expressed by lower and slower contrast enhancement, and as quantified by increased Tmax, and decreased A and kep in the prostatic suburethral area. They concluded that finasteride would decrease the prostatic microcirculation and therefore diminish prostatic bleeding in BPH and TURP.In a recent experimental paper, Canda et al.(1) evaluated the effects of finasteride on the vascular surface density (VSD), number of microvessels (NVES) and vascular endothelial growth factor (VEGF) expression of the rat prostate. After studying 19 adult rats, the authors found that the mean prostatic weights were decreased significantly in rats given finasteride (p=0.0001). On the other hand, finasteride does not seem to decrease VSD, NVES and VEGF expression at the level of the rat prostate. The effect of reduction of bleeding in BPH is more likely to be due to its effect on shrinking glandular hyperplasia, which might enhance vessel wall stability, rather than decreasing overall vascularity (1).From these two papers, we can infer that the exact mechanism of action of finasteride on the prostatic vessels is still open to research and discussion. Purpose: To enhance our understanding of sonographically visible alterations in bladder wall thickness, we delineated phenotypic changes occurring in developing smooth muscle cells of the fetal and postnatal bladder with respect to gender specific differences. Materials and Methods: Bladders of 30 male and 18 female fetuses and 4 stillborn infants were immunostained with an alpha-smooth muscle actin antibody. Morphological and morphometric assessment was performed with the assistance of an image analysis system. Results: Alpha-smooth muscle actin expression in fetal bladder wall was detectable at 9 weeks of gestation. Bladder wall thickness and mean profile area of smooth muscle bundles increased significantly with advancing gestation, mediated by linear growth patterns. Fetal bladder wall development occurred uniformly, unrelated to gender. Dr. Francisco Sampaio