Abstract: PD26-05
Sources of Funding: Portuguese Association of Urology

Introduction

Several studies demonstrated the association between LUTS and atherosclerosis risk factors and metabolic syndrome. However, a direct impact of chronic pelvic ischemia on LUTS in elderly men was never fully determined. The only evidence is coming from animal models of iliac obstruction which show significant bladder dysfunction after ischemia. Herewith, we investigated LUTS and urinary levels of nerve growth factor (NGF) in elderly men with chronic pelvic ischemia caused by documented aorta, unilateral or bilateral common/internal iliac obstruction._x000D_

Methods

Thirteen men >60y, with aorta, unilateral or bilateral common/internal iliac artery occlusion documented by angio-CT scan or angiography, were enrolled from the vascular surgery department. Twelve men >60y without significant aorto-iliac disease, as confirmed by image studies, were used as controls. Exclusion criteria included neurogenic bladder dysfunction, bladder or prostate cancer, prostate surgery, pelvic radiotherapy or chronic treatment for LUTS. _x000D_ Participants underwent urological examination, including IPSS score to assess LUTS, uroflowmetry, postvoid residual (PVR) and prostate volume determination._x000D_ Urine samples were collected from all participants and urinary NGF was measured by ELISA to explore the presence of chronic neurogenic inflammation._x000D_

Results

Data are summarized in the table. Both groups were identical for age and prostate volume. BMI was slightly higher in the control group. IPSS score was statistically significant higher in the pelvic ischemia group than in controls. The IPSS difference between the two groups was 3 points. Urinary NGF/creatinine was significantly higher in the ischemic patients. _x000D_

Conclusions

Severe pelvic ischemia in elderly men is associated with a significant increase in LUTS and chronic bladder neurogenic inflammation, as suggested by the increase of NGF release, a neurotrophin that may sensitize bladder primary afferents. These findings confirm the relevance of pelvic ischemia in bladder function and validate animal models of bilateral iliac artery occlusion currently under use to investigate the pathophysiologic mechanisms at stake._x000D_

Funding

Portuguese Association of Urology