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Mechanisms of reproductive aging in the females
ManQi Deng
Science China Life Sciences , 2012, DOI: 10.1007/s11427-012-4351-6
Abstract: Aging is a developmental process occurring in all living organisms after reaching a critical developmental stage, characterized by progressive loss of functions until death. Different cells/tissues age differently depending on epigenetics and cell-cell interactions. While males maintain fertility for the most part of their life females only maintain reproductive ability for a short time compared with their lifespan. The interesting question is why and how the females lose fertility so quickly. There have been many hypotheses proposed from different perspectives and recent research has revealed unusual interactions between germ cells and somatic cells which may determine the lifespan of reproduction in the females. This review briefly discusses recent progress in reproductive aging in the well studied model, C. elegans, and focuses on the molecular mechanisms which may be conserved across all animals including humans.
Urodynamics in a community-dwelling population of females 80 years or older: which motive? Which diagnosis?
Valentini, Fran?oise A.;Robain, Gilberte;Marti, Brigitte G.;Nelson, Pierre P.;
International braz j urol , 2010, DOI: 10.1590/S1677-55382010000200013
Abstract: purpose: to determine why community-dwelling women aged 80 years or over were referred for urodynamic evaluation despite their advanced age and which urodynamic diagnosis was made. materials and methods: one hundred consecutive females (80-93 years) were referred to our urodynamics outpatient clinic for evaluation of lower urinary tract symptoms (luts) between 2005 and 2008. clinical evaluation comprised of a previous history of luts, previous medical history of neurological disease or dementia, pelvic floor dysfunction or prior pelvic surgery. exclusion criteria were complete retention and severe dementia involving failure to understand simple instructions. assessed items were results of uroflows (free flow and intubated flow), cystometry and urethral pressure profilometry, and final urodynamic diagnosis. results: the main complaint evoked by the patients was incontinence (65.0%) of which 61.5% was "complicated" and urgency was reported by 70.0%. interpretable free flow at arrival was very low (44.0%). prevalence of detrusor overactivity was high, found in 45 patients of whom 16 had detrusor hyperactivity with impaired detrusor contractility. detrusor overactivity and urgency were strongly associated (p = 0.004). twenty-five patients had intrinsic sphincteric deficiency alone and 15 detrusor underactivity. conclusion: in this particular community-dwelling with an elderly female population, urodynamics is easily feasible. incontinence, mainly "complicated" is the more frequent complaint and urgency the more frequent symptom. urodynamic diagnosis underlines the high incidence of detrusor overactivity as well as impaired detrusor function.
Ultrasound Estimated Bladder Weight in Asymptomatic Adult Females  [cached]
Ghadeer Al-Shaikh,Hazem Al-Mandeel
Urology Journal , 2012,
Abstract: PURPOSE: To estimate the bladder weight by automated ultrasound method (BladderScan BVM 9500) in adult females without lower urinary tract symptoms and to assess both the intra-observer and interobserver reproducibility of this method. MATERIALS AND METHODS: Healthy volunteers were recruited in King Khalid University Hospital from hospital staff and patients attending the gynecological clinic over a period of six months. All women were screened for any lower urinary tract symptoms using a validated short version of Urinary Distress Inventory questionnaire. BladderScan BVM 9500 device (Diagnostic Ultrasound, Bothell, WA) was used to measure bladder wall thickness, bladder volume, and calculated bladder weight. RESULTS: Eighty-five women were included in the study. The mean age was 37.5 years (± 11.1). Mean bladder wall thickness (BWT) was 1.68 mm (95% confidence interval: 1.61 to 1.75) and the mean ultrasound-estimated bladder weight (UEBW) was 32.25 g (95% confidence interval: 31.7 to 32.8). The UEBW intra-observer (ICC: 0.81) and interobserver (ICC: 0.8) reproducibility were excellent while intra-observer (ICC: 0.55) and interobserver (ICC: 0.6) reproducibility for BWT were moderate. No correlation was found between UEBW and age, height, body weight, or bladder volume. CONCLUSION: The estimated bladder weight by automated ultrasound device in asymptomatic adult females yields reproducible measurements and can be used as a reference for future understanding of the changes in bladder weight related to different types of urinary incontinence or voiding disorders.
How frequent are overactive bladder symptoms in women with urodynamic verification of an overactive bladder?  [cached]
Ahmet ?zgür Yeniel,Mete Ahmet Ergeno?lu,Reci Meseri,Niyazi A?kar
Journal of the Turkish-German Gynecological Association , 2012,
Abstract: Objective: To determine the relationship between overactive bladder symptoms and urodynamic verification of overactive bladder.Material and Methods: Between June 2011 and November 2011, 159 patients underwent urodynamics (UDS) at our urogynecology unit in the Ege University Hospital. Of these, 95 patients who complained of urgency, did not have any overt neurological diseases, bladder outlet obstruction and did not take any medication affecting the lower urinary tract function were evaluated. SPSS (ver. 15.0) was used to evaluate the data and the chi-square test and t test for independent samples were used for analysis. Results: The mean age was found to be 54.5±12. Frequency was the most frequent symptom in women with overactive bladder (OAB) (82.1%), nocturia (57.8%) and (57.8%) urgency urinary incontinence followed in frequency. Detrusor over activity incidence was found to be 38.9%. There was no significant relationship between the presence of detrusor over activity (DOA) and OAB symptoms. Leak at urodynamics was found in 46.3% and there is no significant association with detrusor overactivity. Total bladder capacity was found to be significantly lower in women who had DOA (p=0.000). Conclusion: It appears that overactive bladder symptoms do not predict detrusor over activity. Urodynamic investigation is not mandatory in the initial management of women with only OAB symptoms.
Urodynamics post stroke in patients with urinary incontinence: Is there correlation between bladder type and site of lesion?
Gupta Anupam,Taly Arun,Srivastava Abhishek,Thyloth Murali
Annals of Indian Academy of Neurology , 2009,
Abstract: Objective: Assessment of bladder by urodynamic study (UDS) in patients with urinary incontinence following stroke, and correlation with site of lesion. Study Design and Setting: Retrospective cross-sectional study in the neurological rehabilitation unit of a tertiary care institute. Materials and Methods: Forty patients (22 males) with arterial or venous, ischemic or hemorrhagic stroke, with urinary incontinence in the acute phase following the event, underwent UDS. Seventeen patients had right hemiplegia, 18 had left hemiplegia, and five had posterior circulation stroke with brainstem/cerebellar features. Bladder type was correlated with age, side, and site of lesion. Results: The mean age was 46.80 ± 16.65 years (range: 18-80 years). Thirty-six patients had arterial stroke and four had cortical venous thrombosis. UDS was performed after a mean of 28.32 ± 10.27 days (range: 8-53 days) after the stroke. All but one patient had neurogenic bladder dysfunction, with 36 patients (90%) having overactive detrusor (OD) and three having underactive/areflexic detrusor. Among the 36 patients with OD, 25 patients (62.5%) had OD without detrusor-sphincter dyssynergy (DSD) and 11 (27.5%) had OD with DSD. Bladder management was advised based on the UDS findings. No significant correlation ( P > 0.05) was found between type of bladder and age or side and site of lesion. Conclusions: UDS is a useful tool to assess and manage the bladder following stroke with urinary incontinence. In this study, no significant correlation was found between UDS findings and site of lesion.
Leiomyoma of the bladder presenting as acute urinary retention in a female patient: urodynamic analysis of lower urinary tract symptom; a case report
Masashi Matsushima, Hirotaka Asakura, Hirofumi Sakamoto, Minoru Horinaga, Yoko Nakahira, Hitoshi Yanaihara
BMC Urology , 2010, DOI: 10.1186/1471-2490-10-13
Abstract: A 56-year-old woman presented with acute urinary retention. Evaluations including ultrasound, magnetic resonance imaging, cystoscopy, and urodynamics contributed to a diagnosis of leiomyoma of the bladder. Various medications were ineffective for solving her lower urinary tract symptoms; therefore, a transurethral resection was performed. The final pathological report was leiomyoma. After the operation, her symptoms resolved; this improvement was confirmed by an urodynamic analysis. The postoperative urodynamics demonstrated a lower frequency of detrusor overactivity during filling cystometry and an increase in the uroflow rate, with reduced detrusor pressure in a pressure flow study.Leiomyoma of the bladder can cause female outlet obstruction. A review of the literature and disease management is discussed.Most bladder tumors are derived from the urothelium. Benign mesenchymal tumors are rare and comprise 1 to 5% of all bladder neoplasms [1]. Among them, leiomyoma is the most common benign neoplasm, accounting for 0.43% of bladder tumors [2]. Approximately 75% of the patients are young or middle aged [3]. We present a case of leiomyoma of the bladder with acute urinary retention in a female patient and report on the urodynamic changes after transurethral resection (TUR). A literature search of PubMed using the terms leiomyoma of the bladder and urodynamics suggested that only one other case of a bladder leiomyoma with acute urinary retention in a female patient who was evaluated using urodynamics has been previously published [4]. To our knowledge, there are few cases describing an urodynamic evaluation of a female patient with a bladder leiomyoma. Here, we present and discuss an exemplary case of lower urinary tract symptom (LUTS) caused by a leiomyoma of the bladder.A 56-year-old woman presented at our hospital with an episode of acute urinary retention. She also complained of urinary frequency and urgency for the past 4 months. A physical examination did not reve
Somatic signals counteract reproductive aging in females
Ronald E Ellis, Qing Wei
Genome Biology , 2010, DOI: 10.1186/gb-2010-11-11-142
Abstract: Females are born with their complete complement of oocytes or egg cells. Although these oocytes can remain arrested for decades, during aging they decline in quality or undergo programmed cell deaths. Using the nematode Caenorhabditis elegans as a model, Luo et al. [1] showed recently that mutations in the insulin/insulin-like growth factor (IGF) and transforming growth factor (TGF)β signal transduction pathways improve oocyte quality in older females. Furthermore, genetic mosaic analyses revealed that each of these regulatory pathways acts in a different somatic tissue to control reproductive aging. Thus, declining oocyte quality is not inevitable in these worms, but seems to be determined by regulatory controls that balance somatic and reproductive needs. Given that the insulin/IGF and TGFβ signaling pathways are conserved, these results raise the possibility that somatic signals regulate the quality of oocytes in older women.As a woman ages, her chance of conceiving a healthy child declines precipitously (reviewed in [2]). During this period, many of her oocytes are lost through programmed cell death, but reproductive problems predate their complete depletion. In particular, even oocytes that survive and mature are of lower quality than those found in young women. Defects in these oocytes lead to a decreasing chance of fertilization and an increasing risk of miscarriage or of a child with birth defects. Much of this decline in oocyte quality is due to errors in handling chromosomes that lead to aneuploidy or triploidy (reviewed in [3]). Additional factors also contribute to lower oocyte quality but remain poorly understood.Although nematodes have very short lifespans, several assays reveal that their oocytes also decline in quality with age. Perhaps the simplest method is to measure the probability that an oocyte will produce a healthy worm after fertilization. Using this definition, oocyte quality declines during normal aging in nematodes [4], as it does in wome
Diurnal Variation in Urodynamics of Rat  [PDF]
Gerald M. Herrera,Andrea L. Meredith
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0012298
Abstract: In humans, the storage and voiding functions of the urinary bladder have a characteristic diurnal variation, with increased voiding during the day and urine storage during the night. However, in animal models, the daily functional differences in urodynamics have not been well-studied. The goal of this study was to identify key urodynamic parameters that vary between day and night. Rats were chronically instrumented with an intravesical catheter, and bladder pressure, voided volumes, and micturition frequency were measured by continuous filling cystometry during the light (inactive) or dark (active) phases of the circadian cycle. Cage activity was recorded by video during the experiment. We hypothesized that nocturnal rats entrained to a standard 12:12 light:dark cycle would show greater ambulatory activity and more frequent, smaller volume micturitions in the dark compared to the light. Rats studied during the light phase had a bladder capacity of 1.44±0.21 mL and voided every 8.2±1.2 min. Ambulatory activity was lower in the light phase, and rats slept during the recording period, awakening only to urinate. In contrast, rats studied during the dark were more active, had a lower bladder capacities (0.65±0.18 mL), and urinated more often (every 3.7±0.9 min). Average bladder pressures were not significantly different between the light and dark (13.40±2.49 and 12.19±2.85 mmHg, respectively). These results identify a day-night difference in bladder capacity and micturition frequency in chronically-instrumented nocturnal rodents that is phase-locked to the normal circadian locomotor activity rhythm of the animal. Furthermore, since it has generally been assumed that the daily hormonal regulation of renal function is a major driver of the circadian rhythm in urination, and few studies have addressed the involvement of the lower urinary tract, these results establish the bladder itself as a target for circadian regulation.
Oxidative Status and Lipofuscin Accumulation in Urothelial Cells of Bladder in Aging Mice  [PDF]
Martina Per?e, Rade Injac, Andreja Erman
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0059638
Abstract: Age-related changes in various tissues have been associated with the onset of a number of age-related diseases, including inflammation and cancer. Bladder cancer, for instance, is a disease that mainly afflicts middle-aged or elderly people and is mostly of urothelial origin. Although research on age-related changes of long-lived post-mitotic cells such as neurons is rapidly progressing, nothing is known about age-related changes in the urothelium of the urinary bladder, despite all the evidence confirming the important role of oxidative stress in urinary bladder pathology. The purpose of this study was thus to investigate the oxidative status and age-related changes in urothelial cells of the urinary bladder of young (2 months) and aging (20 months) mice by means of various methods. Our results demonstrated that healthy young urothelium possesses a powerful antioxidant defence system that functions as a strong defence barrier against reactive species. In contrast, urothelial cells of aging bladder show significantly decreased total antioxidant capacity and significantly increased levels of lipid peroxides (MDA) and iNOS, markers of oxidative stress. Our study demonstrates for the first time that ultrastructural alterations in mitochondria and accumulation of lipofuscin, known to be one of the aging pigments, can clearly be found in superficial urothelial cells of the urinary bladder in aging mice. Since the presence of lipofuscin in the urothelium has not yet been reported, we applied various methods to confirm our finding. Our results reveal changes in the oxidative status and structural alterations to superficial urothelial cells similar to those of other long-lived post-mitotic cells.
Long term evaluation of functional and morphological bladder alterations on alloxan-induced diabetes and aging: experimental study in rats
Rodrigues Jr, Antonio Antunes;Suaid, Haylton Jorge;Tucci Jr, Silvio;Fazan, Valéria Paula Sassoli;Foss, Milton César;Cologna, Adauto José;Martins, Antonio Carlos Pereira;
Acta Cirurgica Brasileira , 2008, DOI: 10.1590/S0102-86502008000700010
Abstract: purpose: to evaluate structural and functional effects of alloxan- induced diabetes and aging on bladder of rats. methods: evaluations were performed in three groups: a - 8 weeks of age, b - 44 weeks of age, c - 44 weeks of age with alloxan-induced diabetes. muscle layer thickness, extracellular matrix fibrosis and collagen were quantified on digital images of bladder samples. cystometric evaluations before surgical vesical denervation (svd), included maximum cystometric capacity (mcc), maximum bladder pressure (mbp), bladder contraction frequency (vcf), duration of bladder contraction (dc), threshold pressure (tp) and bladder compliance (bc). after svd, maximum cystometric capacity (mcc), bc and maximum urethral closing pressure (mucp) were also measured. results: reduced extracellular matrix fibrosis concentration and contraction strength were found in the bladders of group c. before svd, bladder compliance was not different between groups. alterations were observed in mcc after svd. conclusions: we did not notice smooth muscle hypertrophy in alloxan-induced diabetic rats after 44 weeks. there was alteration in the total and relative amount of fibrosis and collagen. the cystometric studies support the idea that this morphological alterations are important to determine the different bladder functional patterns found in the aging and the alloxan-induced diabetic animals.
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