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We conducted two studies to examine the hypothesis that lower urinary tract obstruction induces excessive production of prostaglandin E2 (PGE2) in the bladder in young boys, with consequent overactive bladder (OAB) symptoms. The subjects were boys aged less than 15 years old who were scheduled to undergo surgery in our department from October 2006 to March 2008. In study 1 (n=25), the patients were divided into two groups based on the presence or absence of lower urinary tract obstruction. In study 2 (n=38), the patients were classified by age. The PGE2 level in the bladder was determined by washing with saline before the operation and urinary symptoms were evaluated using the Pediatric Lower Urinary Tract Scoring System. In study 1, the PGE2 level in the bladder of patients with lower urinary tract obstruction was higher than in those without obstruction (49.1+/-37.4 vs. 21.5+/-10.1 pg/mL, P=0.0475). In study 2, the PGE2 level in the bladder was negatively correlated with age (r=-0.379, P=0.0207). A higher level of PGE2 is found in boys with bladder outlet obstruction due to urethral stricture and in younger boys, and this elevated level of PGE2 may induce OAB symptoms.

A higher level of prostaglandin E2 in the urinary bladder in young boys and boys with lower urinary tract obstruction