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The mechanism of ischaemia-induced bladder dysfunction is not entirely clear,but is thought to be a result of the ischaemia-related M-receptor hypersensitivityto acetylcholine. In addition to nerve injury, ischaemia may cause bladder detrusorfibrosis and urethra de-epithelialization. Bladder dysfunctions caused by bladderoutlet obstruction (BOO) and aging detrusor were considered to be associated withchronic ischaemia. To date, there has been no effective treatment for the histologicaland functional changes of the bladder caused by bladder ischaemia. The presentstudy evaluated the feasibility and effectiveness of using bone marrow mesenchymalstem cells in the treatment of chronic ischaemia-induced bladder detrusor dysfunctionin an experimental model. Bone marrow mesenchymal stem cells from Sprague-Dawley(SD) rats were injected into the common iliac artery of experimental animals,then bilateral iliac arteries were ligated and doxazosin mesylate was intragastricallyadministered. Eight weeks later, urodynamic examination and intravesical pressuremeasurements were performed on experimental animals. Histological changes of thetaken bladder from sacrificed SD rats were evaluated by immunohistochemistry andtrichrome staining and the images captured were analyzed by a software program.The average intravesical pressure and detrusor contraction power of the ischaemiagroup was 16.21±5.26 and 17.26±5.72; those of the experimental group were 24.02±10.06and 25.84±11.99; the average intravesical pressure and detrusor contraction powerof the control group was 28.56±4.48 and 29.57±5.01. The average intravesical pressureand detrusor contraction power of the ischaemia group were significantly lowerthan those of the experimental and control group, while no significant differencewas shown between the experimental and control groups. 5-Bromo-2'-deoxyuridine(BrdU) staining for the experimental group was positive. The percentage of thesmooth muscle content in the bladder wall was (25.21±6.28)%, (49.38±6.32)% and(48.00±17.39)% for ischaemia, experimental and control group, respectively. Thepercentage of smooth muscle in the bladder wall of the ischaemia group was significantlylower than that of the experimental and control group, while no significant differencewas observed between the experimental and control groups. The number of nervefibers per high power field of the experimental group was significantly higherthan that of the ischaemia group, but lower than the control group. In conclusion,the percentage of smooth muscle content and the number of nerve cells per highpower field decreases in ischaemia bladder, with detrusor contractility decreased.Injection of stem cell suspension into the common iliac artery in rats with ischaemicbladder, followed by intragastric administration of doxazosin mesylate, makestransplanted stem cells regenerate in the bladder tissue, increases the percentageof smooth muscle content and nerve cells per high power field in the bladder wall,and improve bladder detrusor contraction function.

Treatment for chronic ischaemia-induced bladder detrusor dysfunction using bone marrow mesenchymal stem cells: An experimental study