De-obstruction of bladder outlet in humans reverses organ remodeling

Bladder outlet obstruction (BOO) causes lower urinary tract symptoms and objectifiable urodynamic changes in bladder function. We carried out an integrated transcriptome and proteome analysis of bladder samples from male patients with BOO before and 3 months after de-obstruction surgery (transurethral resection of the prostate, TURP). mRNA and protein profiles were correlated with urodynamic findings, specifically voiding detrusor pressure (PdetQmax) before TURP. Patients with high PdetQmax showed less advanced remodeling and inflammatory changes than those with lower values. We oberved significant dysregulation of gene expression, which was reversed by de-obstruction in both patients’ groups. We propose a series of biomarker genes, indicative of BOO, and possibly contributing to the bladder changes. Our data sheds light on the stages of progressive obstruction-induced bladder decompensation, and might add selecting the operation point to avoid the loss of contractility.