Bladder Neck Morphologic Changes and Clinical Correlation of Smokers Submitted to Radical Prostatectomy

Abstract

Introduction: Smoking is an important risk y factor to many diseases, affecting arterial system, skin and urogenital system, including bladder neck stenosis. Its effect on bladder neck has not been described. Objective: Evaluate possible morphological changes caused by nicotine in the bladder neck. Material and Method: Fragments of bladder neck of 16 patients were submitted to stereological analysis, and those patients are divided into two groups, one of smokers and the other of non-smokers with 7 and 9 patients, respectively. After 90 days of surgery , they were submitted to free uroflowmetry and data analyzed by T test, having statistical significance with P < 0 . 05. Results : An increase of 63.26% in the amount of fibers in the elastic system of the smokers group was observed, a reduction of 35.96% in the thickness of arteries, as well as an increase of IPSS and decrease of maximum flow in uroflowmetry, all with statistical significance. Discussion: Laboratorial changes are similar to those found in other studies with different tissues, such as skin, in which those findings are related to premature ageing. Clinical results, though statistically significant, do not have clinical consistence because the study was meant to morphological analysis. Conclusion: Smoking increases the amount of fibers in the elastic system and decreases the thickness of bladder neck arteries.