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A novel histologic finding in male patients with bladder outlet obstruction: a possible etiopathogenesis of Marion’s disease?

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Abstract

Purpose

George Marion first described primary bladder neck obstruction in 1933. Even today, the etiopathogenesis of this condition is unknown. The objective of this study is to associate a novel histologic finding with Marion’s disease to contribute to its etiopathogenesis, and to seek the reason why the lower urinary tract symptoms of some patients was not relieved after pharmacological treatment.

Methods

The retrospective study was carried out with patients who underwent transurethral resection of the prostate from 2009 to 2019. Patients with histological diagnosis did not present hyperplastic nodules, and the presence of skeletal muscle fibers were included in the study. The frequency of cases with presence of skeletal muscle fibers was assessed as well as the area occupied by these fibers in each resected fragment. As a control group, fragments of bladder neck of surgical specimens from 50 radical prostatectomies were analyzed.

Results

In 14 patients with skeletal muscle fibers in the resected fragments the extent of each positive fragment was < 25%, > 25–50%, > 50–75%, and > 75% in 28.6%, 28.6%, 21.4%, and 21.4% fragments, respectively. In the control group, 20% (10/50) of the patients had skeletal muscle fibers and, in all cases, they occupied < 25%.

Conclusion

In these 14 cases, the presence of skeletal muscle fibers is frequent and predominant in TURP fragments, which stands in striking contrast to the control group. We consider that presence of skeletal muscle fibers may be related to Marion’s disease, thus contributing to explain its etiopathogenesis and the unsuccessful alpha-blocker treatment in these patients.

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Author information

Authors and Affiliations

  1. Department of Pathology, School of Medical Sciences, University of Campinas, UNICAMP, Rua Dr. Miguel Penteado, 1073, Campinas, SP, 13070-118, Brazil

    Athanase Billis & Bruna Zaidan

  2. Division of Urology, School of Medical Sciences, University of Campinas, UNICAMP, Campinas, SP, Brazil

    Carlos D’Ancona, Thairo Pereira & Arnold Achermann

Authors
  1. Athanase Billis
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  2. Carlos D’Ancona
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  3. Thairo Pereira
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  4. Bruna Zaidan
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  5. Arnold Achermann
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Contributions

AB: project development, manuscript writing; CD’A: project development, manuscript writing; TP: data collection; BZ: data collection; AA: editing.

Corresponding author

Correspondence to Carlos D’Ancona.

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Conflicts of interest

There are no conflicts of interest in the content and in the writing of this manuscript.

Human participants

This manuscript was approved by Ethics Committee of School of Medical Sciences, Universidade Estadual de Campinas, SP, Brazil, with number—CAAE: 11562019.0.0000.5404.

Informed consent

The Ethical Committee allowed us to do not apply informed consent due to it is a revision of the medical records and anatomopathological slides. The Clinical Trial number is not requered int his study.

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Billis, A., D’Ancona, C., Pereira, T. et al. A novel histologic finding in male patients with bladder outlet obstruction: a possible etiopathogenesis of Marion’s disease?. World J Urol 39, 3497–3501 (2021). https://doi.org/10.1007/s00345-021-03596-7

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  • DOI: https://doi.org/10.1007/s00345-021-03596-7

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