VIRAL CYSTITIS INDUCED BY CROSS-INFECTION FROM THE COLON - POTENTIAL MECHANISM FOR INTERSTITIAL CYSTITIS

INTRODUCTION AND OBJECTIVES: Many urologic conditions are associated with dysfunction of autonomic bladder innervation. A precise understanding of the anatomical relationship of the bladder neck and its autonomic nervous system could substantially improve treatment modalities. Currently there is no comprehensive model that provides a detailed three-dimensional (3D) view of bladder neck innervation. Therefore, we sought to create a 3D reconstruction of autonomic nervous tissue innervating the bladder neck using male and female cadaver histopathology. METHODS: We obtained intact pelvic tissues from a male and female cadaver. Axial cross-sections of the bladder neck were generated at 3e5mm intervals and stained for S100 protein. Distances between autonomic nerves and bladder mucosa were recorded. Nerve tracings were manually demarcated and imported into SolidWorks (Waltham, MA, USA) and Blender (Amsterdam, Netherlands) software programs to generate 3D reconstructions of autonomic nerve anatomy. RESULTS: Longitudinal and circular nerve tracings were successfully demarcated and converted into a 3D image reconstruction. We successfully precisely characterized anatomic nerve distributions. Axial cross-sections and 3D images showed that autonomic innervation was highly concentrated in the posterior aspect of the bladder neck in both male and female bladder specimens (Figures 1 and 2). The mean distances between autonomic nerve tissue and the bladder mucosa was 1.15mm posteriorly and 4.0mm anteriorly in the male bladder (0.27-2.87 vs. 2.03-6.20, pu003c0.001) and 1.51mm posteriorly and 1.83mm anteriorly in the female bladder (0.50-2.91 vs. 0.553.07, p1⁄40.027). CONCLUSIONS: Novel 3D reconstruction of the bladder is feasible and may help re-define our understanding of human bladder innervation. Autonomic innervation of the bladder is highly focused in the posterior aspect of the bladder neck in both male and female bladders. Source of Funding: None