Oxidative Stress and Lower Urinary Tract Dysfunctions Primarily Found in Women

The incidence of lower urinary tract dysfunctions (LUTDs) in women increases with age. These dysfunctions include incontinence, recurrent urinary bladder infection, and poor bladder and urethral contraction. There is a corresponding progressive decrease in mean circulating estrogen as women age. We have data indicating that the rate at which LUTDs develop and progress is directly related to the decrease in circulating estrogen. Our studies on rabbits indicate that low circulating estrogen mediates a de crease in blood flow to the bladder and urethra. This in turn results in mucosal and smooth muscle hypoxia and the generation and release of free radicals. The end result is slow progressive oxidation damage of cellular and subcellular membranes (protein, lipids, and phospholipids), which relates directly to the etiology of age-related progressive LUTD. Estrogen administration to ovariectomized rabbits reverses these effects while causing smooth muscle hypertrophy, mucosal hyperplasia, increased vascularity and blood flow, fully oxygenated tissue, and reduced oxidative damage.