ABSTRACT
Answer: (c)Muchevidencesupportsthe notion of a bladder wall microcirculation which serves to maintain adequate oxygen tension within the bladder wall during normal filling cycles. Lapides 1 first suggested nearly 40 years ago that outlet obstruction resulted in bladder wall hypoxia, and modern molecular and physiology studies demonstrate he was correct. The cyclic drop in perfusion followed by reperfusion leads to free-radical-mediated damage. Partial outlet obstruction leading to the end-stage bladder is clearly associated with significant increases in smooth muscle bundle size, extracellular matrix deposition, postvoid residual urine, and a postobstructive diuresis.
