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Morphometry of the obstructed detrusor: II. Principles of a comprehensive protocol

Morphologic studies on the obstructed detrusor have revealed several structural neuromuscular changes that must be evaluated quantitatively by morphometry to be functionally meaningful and clinically relevant. The peculiar structural organization of the detrusor poses important limitations to methods of morphometry that have withstood the test of time in other visceral smooth muscle systems, particularly the intestine. Because of this, conclusions in the literature about structure of the obstructed detrusor based on standard methods of morphometry are in many instances open to question. What is needed for scientifically credible morphometry of the detrusor is a comprehensive protocol that takes into consideration its peculiar structural organization and outlines the most appropriate methods for its processing and study within the context of the morphometric parameters to be evaluated. The principles of such a protocol will be presented in this report after a review of standard methods of morphometry and their applicability to the detrusor.