Congenital urethral valves and a dysfunctional sphincter after spina bifida are the two major causes for a partial urethral obstruction in children, causing bladder dysfunction. The aim of this study is to find a solution to get this insight in the development of bladder damage and the further course of bladder functional development during and after intervention. This thesis describes two main research lines: the first investigates the correlation between bladder function and bladder structure, paying particular attention to the role of ischemia. An animal model was used that allowed us to simulate a partial obstruction of the urethra and monitor changes in bladder function over time. We have found a relationship between the severity of ischemic periods, characterized by the number of glycogen deposits, and the level of functional changes. The second main study outline was to apply determination of glycogen deposits in a clinical set up and in a non-destructive manner, thus without the need for biopsies. For this we studied the possibilities of Raman spectroscopy. In vitro Raman spectroscopy was successfully used to determine structural changes in ! tissue sections in a non-destructive manner and it initiated the study for the scoring of glycogen granules related to bladder function. Additionally, bladder tumor and non-tumor tissue areas were successfully discriminated with Raman mapping. Spectral analysis revealed the compositional basis for this. The techniques used and findings presented in this thesis are the basis for further research in order to develop the scoring of glycogen deposits as a measure for historic bladder function into a clinical application.

Raman spectroscopy, bladder dysfunction, glycogen, ischemia, partial obstruction, structure analysis
R. van Mastrigt (Ron)
Erasmus University Rotterdam
Mastrigt, Prof. Dr. Ir. R. van (promotor), Dutch Kidney Foundation (NSN), Stichting Urologisch Wetenschappelijk Onderzoek
978-90-90-22917-1
hdl.handle.net/1765/12280
Erasmus MC: University Medical Center Rotterdam

de Jong, B.W.D. (2008, May 7). Tissue Structure Analysis in Urological Dysfunctions. Erasmus University Rotterdam. Retrieved from http://hdl.handle.net/1765/12280