Oestrogen and progesterone receptor expression in the female lower urinarytract, with reference to oestrogen status

Objective To assess the incidence and distribution of both oestrogen and pr ogesterone receptors throughout the female lower urinary tract, and to comp are receptor expression in women of varying oestrogen status. Patients and methods The study included 90 women undergoing surgery for uro gynaecological conditions; 33 were premenopausal, 26 postmenopausal and tak ing no oestrogen supplementation, and 31 postmenopausal and receiving some form of hormone-replacement therapy. Biopsies were taken during surgery fro m the bladder dome, trigone, proximal urethra, distal urethra, vagina and v esicovaginal fascia in the region of the bladder neck. All biopsies were ro utinely fixed and processed for histopathological assessment and were then labelled immunohistochemically with monoclonal antibodies directed against human oestrogen (NCL-ERLH2) and progesterone (NCL-PGR) receptors. Both oest rogen and progesterone receptor expression were assessed in the epithelial, subepithelial and muscle/deeper fascial regions of all tissue for overall tissue positivity for each receptor, and by semiquantitative analysis of re ceptor concentration using histochemical scoring of the tissues. Results Oestrogen receptors were consistently detected in the squamous epit helia and were consistently absent in the urothelial tissues of the lower u rinary tract of all women irrespective of oestrogen status: there was no si gnificant variation in histological score. Progesterone receptor expression was more variable, being mostly subepithelial, and significantly lower in postmenopausal women receiving no oestrogen replacement. Conclusion These findings confirm the female lower urinary tract to be a ta rget organ far the action of oestrogen and progesterone, and shed further l ight on the areas of the lower urinary tract likely to respond to hormone-r eplacement therapy. This may have implications for the use of oestrogen sup plementation in the treatment of lower urinary tract disorders of postmenop ausal women.