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Changes in bladder tone during filling: pharmacological aspects.
1Department of Clinical Pharmacology, Lund University Hospital, Sweden. Karl-Erik.Andersson@klinfarm.In.se
Scandinavian Journal of Urology and Nephrology. Supplementum
|November 26, 1999
Summary
Bladder filling involves complex mechanisms, including sympathetic nerve activity and potential unidentified relaxant factors. Further research is needed to understand these processes and their therapeutic potential.
Area of Science:
- Urology
- Neuroscience
- Pharmacology
Background:
- The precise mechanisms regulating low bladder pressure during filling remain unclear.
- Both myogenic and neural factors are implicated, but their relative contributions are not well-defined.
Purpose of the Study:
- To explore the neural and non-neural factors contributing to bladder relaxation during the filling phase.
- To investigate the role of sympathetic outflow, neurotransmitters like noradrenaline, and potential unidentified relaxant factors.
Main Methods:
- Review of existing literature on sympathetic and parasympathetic control of the lower urinary tract.
- Analysis of the roles of adrenoceptors (beta and alpha), nitric oxide, vasoactive intestinal polypeptide, and acetylcholine (ACh).
Main Results:
- Sympathetic noradrenaline release acting on beta-adrenoceptors may relax the detrusor due to beta- over alpha-adrenoceptor dominance.
- Evidence for non-adrenergic, non-cholinergic mediators is limited; unidentified relaxant factors may exist.
- Evidence suggests ongoing, albeit low-level, acetylcholine-mediated detrusor stimulation during filling, implying potential for ACh release inhibition.
Conclusions:
- Bladder filling likely involves a balance of sympathetic relaxation and potential ongoing cholinergic stimulation.
- Further investigation into unidentified relaxant factors and mechanisms inhibiting ACh release is warranted for therapeutic development.