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Innervation of the child urinary bladder
Scandinavian Journal of Urology and Nephrology
|January 1, 1986
Summary
This study reveals acetylcholine as the primary neurotransmitter for detrusor muscle contraction in children, with VIP potentially modulating its action. Terodiline effectively inhibited bladder muscle activity, suggesting its therapeutic potential for diurnal enuresis.
Area of Science:
- Urology
- Neuropharmacology
- Pediatric Surgery
Background:
- Understanding bladder innervation is crucial for treating conditions like vesico-ureteric reflux.
- The role of various neurotransmitters in pediatric bladder function requires further elucidation.
Purpose of the Study:
- To investigate the neurochemical and neurophysiological properties of the pediatric bladder detrusor muscle.
- To assess the effects of specific drugs on bladder muscle activity.
Main Methods:
- Histochemical and immunohistochemical analysis of muscle strips from pediatric bladders.
- Organ bath studies involving electrical nerve stimulation.
- Pharmacological testing with acetylcholine, imipramine, and terodiline.
Main Results:
- Cholinergic nerves containing acetylcholine were abundant, mediating detrusor contraction.
- Vasoactive intestinal peptide (VIP) was found in some nerve terminals and modulated muscle activity.
- Adrenergic innervation was sparse; a novel beta-adrenergic receptor type was postulated.
- Terodiline demonstrated potent inhibition of all induced bladder muscle activities.
Conclusions:
- Acetylcholine is the main excitatory neurotransmitter in the pediatric detrusor muscle.
- VIP may act as a neuromodulator in the bladder.
- Terodiline's broad inhibitory action supports its use in treating diurnal enuresis.