[Changes in intrinsic autonomic innervation in congenital or primary megabladder]

In eleven non-diabetic women suffering from high compliance bladder, the authors correlate urodynamic findings with the modifications of the autonomic vesical innervation. Endoscopic biopsies show a dramatic reduction in acetylcholinesterase-positive innervation in the detrusor but less visible in the trigone. The adrenergic network density is also reduced in both areas, according to age. Congenital conditions, high pressure mechanisms, vascular hypoxia explain these autonomic alterations inducing iatrogenic problems associated with different drug treatments. In some cases, urethral hypertonic instability acts in the same way as mechanical obstruction.