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Bladder outflow obstruction--a cause of denervation supersensitivity
M J Speakman1, A F Brading, C J Gilpin
1Department of Urology, Churchill Hospital, Oxford, England.
The Journal of Urology
|December 1, 1987
Summary
Partial bladder outflow obstruction in pigs caused increased voiding pressures and bladder instability. These findings suggest bladder smooth muscle stabilizers may treat detrusor instability from obstruction.
Area of Science:
- Urology
- Veterinary Medicine
- Physiology
Background:
- Bladder outflow obstruction is a common condition.
- Detrusor instability is a frequent complication of bladder outflow obstruction.
- Understanding the pathophysiology is crucial for effective treatment.
Purpose of the Study:
- To investigate the physiological and morphological changes in the bladder following experimental partial bladder outflow obstruction in pigs.
- To explore the mechanisms underlying detrusor instability in this model.
Main Methods:
- Partial bladder outflow obstruction was surgically induced in Landrace pigs and Göttingen mini-pigs.
- Animals were assessed using cystometry, physiological measurements, and morphological analysis.
- In vitro studies examined smooth muscle sensitivity to agonists and nerve stimulation.
Main Results:
- Obstructed animals exhibited increased voiding pressures and reduced flow rates.
- Seventy-seven percent of obstructed animals displayed cystometric evidence of bladder instability.
- In vitro studies revealed increased agonist sensitivity and decreased nerve stimulation sensitivity, consistent with post-junctional supersensitivity due to partial denervation.
Conclusions:
- Experimental bladder outflow obstruction leads to significant functional and structural changes in the bladder.
- These changes, including detrusor instability, are linked to partial denervation and supersensitivity.
- Agents stabilizing the bladder smooth muscle membrane may offer a therapeutic strategy for detrusor instability associated with bladder outflow obstruction.