[Pharmacologic modification of ureteral activity].

Area of Science:

• Urology
• Physiology
• Pharmacology

Context:

• The renal pelvis and ureter form a functional system responsible for urine transport.
• Autonomic nervous system (ANS) significantly modulates pyeloureteral activity via adrenergic and cholinergic pathways.
• Emerging evidence suggests the existence of non-adrenergic, non-cholinergic (NANC) systems influencing ureteral function.

Purpose:

• To investigate the physiological mechanisms governing renal pelvis and ureter activity.
• To explore the modulatory effects of various neurochemicals and pharmacological agents on pyeloureteral function.
• To assess the potential for direct therapeutic intervention targeting ureteral activity.

Summary:

• Pyeloureteral activity is myogenic, modulated by ANS (alpha-adrenergic and cholinergic stimulation; beta-adrenergic inhibition).
• Vasoactive intestinal peptide (VIP) and calcium antagonists (e.g., nifedipine) directly inhibit ureteral activity.
• Therapeutic modulation is challenging; glucagon and prostaglandin antagonists show potential but have limitations.

Impact:

• Provides insights into the complex neuropharmacology of the upper urinary tract.
• Highlights the limited efficacy of direct therapeutic interventions for ureteral colic or stone expulsion.
• Suggests potential avenues for drug development targeting ureteral smooth muscle relaxation.