Noradrenergic innervation of the human bladder in neurogenic dysfunction

The purpose of this investigation has been to determine the distribution of noradrenergic nerves in biopsy samples of the urinary bladder obtained from a total of 34 patients with neurogenic bladder disorders. On the basis of clinical evaluation, 12 patients were classified as having neurological lesions of the lower motor neuron type, the remainder consisted of cases of partial or complete spinal cord injury at various segmental levels. Irrespective of the type of neurological lesion, all specimens of posterior bladder wall and trigone contained few noradrenergic nerves. The smooth muscle bundles were rarely associated with this type of nerve and those fibers which were observed usually accompanied the vascular study of the region. These findings are indistinguishable from the results obtained in normal subjects and indicate that the sparse peripheral distribution of vesical noradrenergic nerves is unaffected in cases of neurogenic bladder dysfunction.