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Related Experiment Videos

Outflow obstruction in neuropathic bladder dysfunction: the neuropathic urethra

G S Sunder, K F Parsons, N O Gibbon

    British Journal of Urology
    |May 1, 1978
    PubMed
    Summary

    Spinal cord injuries affect bladder control by altering urethral pressure profiles. Alpha-adrenergic blockers revealed differences in smooth muscle contributions and postural responses, suggesting decentralization supersensitivity.

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    Protocol of a prospective cohort study of the effect of different methods of drainage of neuropathic bladder on occurrence of symptomatic urinary infection, and adverse events related to the urinary drainage system in spinal cord injury patients.

    BMC urology·2001

    Area of Science:

    • Neuroscience
    • Urology
    • Physiology

    Background:

    • Traumatic spinal cord injuries frequently cause vesico-urethral dysfunction.
    • Understanding the neurogenic control of urethral pressure is crucial for managing bladder dysfunction.

    Purpose of the Study:

    • To investigate urethral pressure profiles in patients with spinal cord injuries.
    • To determine the smooth muscle contribution to maximum urethral pressure.
    • To explore postural effects on urethral pressure and their relation to lesion level.

    Main Methods:

    • Recording urethral pressure profiles in patients with traumatic spinal cord lesions.
    • Classifying patients based on lesion-related sympathetic outflow to the bladder and urethra.
    • Administering alpha-adrenergic blocking agents to assess smooth muscle contribution.

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  • Investigating changes in maximum urethral pressure with postural variations.

    • Main Results:

    • Differences in urethral pressure profile configuration and smooth muscle component were observed between patient groups.
    • The increase in maximum urethral pressure upon postural change varied significantly with spinal lesion level and sacral reflex integrity.
    • Smooth muscle contribution to urethral pressure was modulated by the sympathetic nervous system.

    Conclusions:

    • Urethral pressure dynamics are significantly altered by spinal cord injuries.
    • Sympathetic and cholinergic pathways play critical roles in maintaining urethral closure and responding to postural changes.
    • The findings support a hypothesis of urethral decentralization supersensitivity due to altered catecholamine levels.