483 Impairment of bladder neck innervation upon bladder outlet obstruction contributes to the development of erectile dysfunction

2012 ◽  
Vol 11 (1) ◽  
pp. e483-e483a
Author(s):  
A.P. Malykhina ◽  
S. Chang ◽  
Q. Lei ◽  
J. Hypolite ◽  
A. Seftel
Keyword(s):  
Erectile Dysfunction ◽  
Bladder Neck ◽  
Bladder Outlet Obstruction ◽  
Outlet Obstruction

scholarly journals Bladder outlet obstruction triggers neural plasticity in sensory pathways and contributes to impaired sensitivity in erectile dysfunction

2013 ◽  
Vol 304 (10) ◽  
pp. R837-R845 ◽  
Author(s):  
Anna P. Malykhina ◽  
Qi Lei ◽  
Shaohua Chang ◽  
Xiao-Qing Pan ◽  
Antonio N. Villamor ◽  
...  
Keyword(s):  
Smooth Muscle ◽  
Erectile Dysfunction ◽  
Urinary Bladder ◽  
Bladder Neck ◽  
Bladder Outlet Obstruction ◽  
Corpus Cavernosum ◽  
Outlet Obstruction ◽  
Nerve Damage ◽  
Sensory Innervation ◽  
Sensory Neuropeptides

Lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are common problems in aging males worldwide. The objective of this work was to evaluate the effects of bladder neck nerve damage induced by partial bladder outlet obstruction (PBOO) on sensory innervation of the corpus cavernosum (CC) and CC smooth muscle (CCSM) using a rat model of PBOO induced by a partial ligation of the bladder neck. Retrograde labeling technique was used to label dorsal root ganglion (DRG) neurons that innervate the urinary bladder and CC. Contractility and relaxation of the CCSM was studied in vitro, and expression of nitric oxide synthase (NOS) was evaluated by Western blotting. Concentration of the sensory neuropeptides substance P (SP) and calcitonin gene-related peptide was measured by ELISA. Partial obstruction of the bladder neck caused a significant hypertrophy of the urinary bladders (2.5-fold increase at 2 wk). Analysis of L6-S2 DRG sections determined that sensory ganglia received input from both the urinary bladder and CC with 5–7% of all neurons double labeled from both organs. The contractile responses of CC muscle strips to KCl and phenylephrine were decreased after PBOO, followed by a reduced relaxation response to nitroprusside. A significant decrease in neuronal NOS expression, but not in endothelial NOS or protein kinase G (PKG-1), was detected in the CCSM of the obstructed animals. Additionally, PBOO caused some impairment to sensory nerves as evidenced by a fivefold downregulation of SP in the CC ( P ≤ 0.001). Our results provide evidence that PBOO leads to the impairment of bladder neck afferent innervation followed by a decrease in CCSM relaxation, downregulation of nNOS expression, and reduced content of sensory neuropeptides in the CC smooth muscle. These results suggest that nerve damage in PBOO may contribute to LUTS-ED comorbidity and trigger secondary changes in the contraction/relaxation mechanisms of CCSM.

scholarly journals Transurethral Incision of the Bladder Neck in a Woman with Primary Bladder Neck Obstruction after Kidney Transplantation

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Dean Markić ◽  
Maksim Valenčić ◽  
Anton Maričić ◽  
Kristian Krpina ◽  
Dražen Rahelić ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Bladder Neck ◽  
Bladder Outlet Obstruction ◽  
Voiding Dysfunction ◽  
Outlet Obstruction ◽  
Postvoid Residual Urine ◽  
Bladder Neck Obstruction ◽  
Primary Bladder ◽  
Primary Bladder Neck Obstruction ◽  
Transurethral Incision

Voiding dysfunction is frequently seen in the early posttransplant period. Among other causes, this condition can arise due to bladder outlet obstruction. Primary bladder neck obstruction (PBNO) is a possible but very rare cause of bladder outlet obstruction. We present the case of a 52-year-old woman who, after kidney transplantation, presented with PBNO. The diagnosis was established based on symptoms, uroflowmetry, and multichannel urodynamics with electromyography. The transurethral incision of the bladder neck was made at the 5- and 7-o’clock position. After the operation, the maximal flow rate was significantly increased, and postvoid residual urine was decreased compared to the preoperative findings. The patient was followed for 5 years, and her voiding improvement is persistent. This is the first reported case of PBNO treated with a transurethral incision of the bladder neck in a posttransplantation female patient.

A CRITICAL EVALUATION OF URETHRAL OBSTRUCTION IN FEMALE CHILDREN

PEDIATRICS ◽  
1973 ◽  
Vol 51 (2) ◽  
pp. 272-277
Author(s):  
Dixon Walker ◽  
George A. Richard
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Bladder Neck ◽  
Bladder Outlet Obstruction ◽  
Critical Evaluation ◽  
Outlet Obstruction ◽  
Significant Degree ◽  
Surgical Correction ◽  
Female Children ◽  
Tract Infections

In this article we have attempted to partially review the literature in regard to bladder outlet obstruction in female children. It should be reiterated that, despite the great amount of information available and the number of studies done, when subjected to critical evaluation, there is no distinctive study at this time which clearly indicates that routine surgical correction, either by bladder neck revision, dilation, urethrotomy, or meatotomy, alters the course of recurrent urinary tract infections to any significant degree.

EFFECT OF SYSTEMIC NITRIC OXIDE AUGMENTATION IN PATIENTS WITH BLADDER OUTLET OBSTRUCTION DUE TO SPASTIC BLADDER NECK

2008 ◽  
Vol 179 (4S) ◽  
pp. 443-443
Author(s):  
Sharmistha G Roy-Guggenbuehl ◽  
Michael Muntener ◽  
Tullio Sulser ◽  
Brigitte Schurch ◽  
Daniel M Schmid
Keyword(s):  
Nitric Oxide ◽  
Bladder Neck ◽  
Bladder Outlet Obstruction ◽  
Outlet Obstruction

scholarly journals Devastated Bladder Outlet in Pelvic Cancer Survivors: Issues on Surgical Reconstruction and Quality of Life

2021 ◽  
Vol 10 (21) ◽  
pp. 4920
Author(s):  
Francisco E. Martins ◽  
Henriette Veiby Holm ◽  
Nicolaas Lumen
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Urinary Diversion ◽  
Bladder Neck ◽  
Bladder Outlet Obstruction ◽  
Outlet Obstruction ◽  
Surgical Reconstruction ◽  
Pelvic Cancer ◽  
Posterior Urethra

Bladder outlet obstruction following treatment of pelvic cancer, predominantly prostate cancer, occurs in 1–8% of patients. The high incidence of prostate cancer combined with the long-life expectancy after treatment has increased concerns with cancer survivorship care. However, despite increased oncological cure rates, these adverse events do occur, compromising patients’ quality of life. Non-traumatic obstruction of the posterior urethra and bladder neck include membranous and prostatic urethral stenosis and bladder neck stenosis (also known as contracture). The devastated bladder outlet can result from benign conditions, such as neurogenic dysfunction, trauma, iatrogenic causes, or more frequently from complications of oncologic treatment, such as prostate, bladder and rectum. Most posterior urethral stenoses may respond to endoluminal treatments such as dilatation, direct vision internal urethrotomy, and occasionally urethral stents. Although surgical reconstruction offers the best chance of durable success, these reconstructive options are fraught with severe complications and, therefore, are far from being ideal. In patients with prior RT, failed reconstruction, densely fibrotic and/or necrotic and calcified posterior urethra, refractory incontinence or severe comorbidities, reconstruction may not be either feasible or recommended. In these cases, urinary diversion with or without cystectomy is usually required. This review aims to discuss the diagnostic evaluation and treatment options for patients with bladder outlet obstruction with a special emphasis on patients unsuitable for reconstruction of the posterior urethra and requiring urinary diversion.

Alfuzosin attenuates erectile dysfunction in rats with partial bladder outlet obstruction

2008 ◽  
Vol 102 (11) ◽  
pp. 1651-1657 ◽  
Author(s):  
Serap Gur ◽  
Suresh C. Sikka ◽  
Surabhi Chandra ◽  
Padma Sandeep Koka ◽  
Krishna C. Agrawal ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Bladder Outlet Obstruction ◽  
Outlet Obstruction ◽  
Partial Bladder Outlet Obstruction
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