scholarly journals OAB without an overactive bladder in the acute prostaglandin E2 rat model

2017 ◽  
Vol 313 (5) ◽  
pp. F1169-F1177 ◽  
Author(s):  
James A. Hokanson ◽  
Christopher L. Langdale ◽  
Arun Sridhar ◽  
Warren M. Grill
Keyword(s):  
Overactive Bladder ◽  
Prostaglandin E2 ◽  
Perfusion Pressure ◽  
Bladder Dysfunction ◽  
Bladder Capacity ◽  
Wistar Rat ◽  
Bladder Compliance ◽  
Urethral Smooth Muscle ◽  
Proximal Urethra ◽  
Promising Avenue

Intravesical prostaglandin E2 (PGE2) was previously used to induce overactive bladder (OAB) symptoms, as it reduces bladder capacity in rats and causes a “strong urgency sensation” in healthy women. However, the mechanism by which this occurs is unclear. To clarify how PGE2 reduces bladder capacity, 100 µM PGE2 was administered intravesically during open, single-fill cystometry with simultaneous measurement of sphincter EMG in the urethane-anesthetized female Wistar rat. PGE2 was also applied to the urethra or bladder selectively by use of a ligature at the bladder neck before (urethra) or during (bladder) closed-outlet, single-fill cystometry. Additional tests of urethral perfusion with PGE2 were made. PGE2 decreased bladder capacity, increased voiding efficiency, and increased sphincter EMG during open cystometry compared with saline controls. The number of nonvoiding contractions did not change with PGE2; however, bladder compliance decreased. During closed-outlet cystometry, PGE2 applied only to the bladder or the urethra did not decrease bladder capacity. Urethral infusion of PGE2 decreased urethral perfusion pressure. Taken together, these results suggest that intravesical PGE2 may decrease bladder capacity by targeting afferents in the proximal urethra. This may occur through urethral relaxation and decreased bladder compliance, both of which may increase activation of proximal urethra afferents from distension of the proximal urethra. This hypothesis stands in contrast to many hypotheses of urgency that focus on bladder dysfunction as the primary cause of OAB symptoms. Targeting the urethra, particularly urethral smooth muscle, may be a promising avenue for the design of drugs and devices to treat OAB.

Effects of Intravesical Prostaglandin E2 on Bladder Function are Preserved in Capsaicin-Desensitized Rats

2020 ◽  
Author(s):  
James A. Hokanson ◽  
Christopher L Langdale ◽  
Philip H Milliken ◽  
Arun Sridhar ◽  
Warren M. Grill
Keyword(s):  
Perfusion Pressure ◽  
Bladder Capacity ◽  
Female Rats ◽  
Bladder Function ◽  
Prostaglandin E ◽  
Urethral Pressure ◽  
Urinary Urgency ◽  
Hypogastric Nerve ◽  
C Fibers ◽  
Bladder Compliance

Prostaglandin E2 (PGE2) instilled into the bladder generates symptoms of urinary urgency in healthy women and reduces bladder capacity and urethral pressure in both humans and female rats. Systemic capsaicin desensitization, which causes degeneration of C-fibers, prevented PGE2 mediated reductions in bladder capacity, suggesting that PGE2 acts as an irritant (Maggi et al.1988). In the present study, we instilled PGE2 in female rats after capsaicin desensitization, but without the hypogastric nerve transection that was conducted in the Maggi et al. study. One week after capsaicin injection (125 mg/kg, SC) rats underwent cystometric and urethral perfusion testing under urethane anesthesia with saline and 100 µM PGE2. Similar to naïve rats, capsaicin-desensitized rats exhibited a reduction in bladder capacity from 1.24 ± 0.13 ml to 0.70 ± 0.10 ml (P=0.002, n=9), a reduction in urethral perfusion pressure from 19.3 ± 2.1 cmH2O to 10.9 ± 1.15 cmH2O (P=0.004, n=9), and a reduction in bladder compliance from 0.13 ± 0.020 ml/cmH2O to 0.090 ± 0.014 ml/cmH2O (P=0.011, n=9). Thus, changes in bladder function following the instillationof PGE2 were not dependent on capsaicin-sensitive pathways. Further, these results suggest that urethral relaxation/weakness and/or increased detrusor pressure as a result of decreased compliance may contribute to urinary urgency and highlight potential targets for new therapies for overactive bladder.

Combination of bladder ultrasonography and novel cystometry method in mice reveals rapid decrease in bladder capacity and compliance in LPS-induced cystitis

2014 ◽  
Vol 307 (2) ◽  
pp. F234-F241 ◽  
Author(s):  
Kentaro Takezawa ◽  
Makoto Kondo ◽  
Hiroshi Kiuchi ◽  
Tetsuji Soda ◽  
Tetsuya Takao ◽  
...  
Keyword(s):  
Bladder Dysfunction ◽  
Bladder Wall ◽  
Bladder Capacity ◽  
Rapid Decrease ◽  
Bladder Function ◽  
Functional Changes ◽  
Pressure Threshold ◽  
Bladder Compliance ◽  
Conventional Methods ◽  
Voided Volume

Various animal models have been used in research into bladder dysfunction, and in vivo cystometry is a common method to analyze bladder function in animals. However, it is rather difficult to perform reliably in small animals. Transabdominal bladder ultrasonography combined with cystometry in urethane-anesthetized mice have revealed physical inhibition of bladder wall movement by a bladder catheter conventionally placed in the bladder apex. For reliable evaluation of mouse lower urinary tract function, we established a novel cystometry method in which a catheter was placed in the bladder anterior wall, in combination with bladder ultrasonography. This new method allowed the bladder to be well distended (i.e., larger maximum bladder capacity, lower pressure threshold, higher voided volume, and higher bladder compliance compared with conventional methods), which reflected more spontaneous voiding than conventional cystometry methods. We also demonstrated the usefulness of bladder ultrasonography for analysis of mouse bladder function, especially bladder dynamics, maximum bladder capacity, and post-voiding residual volume. We analyzed bladder functional changes in lipopolysaccharide (LPS)-induced cystitis by combining bladder ultrasonography and this new cystometry method. Bladder ultrasonography revealed a rapid decrease in bladder capacity, and cystometry showed a rapid decrease in voided volume due to intravesical LPS instillation. This new cystometry method also revealed a rapid decrease in bladder compliance caused by LPS instillation, which was not detectable by conventional methods. The combination of ultrasonography and the new cystometry method may become a powerful tool for analysis of mouse bladder function and could contribute to the development of new treatments for bladder dysfunction.

Introduction to sacral neuromodulation therapy for urinary bladder dysfunction using an InterStim system

2020 ◽  
Vol 29 (9) ◽  
pp. S23-S26 ◽  
Author(s):  
Frances Harries
Keyword(s):  
Breast Cancer ◽  
Urinary Bladder ◽  
Overactive Bladder ◽  
Sacral Neuromodulation ◽  
Bladder Dysfunction ◽  
Queen Elizabeth Hospital ◽  
Urinary Bladder Dysfunction ◽  
Satisfaction With Treatment ◽  
Bladder Symptoms ◽  
The Individual

Sacral neuromodulation is an internationally endorsed therapy recognised by the National Institute for Health and Care Excellence for patients who have refractory overactive bladder symptoms and/or idiopathic non-obstructive urinary retention when conservative treatments have failed or when patients have been unable to tolerate them. The Medtronic InterStim System used at the Queen Elizabeth Hospital Birmingham received CE mark approval in 1995 for bladder indications. To date, over 300 000 patients worldwide have been treated, with 61–90% reporting satisfaction with treatment ( Sutherland et al, 2007 ; Leong et al, 2011 ). It is a safe and effective intervention that can positively impact upon the management of both of these conditions, in particular overactive bladder. This highly prevalent condition is distressing to the individual and has an economic burden to society comparable in magnitude with that of breast cancer and osteoporosis ( Hu and Wagner, 2005 ).

scholarly journals Role of Phosphodiesterase Inhibitors in Improving Urodynamic Parameters in Patients with Spinal Cord Injury: A Preliminary Report

2020 ◽  
Vol 09 (01) ◽  
pp. 30-34
Author(s):  
Muzzain Iqbal ◽  
Sarbjit Singh Chhiber ◽  
Baldev Singh Wazir ◽  
Altaf Umar Ramzan ◽  
Mohammad Saleem Wani
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Oral Dose ◽  
Single Oral Dose ◽  
Bladder Capacity ◽  
Final Conclusion ◽  
Bladder Compliance ◽  
Cord Injury ◽  
Urodynamic Parameters

Abstract Objective To analyze role of phosphodiesterase 5 (PDE5) inhibitors on urodynamic parameters in patients with suprasacral spinal cord injury. Materials and Methods This was a prospective observational hospital-based study conducted on a cohort of patients, aged between 18 and 65 years with suprasacral spinal cord injury, who were registered in Department of Neurosurgery/Urology. Cutoff period since injury was 2 years. After taking consent, baseline urodynamic study was performed, which was repeated 2 hours after taking single oral dose of 20 mg tadalafil. Urodynamic parameters such as maximum detrusor filling/voiding pressures, maximum bladder capacity, and bladder compliance before and after taking drug were compared for final results and conclusion. Results Following administration of 20 mg of tadalafil, maximum bladder capacity in mL showed statistically significant improvement from 268.39 ± 130.0 to 298.55 ± 112.0.(p < 0.05). Bladder compliance improved from 18.68 ± 6.4 to 20.25 ± 7.5 mL/cm H2O (p > 0.05). Maximum detrusor filling pressure improved from 36.03 ± 20.54 to 32.90 ± 16.47 cm H2O (p > 0.05). Maximum detrusor voiding pressure improved from 64.65 ± 33.19 to 58.13 ± 20.7 cm H2O (0 > 0.05). In patients with injury above D6 spinal cord level, statistically significant improvement was seen in maximum bladder capacity and bladder compliance after 2 hours of single oral dose of tadalafil (p < 0.05). Conclusion Our study suggests a positive role of PDE inhibitors in improving urodynamic parameters in patients with suprasacral spinal cord injury with improvement in parameters such as bladder capacity, detrusor pressures, and bladder compliance. Because this is a small study group, more studies such as this are required to reach to final conclusion.

Epidural Electrical Stimulation on Neurogenic Bladder

1993 ◽  
Vol 60 (1) ◽  
pp. 87-89 ◽  
Author(s):  
C. Simeone ◽  
E. Frego ◽  
T. Zanotelli ◽  
R. Capra ◽  
A. Lenzi ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Electrical Stimulation ◽  
Beneficial Effect ◽  
Bladder Dysfunction ◽  
Bladder Capacity ◽  
Bladder Function ◽  
Complete Relief ◽  
Detrusor Sphincter Dyssynergia ◽  
Thoracic Level ◽  
Stimulation Of

In 1967 Shealy first used electrical stimulation of the spinal cord to treat spasticity and pain. This therapy proved to be effective for bladder dysfunction too. The effect of electrical stimulation of the spinal cord at thoracic level has been evaluated in 18 neurogenic patients suffering from hyperreflexia with detrusor-sphincter dyssynergia. Bladder function improved significantly in 13 (73%). Partial or complete relief of bladder hyperreflexia, marked increased of bladder capacity and reduction of residual urine were recorded. The beneficial effect of stimulation indicates that it is a safe and effective alternative treatment for the neuropathic bladder and careful trials with further investigations should be carried out.

BPH with coexisting overactive bladder dysfunction?an everyday urological dilemma

2001 ◽  
Vol 20 (3) ◽  
pp. 237-247 ◽  
Author(s):  
Tomas Knutson ◽  
Christer Edlund ◽  
Magnus Fall ◽  
Christer Dahlstrand
Keyword(s):  
Overactive Bladder ◽  
Bladder Dysfunction

Differential sacral rhizotomy in the treatment of neurogenic bladder dysfunction

1973 ◽  
Vol 38 (6) ◽  
pp. 748-754 ◽  
Author(s):  
Gaylan L. Rockswold ◽  
William E. Bradley ◽  
Shelley N. Chou
Keyword(s):  
Neurogenic Bladder ◽  
Bladder Dysfunction ◽  
Operative Procedure ◽  
Bladder Capacity ◽  
Neurogenic Bladder Dysfunction ◽  
Nerve Blocks ◽  
Content Type ◽  
Sphincter Function ◽  
Sacral Nerve ◽  
Detrusor Hyperreflexia

✓ This report describes a technique of differential sacral rhizotomy for the treatment of neurogenic bladder dysfunction, particularly symptoms of frequency, urgency, and incontinence due to detrusor hyperreflexia. Under cystometric control, the sacral nerve roots are stimulated and anesthetized to determine the correct roots for section. Under magnification, cutting a few but not all of the fascicles in one or two roots increases bladder capacity while preserving detrusor reflex and sphincter function. Air cystometry and selective percutaneous sacral nerve blocks are used preoperatively to determine whether the operative procedure could be of value in relieving the symptoms. Our experience with six patients so evaluated and treated has been encouraging.

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