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At least 433 records · Page 24Linked to original sources
PubMed1985

The effect of parasympathetic decentralization on the feline urinary bladder.

To examine the pharmacologic nature of parasympathetic decentralization on feline vesical smooth muscle, male cats were subjected to bilateral ventral rhizotomy from levels lumbar 7 to coccygeal 1 and studied at 1 and 3 months. By employing manual bladder decompression twice daily, compensatory bladder hypertrophy was absent or minimal in all specimens. In vitro muscle bath studies of bladder body demonstrated no significant end organ pharmacologic supersensitivity to cholinergic or alpha and beta adrenergic stimulation. Membrane receptor assays displayed a rise in muscarinic cholinergic and beta adrenergic receptors at 1 month which decreased at 3 months. The cholinergic receptor data parallels ultrastructural studies which demonstrate early cholinergic nerve terminal degeneration after motor decentralization followed by subsequent regrowth of cholinergic axons. Alpha 1 and alpha 2 adrenergic receptor densities remained constant in control, 1 month, and 3 month preparations. This lack of classic end organ denervation supersensitivity in the decentralized urinary bladder suggests that other mechanisms may be responsible for eliciting a positive response with the clinical denervation supersensitivity test.

Animals↗
PubMed1984

The effect of short-term obstruction on urinary bladder function in the rabbit.

The effect of short term partial obstruction on urinary bladder function was studied in rabbits. After 1 week of partial bladder obstruction, the bladders were significantly hypertrophied with a mass over 9 times that of control bladders. The obstruction resulted in a marked decrease in both intracellular ATP and muscarinic receptor density. In vitro response of isolated smooth muscle strips from the obstructed bladder body to cholinergic stimulation was only 50 per cent of the response of control bladders. The obstructed bladder was able to expel only 28 per cent of its volume whereas control bladders expelled 100 per cent of their volume. The results of these studies demonstrate the rapid nature of the response of the bladder to chronic obstruction. Within 1 week frank hypertrophy and significant defects in the contractile ability of the bladder were evident.

Adenosine Triphosphate↗
PubMed1984

Malacoplakia associated with vesicoureteral reflux and selective immunoglobulin A deficiency.

A case of malacoplakia involving the lower urinary tract of a young black boy, with associated bilateral vesicoureteral reflux, hydronephrosis and selective immunoglobulin A deficiency is reported. Reflux was caused by the malacoplakia. Reflux and hydronephrosis persisted despite elimination of bacterial infection and malacoplakia by drug therapy. These abnormalities were corrected by a conventional antireflux operation. Malacoplakia appears to be related to immunologic incompetence and diminished levels of intracellular cyclic 3',5' guanine monophosphate. Cholinergic agonists reverse or prevent the pathological changes of malacoplakia.

Anti-Infective Agents, Urinary↗
PubMed1984

Urethral response during bladder contraction induced by subcutaneous bethanechol chloride: elicitation of a sympathetic reflex urethral constriction.

The responses of the urethra to bladder filling and to subcutaneous bethanechol were studied in a surgically separated bladder-urethra preparation in chloralose anesthetized cats. With the pudendal nerves cut or the neuromuscular junction blocked with gallamine, urethral closure pressure increased during bladder filling and the initial phase of the micturition contraction. It then fell spontaneously or in response to bladder emptying through a vent. With the bladder volume held constant subcutaneous bethanechol induced an increase in basal bladder pressure which culminated in a sustained (reflex) contraction. The urethral constrictor response resembled that seen during the cystometrogram; an increase during the rise in detrusor pressure and a fall during the latter part of the sustained (reflex) contraction. In both cases the urethral response was substantially depressed by hypogastric nerve transection or by intravenous prazosin, implying that the urethral responses were reflexly mediated through the sympathetic system. Intra-arterial bethanechol also produced a urethral constriction, but this response was abolished by atropine and not affected by hypogastric nerve section or prazosin. It is therefore concluded that although bethanechol can produce urethral constriction through a direct muscarinic action on the urethra, it does not do so after subcutaneous administration in a neurally intact cat. The urethral response seen after subcutaneous bethanechol administration is part of the micturition reflex complex and is sympathetically mediated.

Animals↗
PubMed1984

The urodynamic aspects of the Guillain-Barré syndrome.

A total of 7 patients with the Guillain-Barré syndrome and voiding dysfunction, large post-voiding residuals or urinary retention underwent urodynamic evaluation. Of the patients 4 had detrusor areflexia with a positive bethanechol supersensitivity test, including 3 with electromyographic evidence suggestive of neuropathy. This is the expected pattern in the Guillain-Barré syndrome. However, 3 patients had detrusor hyperreflexia with appropriate sphincteric relaxation, which was associated with Babinski's sign in 2. The presence of detrusor hyperreflexia suggests the possibility of Guillain-Barré pathological conditions involving the central nervous system, although the Guillain-Barré syndrome typically is a disease of the peripheral nervous system. Long-term urodynamic studies may help clarify such issues in future patients.

Adult↗
PubMed1983

Comparative pharmacological response of an in vitro whole bladder preparation (rabbit) with response of isolated smooth muscle strips.

Although much of our knowledge of the pharmacological response of the urinary bladder comes from in vitro muscle strip studies, it is not clear if these studies can be directly correlated with bladder function. We have compared the pharmacological response of an in vitro whole bladder model with the response of the standard muscle strip technique. The whole bladder model has the advantage of being able to measure both the isometric contractile response to drugs as well as a functional response in which the bladder can empty in the presence of a constant resistance. The results of these studies may be summarized as follows: 1) bethanechol was equipotent in contracting the muscle strips and in the closed whole bladder model; 2) at low and intermediate bladder volumes, the bladder fully emptied at concentrations of bethanechol significantly below the concentration required for maximal contraction; 3) isoproterenol, a potent beta-adrenergic agonist, stimulated a strong relaxation in muscle strips, whereas the whole bladder responded very poorly to isoproterenol; 4) in muscle strips isoproterenol strongly antagonized bethanechol contraction, whereas, in the whole bladder system, isoproterenol did not significantly antagonize bethanechol contraction; 5) methoxamine and adenosine triphosphate produced a moderate, equipotent contraction in both models.

Adenosine Triphosphate↗
PubMed1983

Malacoplakia of the bladder: a case report of resolution with bethanechol, trimethoprim-sulfamethoxazole and ascorbic acid.

Malacoplakia is a granulomatous disease that most frequently involves the urinary tract but also may involve the genital tract, gastrointestinal tract and retroperitoneum. It is believed to be infectious in origin, secondary to a deficiency of intracellular lysosomal digestion, and heretofore considered a chronic problem. We report a case of malacoplakia of the bladder, which was treated successfully with a combination of bethanechol, trimethoprim-sulfamethoxazole and ascorbic acid.

Anti-Infective Agents, Urinary↗
PubMed1983

Neurologic disease masquerading as genitourinary abnormality--the role of urodynamics in diagnosis.

While the great majority of patients with neurogenic bladder and sphincter dysfunction have identifiable neurologic disease a small group will present with obvious genitourinary problems caused by not so obvious neurologic conditions. Thirteen such patients are presented, with a discussion of the ability of various urodynamic tests to predict the presence of significant neurologic disease.

Adolescent↗
PubMed1983

Neurogenic detrusor areflexia: correlation of perineal electromyography and bethanechol chloride supersensitivity testing.

We investigated 63 patients with detrusor areflexia by cystometrography, perineal floor electromyography and bethanechol chloride supersensitivity testing. Of the patients 48 had unequivocal evidence of neuropathy, while 15 were neurologically normal and served as controls. The bethanechol chloride supersensitivity test was positive in 98 per cent of the patients and none of the controls, whereas neuropathic changes by electromyography were found in 67 per cent of the patients and 7 per cent of the controls. These findings suggest that the bethanechol chloride supersensitivity test is more sensitive and more specific than perineal floor electromyography in corroborating bladder neuropathy.

Adult↗
PubMed1983

Response of the urethral smooth muscles to pharmacological agents. I. Cholinergic and adrenergic agonists and antagonists.

We studied the effects of cholinergic and adrenergic agents on the 2 muscle layers of the proximal urethra of the cat. Strips were challenged with bethanechol chloride, phenylephrine and isoproterenol. Bethanechol chloride caused contraction of the longitudinally oriented strips; the circularly oriented strips revealed either minimal or no response to the same doses. The difference between the response of the 2 layers was highly significant (p less than 0.001). Phenylephrine stimulated both layers with a nonsignificant difference. Isoproterenol caused relaxation of both layers with a significant action on the circularly oriented fibers (p less than 0.05). It could be concluded that the cholinergic effect which is predominant on the longitudinal fibers is important for voiding by shortening the proximal urethra. alpha-adrenergic innervation of the bladder neck has a function during ejaculation: closure of the bladder outlet by the circular fibers. beta-adrenergic agonists decrease the urethral pressure probably by relaxing both layers with a dominant effect on the circular layer.

Animals↗
PubMed1982

Bethanechol chloride and the traumatic cord bladder.

The effect of bethanechol chloride was evaluated in 28 men with neurogenic bladder disease secondary to traumatic spinal cord damage. Simultaneous measurements of bladder pressure, electromyography of the pelvic floor and flow rate were obtained to evaluate the effect on voiding. The results of these studies revealed that bethanechol chloride failed to improve voiding dysfunction in these patients in either the supine or sitting position. Functional bladder outlet obstruction was aggravated by bethanechol chloride. It was found that the effect of this drug on the bladder was unpredictable, as evidenced by some patients converting from a definite detrusor contraction to a wave type pattern. Bethanechol chloride failed to induce a detrusor contraction in patients with areflexia or wave pattern bladders.

Adult↗
PubMed1982

Metabolic and contractile effects of anoxia on the rabbit urinary bladder.

The in vitro metabolic and contractile effects of anoxia and glucose deprivation on the rabbit urinary bladder were studied. The exposure of isolated strips of rabbit urinary bladder to a glucose deficient medium equilibrated with nitrogen rather than with oxygen resulted in 1) a rapid decrease in baseline tension, 2) a progressive decrease in the intracellular concentration of adenosine 5'-triphosphate (ATP) and progressive increases in the concentrations of adenosine 5'-monophosphate and adenosine 5'-diphosphate, 3) a rapid decrease in the ability of bethanechol to stimulate contractility, and 4) the inability of bethanechol to maintain a sustained increase in contractile force. Recovery from a 60-minute exposure of bladder strips to anoxia was characterized by a rapid recovery of the ability of the bladder to respond to bethanechol (50 per cent recovery occurring within 15 minutes) and a slightly slower recovery of the intracellular ATP level. Both the contractile response to bethanechol and the intracellular concentration of ATP returned to control levels within 60 minutes after the termination of anoxia.

Adenosine Diphosphate↗
PubMed1982

Response of the in vitro whole bladder (rabbit) preparation to autonomic agonists.

Using an in vitro whole bladder preparation (rabbit), we studied both the volume-pressure relationship and the response of the bladder to specific autonomic agonists. We determined the response in: 1) an isovolumetric system in which the intravesical pressure was monitored in the absence of volume changes; 2) a system in which volume alterations were monitored in the presence of increasing pressure; and 3) a system in which the bladder emptied in the presence of a constant pressure. The results of these studies demonstrated: 1) volume-pressure studies generated a typical cystometric curve; 2) bethanechol produced a dose-dependent increase in intravesical pressure (decrease in bladder volume); 3) the whole bladder responded very poorly to isoproterenol; and 4) methoxamine and ATP both produced a modest increase in intravesical pressure. One advantage of the "whole bladder" in vitro preparation is that it can objectively measure a functional response of the bladder to pharmacological agents.

Adenosine Triphosphate↗
PubMed1981

The effect of oral bethanechol chloride on voiding in female patients with excessive residual urine: a randomized double-blind study.

The usefulness of bethanechol chloride as a therapeutic adjunct in the treatment of patients with residual urine but no obstruction has been questioned. This study, in which oral bethanechol chloride was compared to a placebo in a randomized, double-blind fashion, does not show a significant short-term effect in female patients with persistent elevation in residual urine. No differences were seen in voided volume, residual volume, percentage residual volume, mean flow rate and intravesical pressure at 100 ml. volume and at maximal capacity when the treatment groups were compared to the group receiving the placebo.

Administration, Oral↗
PubMed1980

Neuropharmacologic evaluation in spinal cord injury patients using membrane catheter cystosphincterometry.

Synchronous cystosphincterometry with a membrane catheter was done on spinal cord injury patients. Bladder and urethral pressures were monitored quantitatively during vesical filling and emptying. Phentolamine, propantheline and bethanechol chloride were administered to selected patients with bladder and urethral dysfunction. The membrane catheter technique was an excellent method to evaluate the pharmacology of detrusor and urethral function.

Bethanechol Compounds↗