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Partial outlet obstruction induces chronic distension and increased stiffness of rat urinary bladder.

In order to identify the passive properties of the bladder during filling, we measured cystometrograms (CMGs) of rat urinary bladders that had been outlet obstructed for 6 weeks and age-matched controls in conscious, unrestrained animals and in fully relaxed whole bladders in an organ bath. In the organ bath, each bladder was allowed to empty passively at zero transmural pressure. The volume remaining was labelled zero pressure volume (ZPV) and was used as the reference volume to normalize contained volume, deriving wall stretch. Increased ZPV implies that the bladder contains more urine at low stresses and therefore is more distended. In awake animals, the obstructed bladder CMGs showed spontaneous contractions. The pressures between contractions were similar to those in CMGs performed in the organ bath, suggesting that passive properties determine the minimum pressures during filling in vivo. The ZPV of the obstructed and control bladders was 1.07 +/- 0.12 ml and 0.07 +/- 0.01 ml, respectively. The differences were significant (P < 0.01). The ZPV correlated with bladder weight and thus with degree of hypertrophy. Under conditions when weight cannot be determined, e.g., clinically, ZPV may provide a useful measure of the degree of chronic distension and bladder hypertrophy. The pressure-volume curves of the obstructed bladder CMGs in vitro varied between preparations. However, when pressure-volume was converted to stress-stretch using the law of Laplace, the obstructed bladders were all significantly stiffer than the controls. We confirmed this result by step-stretching relaxed bladder strips. The obstructed bladder strips again demonstrated stiffer stress-stretch curves than the controls.

Animals↗

Histology of the kidney and urinary bladder of Siphonops annulatus (Amphibia-Gymnophiona).

The histology of the kidney and urinary bladder of Siphonops annulatus was studied by light microscopy in semithin sections of tissue embedded in hydrophilic resin. The kidney's nephron comprises the renal corpuscle, neck segment, proximal tubule, intermediate segment, distal tubule and collecting tubule. Nephrostomes are present. This structure, the neck segment, and intermediate tubules present long cilia, and probably play important roles in the propulsion of the peritoneal fluid and glomerular filtrate. The proximal tubule cells possess loosely packed microvilli and contain abundant polymorphic granules and vesicles that assume the aspect of lysosomes in different stages of intracellular digestion. The distal tubules are characterized by large, vertically disposed mitochondria assuming the aspect of ions transporting cells. The urinary bladder is lined with a transitional epithelium, whose aspect varies according to the quantity of urine.

Amphibians↗

Phase II study of a new combined primary chemotherapy regimen, intravenous methotrexate and vincristine and intraarterial adriamycin and cisplatin, for locally advanced urinary bladder cancer: preliminary results.

A phase II study of a new combination therapy was performed using intraarterial (i.a.) cisplatin and Adriamycin in combination with i.v. methotrexate and vincristine for 27 patients with invasive urinary bladder carcinoma of stages T2-3NOMO, and the therapeutic effects were assessed. Methotrexate (20 mg/m2) was given i.v. on days 1,15, and 22, and vincristine (0.7 mg/m2) was injected i.v. on day 2 before i.a. infusion therapy and on days 15 and 22. The i.a. chemotherapy was performed after both superior gluteal arteries had been embolized using 3- or 5-mm stainless-steel coils. A mixture of cisplatin (50-70 mg/m2) and Adriamycin (20 mg/m2) was infused i.a. via both internal iliac arteries over a period of 20-30 min. Angiotensin II (mean dose, 21 micrograms) was simultaneously infused i.a. in 15 of 27 patients. In 24 of the 27 patients, at least 2 cycles of full-dose chemotherapy were completed. The dose was decreased in the remaining 3 patients because of their poor health status and advanced age. Among the 27 patients, 9 and 14 had complete (CR) and partial responses (PR), respectively; 3 manifested no change (NC), and 1 had progressive disease (PD). The objective response rate (CR+PR) was 85.2%. Among the 27 patients staged T2-3 NOMO, 6 (CR, 1; PR, 5) underwent total cystectomies and 18 (CR, 8; PR, 8; NC, 2) had transurethral resection of a bladder tumor (TUR-Bt) or partial resections following chemotherapy. The remaining 3 diminished-dose patients had no surgery. Of the 27 patients, 22 were alive after a median follow-up period of 21+ (range, 7-48+) months. No significant side effect was observed except for lower extremity paresthesias in 5 patients (18.5%). These results point to the effectiveness of this therapy and to the possibility of urinary bladder preservation in patients with invasive, advanced urinary bladder cancers.

Adult↗

Study on urinary bladder stone cases at Okhaldhunga Hospital, Nepal. 1988--1994.

A retrospective study on urinary bladder stones among the patients seeking treatment in Okhaldunga Hospital was carried out for six calendar years from 1988 to 1994. Forty-six cases of bladder stones were identified during that period. Among them, 43 patients' records were studied (93.0%) in subsequent analysis. Ninety-seven percent were male with mean age 11.53+/-6.9 years. The number of children are significantly higher in 0-9 years of age (p<0.01). The symptoms lasted more than 2 years with the most common presenting symptoms dysuria (86.0%) and poor flow of urine (41.8%). The average hospital stay was 8.7 days. The majority of cases (78.5%) had undergone cystolithotomy without any complications. The study also showed that the majority (97.0%) of urinary bladder stone cases were successfully managed at a rural hospital like Okhaldhunga.

Adolescent↗

Inhibitory effect of 13-cis-retinoic acid on urinary bladder carcinogenesis induced in C57BL/6 mice by N-butyl-N-(4-hydroxybutyl)-nitrosamine.

The effect of 13-cis-retinoic acid on the induction of urinary bladder carcinoma by N-butyl-N-(4-hydroxybutyl)nitrosamine (OH-BBN) was studied in male C57BL/6 mice. Animals received a total dose of either 90 or 140 mg of OH-BBN via gastric intubations of 7.5 or 10.0 mg of OH-BBN 2 times each week for 6 or 7 weeks, respectively. Seven days after the last OH-BBN intubation, animals were fed laboratory chow diet supplemented with either 200 mg of 13-cis-retinoic acid per kg or its placebo. Animals were killed at 6 months after the first carcinogen intubation. Highly invasive squamous and transitional cell carcinomas of the urothelium were found at autopsy. In the majority of these carcinomas, invasion of the bladder muscle wall by tumor cells had occurred. At the two dose levels of OH-BBN, feeding of 13-cis-retinoic acid reduced the incidence of both carcinomas and noninvasive papillomas, as well as the extent of neoplastic development in the urinary bladder. In mice receiving the lower dose of OH-BBN, the feeding of 13-cis-retinoic acid prevented the appearance of both squamous and transitional cell carcinomas with a reduction in incidence from 33 to 0% (p less than 0.01). The results of this study indicate that 13-cis-retinoic acid reduced not only the severity of highly invasive urinary bladder carcinomas but also the incidence of such cancers.

Animals↗

Metastatic transitional cell carcinoma of the urinary bladder presenting as a mandibular gingival swelling.

Oral cavity metastases mostly originate from the breasts, lungs, or kidneys. Transitional cell carcinoma (TCC), the most frequent malignant tumor of the urinary bladder, rarely metastasizes to the jaws. To the best of our knowledge, only 8 cases of bladder carcinoma have been reported in the English literature to metastasize to the jawbones. A new case of mandibular metastasis of urinary bladder TCC with extension to the gingiva is presented in a 64-year-old white man. The patient was referred for a periodontal infection of the upper right first molar. The clinical examination also showed a gingival swelling located in the lower left premolar region with a hypoasthesia of the left side of the lower lip. The gingival mass was biopsied, and the microscopy showed a mandibular metastatic TCC of the urinary bladder extending to the gingiva. Periodontists should be aware that, although gingival metastases are rare, when they occur they may mimic other local benign pathological conditions.

Bicuspid↗

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↗

Ultrasonography of urinary bladder disorders.

Ultrasonography is often recommended as the first diagnostic imaging modality in patients with hematuria or dysuria. It can provide information relative to the capacity of the urinary bladder, changes in bladder outline, changes in wall thickness, identification of mural and luminal masses, and identification of extrinsic lesions that may displace the bladder wall causing changes in its shape. Ultrasonography allows an evaluation of the entire urinary tract (except distal urethra) in both female and male dogs as well as the sublumbar region for lymphadenopathy.

Animals↗

Radiation-induced impairment of urinary bladder function in mice: fine structure of the acute response and consequences on late effects.

The time course and dose response of radiation-induced impairment of urinary bladder function in the mouse were assessed after local irradiation with graded single doses. Bladder capacity was defined by transurethral cystometry; a reduction in bladder volume at an intravesical pressure of 10 mmHg by > or =50% of the individual pretreatment control value was considered a positive radiation reaction. Reversible effects of radiation on the urinary bladder were found during the first 30 days postirradiation, followed by a symptom-free latent period and irreversible late changes. Maximum-likelihood analysis revealed that the acute response is composed of two distinct waves from days 1-15 and days 16-30, with mean latent times of 7.1 days [95% confidence interval (5.4, 9.0)] and 23.3 days (21.9, 24.5), respectively, which describe the data significantly better than a single normal distribution (P = 0.0052). The ED50 values (+/- their standard deviation sigma), i.e. the doses at which 50% of the irradiated animals show the > or = 50% reduction in bladder capacity during each of the two intervals, were 21.7 +/- 4.1 and 19.3 +/- 3.9 Gy for the first and the second acute wave, respectively. The ED50 for the late functional effects was 18.7 +/- 2.4 Gy. Multivariate analysis demonstrated (1) that a response during the first acute wave correlated significantly with a reaction in the second acute wave (P = 0.0066), and (2) that a response during the second but not the first acute wave correlated significantly with the development of a late response (P = 0.0008). In conclusion, the present analysis suggests that the radiation response of the urinary bladder of the mouse displays a significant consequential component. However, further studies are required to demonstrate if the frequency of late sequelae can be decreased by an early intervention in the sequence of pathogenic processes.

Animals↗

Increased expression of endothelin B receptors in the diabetic rabbit urinary bladder: functional relevance.

OBJECTIVES: To determine the effect of diabetes mellitus on the density and distribution of endothelin A (ETA ) and endothelin B (ETB ) receptor subtypes in the rabbit urinary bladder, and to assess the in vitro functional properties of endothelin-1 (ET-1) receptors in bladder smooth muscle strips from diabetic and healthy rabbits. MATERIALS AND METHODS: Diabetes mellitus was induced in six male New Zealand White rabbits with alloxan and their urinary bladders excised 6 months after the induction of diabetes. On serial detrusor and bladder neck sections, low- and high-resolution autoradiography was performed using radioligands for ET-1, ETA and ETB receptors; these sections were then analysed densitometrically. The results were compared with those from six age-matched healthy control rabbits. Functional responses were investigated using isometric tension studies. RESULTS: ETA and ETB receptor binding sites were localized to both the urothelium and smooth muscle of the detrusor and bladder neck. There were significantly more ETB receptor binding sites in the diabetic detrusor and bladder neck sections than in controls. ET-1 smooth muscle contractile responses were ETA receptor-mediated. The smooth muscle contractile responses to ET-1 were unaltered in the detrusor, but significantly impaired in the bladder neck of diabetic animals compared with controls. CONCLUSION: Alteration in the expression of ETB receptors and in vitro contractile smooth muscle responses to ET-1 in the diabetic rabbit urinary bladder neck may play a role in the pathophysiology of diabetic cystopathy.

Alloxan↗

Selective induction of phase II enzymes in the urinary bladder of rats by allyl isothiocyanate, a compound derived from Brassica vegetables.

Allyl isothiocyanate (AITC) is formed from sinigrin, a glucosinolate that is present in many Brassica vegetables. In the present study, the effect of various dose levels of AITC on the activities of the phase II detoxification enzymes quinone reductase (QR) and glutathione S-transferase (GST) in rat tissues has been examined. High dose levels of AITC, given daily for 5 days, increased the activity of QR and/or GST in the liver, kidneys, lungs, spleen, urinary bladder, glandular and nonglandular stomach, duodenum, jejunum, ileum, cecum, and colon plus rectum of the animals. At low doses, however, increases in enzyme activity were observed only in the urinary bladder of the rats, with a significant effect being recorded in this tissue at a dose of AITC of only 10 micromol/kg/day. The effect of duration of exposure to AITC on enzyme levels in the urinary bladder was also investigated, with rats receiving the isothiocyanate each day for 1-21 days. In the case of QR, a plateau of activity was reached after 15 daily doses of AITC, but GST activity continued to increase with continued exposure, and no plateau was reached after 21 doses. The dose level of AITC found to be effective in rats approaches the level that could be achieved through human consumption of Brassica vegetables, suggesting that induction of phase II enzymes by food-derived isothiocyanates could contribute to the lower incidence of bladder cancer observed in individuals who regularly consume such vegetables.

Animals↗

Kinetics of peptide-induced release of inflammatory mediators by the urinary bladder.

OBJECTIVE: To investigate the release of inflammatory mediators by the urinary bladder in response to exposure to pro-inflammatory peptides. MATERIALS AND METHODS: Isolated guinea pig urinary bladder was incubated with 10 mumol/L each of substance P (SP), neurokinin A (NKA), calcitonin gene-related peptide (CGRP), vasoactive intestinal peptide (VIP), octreotide acetate (a long-acting analogue of somatostatin, SOM), or bradykinin (BK), and the release of histamine, prostaglandin (PG) E2, PGF2 alpha and leukotriene B4 (LTB4) was determined during 0-5, 5-30 and 30-120 min after addition. RESULTS: Substance P, NKA, VIP and BK stimulated the release of histamine, while CGRP and SOM suppressed the release to below the spontaneous rates. All peptides, except CGRP and SOM, stimulated the release of PGE2 between 0 and 30 min, and only VIP failed to stimulate the release of PGF2 alpha within 5 min of exposure. Substance P, NKA, VIP and BK stimulated the release of LTB4 and this required > 5 min of exposure. CONCLUSION: These results indicate that the peptides evaluated induce an immediate and transient release of histamine and activation of cyclooxygenase and delayed activation of 5-lipoxygenase. These actions may directly regulate the participation of these peptides in the pathogenesis of cystitis.

Animals↗

Characterization of the capsaicin-sensitive component of cyclophosphamide-induced inflammation in the rat urinary bladder.

1. Cyclophosphamide (CYP) (150 mg kg-1, i.p. 0.5-48 h before) caused a time-dependent plasma protein extravasation in the rat urinary bladder with the maximal extravasation occurring at between 2 and 4 h after administration of the drug. 2. Prior capsaicin desensitization of capsaicin-sensitive primary afferent neurones (CSPANs) (50 mg kg-1, s.c., 4 days before) resulted in approximately 50% inhibition of the magnitude of the extravasation response at the 2 h time-point. 3. Intraperitoneal (i.p.) pretreatment with the tachykinin NK1 receptor antagonist, RP 67,580 (0.44 mg kg-1) or the bradykinin B2 receptor antagonist, Hoe 140 (0.13 mg kg-1) had significant inhibitory effects, giving responses of 56 +/- 6% and 39 +/- 4% of the control extravasation response to CYP treatment after 2 h. Pretreatment with the tachykinin NK2 receptor antagonist, SR 48,968 (0.3 mg kg-1, i.p.), the histamine H1 receptor blocker, chlorpheniramine (10 mg kg-1, i.p.), the 5-HT receptor blocker, methysergide (6 mg kg-1, i.p.) or the cyclo-oxygenase inhibitor indomethacin (5 mg kg-1, i.p.) had no significant effect upon the development of the extravasation response at this same time-point. 4. In rat isolated urinary bladder strips, the active metabolite of CYP, acrolein (1-300 microM) produced a concentration-dependent contraction that was significantly reduced by in vitro capsaicin desensitization (10 microM for 15 min) indicating direct stimulation of CSPANs. CYP was without appreciable effect. 5. The effect of acrolein in vitro was significantly reduced by pretreatment of the bladder with a combination of tachykinin NK1 and NK2 receptor antagonists, RP 67,580 (3 microM) and SR 48,968 (1 microM). The dose-response curve to acrolein was also significantly inhibited by treatment with indomethacin (10 microM) and slightly affected by Hoe 140 (1 microM). 6. These findings demonstrate the contribution of CSPANs to the development of CYP-induced cystitis.Plasma protein extravasation involves activation of tachykinin NKI and bradykinin B2 receptors.Activation of CSPANs in the urinary bladder is likely to be due to the conversion of CYP into its active metabolite, acrolein, and not to a direct effect of CYP upon these nerve-endings.

Acrolein↗

[The role of alpha1-adrenoblocker alfuzosine in diagnostic-therapeutic algorithm of hyperactive urinary bladder management in women and selection of patients for treatment with M-cholinergic antagonists].

In management of patients with hyperactive urinary bladder (HAUB) it is necessary to take into consideration the fact that long-term intake of M-cholinergic antagonists may result in obstructive miction because of low contractile activity of the urinary bladder. Use of M-cholinergic antagonists also problematic in detruzor dysfunction leading to slowing down of the urinary flow. In view of these possible complications, an algorithm of urodynamic diagnosis is proposed based on non-invasive registration of miction disorders using home uroflowmetry. Correction of detruzor contractility with dalfas combines well with cholinoblockers. In some cases administration of nontitrated alphablockers has no alternative especially in long-term treatment with mediators suppressing nonadapted detruzor contractions as it happens in HAUB. The above diagnosticotherapeutic algorithm of female miction disorders management which regards urine flow rates and comprises intake of alfusozine if necessary allows treatment of females with small urinary bladder when cholinergic antagonists are low-effective.

Adolescent↗

[Diagnosis of urinary bladder cancer by transurethral sonography].

With 66.5% the total reliability of the transurethral sonography is significantly higher than that of all methods hitherto used. If one restricts oneself to the differentiation between muscle-invasive and superficial carcinomas the share of impacts is even 77.5%. Considering an error of nevertheless 33% and 23%, respectively, in the T-classification of the carcinoma of the urinary bladder the new method could, however, not fulfil the high expectations which were set into it at the beginning. Particularly a differentiation between mucosa and lamina propria as well as superficial and deep musculature is not possible. According to this the transurethral sonography is not suited as the only method for preoperative T-classification and basis of therapy planning. Difficulties appear above all in large and echo-dense carcinomas, respectively, as well as in pretreated urinary bladders. Consequently, a sufficient experience in the judgment of sonogrammes is necessary, in order to avoid wrong interpretations as to a tumor infiltration. Nevertheless, the transurethral sonography is an essential enlargement of the hitherto scanty spectre of the T-classification of the carcinoma of the urinary bladder. Supplementing the computer tomogram, the method brings the operator a quick survey of a possible infiltration of the wall of the bladder and a perivesical growth of the tumour. In deeply infiltrating, not radically resectable carcinomas in many cases an extensive staging-TUR may thus be avoided.

Humans↗

Small intestinal incarceration through the lateral ligament of the urinary bladder in a horse.

Small intestinal incarceration through the lateral ligament of the urinary bladder was diagnosed in a 14-year-old, 569-kg, castrated Quarter Horse. The incarceration was corrected by ventral midline celiotomy. Approximately 70 cm of the middle portion of the jejunum was resected and end-to-end, single-layer anastomosis was performed. After surgery, the horse developed signs of adynamic ileus and lameness in the right forelimb. The horse developed laminitis in all 4 feet within 24 hours of surgery. The horse was euthanatized because of poor prognosis for survival. At necropsy, a 4.5-cm rent was found in the left lateral ligament of the urinary bladder. The cause of the rent in the ligament of this horse was not determined.

Animals↗

Differences between binding affinities of some antimuscarinic drugs in the parotid gland and those in the urinary bladder and ileum.

Possible differences between the muscarinic receptors in the guinea pig urinary bladder and those in the ileum and the parotid gland were investigated, using a receptor binding technique. The affinities of 18 antimuscarinic drugs were indirectly derived from the ability to inhibit the receptor-specific binding of the radioligand (-)3H-QNB. The Hill coefficients were close to unity which indicated that the drugs were bound to apparently uniform populations of receptors within each tissue. In contrast to traditional muscarinic antagonists, four drugs - namely, oxybutynine, dicyclomine, benzhexol and pirenzepine - bound with a significantly higher affinity in the parotid gland than in the urinary bladder and ileum. A tendency towards reversed selectivity was found for secoverine. Thus, the present results further support the hypothesis that differences in muscarinic receptors between tissues exist, e.g. smooth muscle compared with parotid gland, which can be detected only by certain antimuscarinic drugs.

Animals↗