Rat: overview and innervation

Putting the past behind us: Social stress-induced urinary retention can be overcome

INTRODUCTION

To study the pathophysiology of dysfunctional voiding, we have previously developed a model of stress-induced voiding dysfunction. We have shown that cyclosporine A (CsA), an inhibitor of the Ca(2+)-calmodulin complex, can prevent social stress-induced urinary retention. However, treatment with cyclosporine has not had an effect on the increase in the stress peptide corticotrophin-releasing factor (CRF) in Barrington's nucleus, which is involved in the micturition pathway.

OBJECTIVE

We now investigate whether cyclosporine administered after stress can reverse the abnormal voiding phenotype, and whether it has effects on the bladder wall itself, or on the stress response within Barrington's nucleus.

MATERIALS AND METHODS

Six-week old Swiss-Webster mice were exposed to aggressor males for 1 h a day, followed by 23 h of barrier separation. In a long-term trial, 1 month of stress was followed by single-cage housing for 6 months. In a separate CsA reversal trial, mice either received CsA in drinking water or had plain drinking water during 1 month of single-cage housing during recovery. Bladder contractile function was examined on a Guth myograph. Nuclear translocation of myocyte enhancing factor (MEF)-2 and NFAT (nuclear factor of activated T cells) in the bladder was assessed using electrophoretic mobility shift assays (EMSAs). The expression of CRF was determined in Barrington's nucleus using in situ hybridization.

RESULTS

Voiding dysfunction persisted for up to 6 months after stress exposure while mice recovered in single-cage housing. In the CsA reversal trial, voiding patterns improved when they received CsA in water during single-cage housing following stress, whereas those that underwent single-cage housing alone had persistent abnormal voiding (Fig. A). There was no difference between CRF levels in Barrington's nucleus between reversal groups (p = 0.42) (Fig. B), possibly indicating a direct effect on the bladder rather than a persistent stress effect. There were no differences in the contractility of bladder wall muscle. CsA decreased the nuclear translocation of MEF-2 and NFAT induced by stress (Fig. C,D).

CONCLUSION

CsA reverses stress-induced urinary retention, but does not change the stress-induced CRF increase in Barrington's nucleus. Furthermore, bladder smooth muscle contractility is unchanged by CsA; however, there are changes in the levels of the downstream transcription factors MEF-2 and NFAT. We suspect that additional CsA responsive neural changes play a pivotal role in the abnormal voiding phenotype following social stress.

AE9C90CB: a novel, bladder-selective muscarinic receptor antagonist for the treatment of overactive bladder

BACKGROUND AND PURPOSE

AE9C90CB (N- [(1R, 5S, 6R)-3-azabicyclo [3.1.0] hex-6-ylmethyl]-2-hydroxy-N-methyl-2, 2-diphenylacetamide), a novel muscarinic receptor antagonist, was synthesized for the treatment of overactive bladder. Here we describe the in vitro and in vivo profiles of AE9C90CB for action in bladder over salivary gland and compare it with four agents already in clinical use (tolterodine, oxybutynin, solifenacin and darifenacin).

EXPERIMENTAL APPROACH

Radioligand binding assay and isolated tissue-based functional assay were used to evaluate affinity, potency, and receptor subtype selectivity of compounds. Inhibition of carbachol-induced increase in intravesicular pressure and salivary secretion were measured in anaesthetized rabbits to assess the functional selectivity.

KEY RESULTS

In vitro radioligand binding study using human recombinant muscarinic receptors showed that AE9C90CB had greater affinity for M(3) muscarinic receptors with pKi of 9.90 +/- 0.11 and was 20-fold more selective for M(3) than for M(2) muscarinic receptors. AE9C90CB exhibited an unsurmountable antagonism on rat bladder strips (pK(B), 9.13 +/- 0.12). In anaesthetized rabbits after intravenous administration, AE9C90CB dose dependently inhibited carbachol-induced increase in intravesicular pressure and salivary secretion, and exhibited functional selectivity for urinary bladder over salivary gland which was ninefold better than that of oxybutynin.

CONCLUSIONS AND IMPLICATIONS

We have identified AE9C90CB, a compound exhibiting moderate selectivity for M(3) over M(2) receptors but greater selectivity for urinary bladder over salivary gland than oxybutynin, tolterodine, solifenacin and darifenacin. Therefore, AE9C90CB may be a promising compound for the treatment of overactive bladder with reduced potential to cause dry mouth than currently available antimuscarinic drugs.

Effect of partial bladder outlet obstruction on detrusor compliance, excitability and contractility in rats

OBJECTIVE

Partial bladder outlet obstruction (PBOO) is believed to change the functions of the detrusor, and can lead to an overactive detrusor (OD). The aim of this study was to investigate changes in bladder compliance, excitability and contractility after PBOO in rats.

MATERIAL AND METHODS

PBOO was performed for 6 weeks in 20 Wistar rats, 13 of which (OD group) had an OD and seven of which (non-OD group) did not. Simultaneously, 10 rats that underwent sham operations (control group) were also studied. Bladder compliance and cystometric capacity were identified in vivo, but bladder compliance was detected without elimination of bladder capacity. Isolated bladder smooth muscle strip (BSMS) was dissected to determine excitability and contractility.

RESULTS

After 6 weeks of PBOO, cystometric capacity and compliance were significantly higher than those in the control group. Compliance was 0.170+/-0.029 and 0.149+/-0.042 ml/cmH2O in the OD and non-OD groups, respectively, compared to 0.037+/-0.017 ml/cmH2O in the control group. The corresponding cystometric capacities were 3.66+/-0.490, 3.08+/-0.590 and 1.14+/-0.225 ml. The excitability in the OD group increased significantly compared to that in the non-OD and control groups. The tension threshold for BSMS contraction was lower in the OD group, and BSMS contracted more frequently at the same tension. The contractility of the BSMS in the OD group decreased significantly compared to that in the non-OD and control groups.

CONCLUSIONS

PBOO can cause a higher cystometric capacity and compliance. After PBOO, there is a chance that an OD may develop. When this occurs, the detrusor excitability increases and contractility decreases.

Social stress-induced bladder dysfunction: potential role of corticotropin-releasing factor

Psychological stress can impact on visceral function with pathological consequences, although the mechanisms underlying this are poorly understood. Here we demonstrate that social stress produces marked changes in bladder structure and function. Male rats were subjected to repeated (7 days) social defeat stress using the resident-intruder model. Measurement of the voiding pattern indicated that social stress produced urinary retention. Consistent with this, bladder size was increased in rats exposed to social stress. Moreover, this was negatively correlated to the latency to assume a subordinate posture, implying an association between passive behavior and bladder dysfunction. In vivo cystometry revealed distinct changes in urodynamic function in rats exposed to social stress, including increased bladder capacity, micturition volume, intermicturition interval, and the presence of non-micturition-related contractions, resembling overactive bladder. In contrast to social stress, repeated restraint (7 days) did not affect voiding, bladder weight, or urodynamics. The stress-related neuropeptide corticotropin-releasing factor (CRF) is present in spinal projections of Barrington's nucleus that regulate the micturition reflex and has an inhibitory influence in this pathway. Social stress, but not restraint, increased the number of CRF-immunoreactive neurons in Barrington's nucleus. Additionally, social stress increased CRF mRNA in Barrington's nucleus. Together, the results imply that social stress-induced CRF upregulation in Barrington's nucleus neurons results in urinary retention and, eventually, bladder dysfunction, perhaps as a visceral component of a behavioral coping response. This mechanism may underlie dysfunctional voiding in children and/or contribute to the development of stress-induced bladder disorders in adulthood.

Persistent detrusor overactivity after transurethral resection of the prostate

Detrusor overactivity is associated with aging and benign prostatic obstruction and often causes the troublesome symptoms of urgency and urgency incontinence (overactive bladder), persistent detrusor overactivity after transurethral resection of the prostate being the cause of more than a third of poor symptomatic outcomes following surgery. Most of the evidence currently suggests that neurons of the urothelium at the bladder neck play a significant role in the genesis of detrusor overactivity. Treatment options including botulinum toxin injections and intravesical vanilloids have been studied in the treatment of persistent detrusor overactivity, but further studies are needed specifically in patients with persistent detrusor overactivity after transurethral resection of the prostate. As urodynamic studies are able to predict a proportion of postoperative failures, more widespread use is advocated by many in the routine assessment of lower urinary tract symptoms thought to be due to benign prostatic obstruction.

Novel biomarkers of bladder decompensation after partial bladder obstruction

AIMS

Partial bladder outlet obstruction (PBOO) results in marked contractile, biochemical, and histological alterations in the bladder. Our aim was to determine the time course of progressive PBOO in the rabbit and to find parameters that marked the shift to decompensation.

MATERIALS AND METHODS

Twenty-four rabbits were subjected to 1, 2, 4, and 8 weeks of PBOO. Sham operated rabbits served as controls. At each time period, cystometry was performed and individual bladder strips were used for contractility studies. Full-thickness sections of bladder body from each rabbit were fixed in formalin and used to determine the vascular density and nerve density. The balance of the bladder body was separated between muscle and mucosa and was analyzed for superoxide dismutase (SOD) and catalase (CAT) activities.

RESULTS

Bladder weight increased progressively and all contractile responses were reduced significantly over the course of obstruction. Markedly increased bladder weight and very large bladder volumes indicated decompensation. Nerve density was marked decreased in decompensated bladders. Similarly, SOD activity in muscle decreased progressively and was markedly lower in decompensated bladders. Although CAT activity of the muscle increased after 2-4 weeks of obstruction, it decreased markedly in decompensated bladders.

CONCLUSION

This study shows that prolonged PBOO causes progressive deterioration in the rabbit bladder with decompensation after 8 weeks. Markedly decreased nerve density and severely reduced SOD and CAT activities are associated with the shift from compensated to decompensated function of the bladder. They may be excellent biomarkers of decompensation.

Multiple intravesical instillation of low-dose resiniferatoxin is effective in the treatment of detrusor overactivity refractory to anticholinergics

OBJECTIVE

To examine the effectiveness and tolerability of multiple intravesical instillations of 10 nmol/L resiniferatoxin in patients with detrusor overactivity (DO) refractory to anticholinergic agents, as not all these patients are successfully treated by one such instillation.

PATIENTS AND METHODS

The study included 53 patients with DO from neurogenic (NDO, 10), previous bladder outlet obstruction (BOO, 20) or idiopathic cause (IDO, 23) and who were refractory to anticholinergic agents. Patients received three to four instillations of 10 nmol/L resiniferatoxin, as outpatients. The International Prostate Symptom Score and quality-of-life index were recorded, and a video-urodynamic study conducted at baseline and 3 months after treatment. The therapeutic results and urodynamic variables were compared among patients with different causes of DO.

RESULTS

Four patients withdrew from the study after the first instillation because of urinary tract infection or severe pain on urination, leaving 49 who completed at least three instillations. The overall results were an excellent response in 17 patients (35%), improvement in 13 (27%) and failure in 19 (39%); the treatment was deemed a success (excellent or improved) in 16 of 20 with previous BOO, 11 of 19 with IDO, and only three of 10 with NDO (P = 0.011). Patients had significant improvements in the storage symptom score, total symptom score and quality-of-life index after treatment. The cystometric capacity and the postvoid residual were significantly greater and voiding efficiency significantly less after treatment. DO during the urodynamic study was absent in 12 patients after treatment.

CONCLUSIONS

Multiple intravesical instillations of 10 nmol/L resiniferatoxin are effective in treating patients with DO refractory to anticholinergics.

Effect of cyclohexenonic long-chain fatty alcohol on rat overactive bladder induced by bladder neck obstruction

We attempted to clarify the preventive effects of cyclohexenonic long-chain fatty alcohol on detrusor overactivity induced by mild bladder neck obstruction. Bladder neck obstruction was created by partial ligation of the urethra. Female Sprague-Dawley rats were divided into three groups: those with bladder neck obstruction treated without long-chain fatty alcohol, those with bladder neck obstruction with long-chain fatty alcohol (8 mg/kg, i.p., every day) and the sham-operated control group (A, B, and C groups, respectively). Six weeks after the induction of bladder neck obstruction, voiding behavior was observed in the metabolic cage, and a cystometrogram was performed in the experimental animals. Furthermore, Hematoxylin and Eosin, Azan-Mallory, and Bodian stainings were performed in these bladders. Bladder weight, voiding behaviors and a cystometry indicated that rats in the A group showed detrusor overactivity, which was improved by treatment with long-chain fatty alcohol. The proportion of connective tissue and the density of bundles of neurofibers in the bladder of the A group was significantly less than that in the other bladders. Mild bladder neck obstruction induces detrusor overactivity, which is improved by treatment with long-chain fatty alcohol.

Basic science and translational research in female pelvic floor disorders: proceedings of an NIH-sponsored meeting

AIMS

To report the findings of a multidisciplinary group of scientists focusing on issues in basic science and translational research related to female pelvic floor disorders, and to produce recommendations for a research agenda for investigators studying female pelvic floor disorders.

METHODS

A National Institutes of Health (NIH)-sponsored meeting was held on November 14-15, 2002, bringing together scientists in diverse fields including obstetrics, gynecology, urogynecology, urology, gastroenterology, biomechanical engineering, neuroscience, endocrinology, and molecular biology. Recent and ongoing studies were presented and discussed, key gaps in knowledge were identified, and recommendations were made for research that would have the highest impact in making advances in the field of female pelvic floor disorders.

RESULTS

The meeting included presentations and discussion on the use of animal models to better understand physiology and pathophysiology; neuromuscular injury (such as at childbirth) as a possible pathogenetic factor and mechanisms for recovery of function after injury; the use of biomechanical concepts and imaging to better understand the relationship between structure and function; and molecular and biochemical mechanisms that may underlie the development of female pelvic floor disorders.

CONCLUSIONS

While the findings of current research will help elucidate the pathophysiologic pathways leading to the development of female pelvic floor disorders, much more research is needed for full understanding that will result in better care for patients through specific rather than empiric therapy, and lead to the potential for prevention on primary and secondary levels.

Mechanisms involved in new therapies for overactive bladder

During the last few years, vanilloid substances and botulinum-A toxin were extensively investigated as new therapies for overactive bladder. Intravesical administration of capsaicin or resiniferatoxin--2 members of the vanilloid family--has been shown to increase bladder capacity and decrease urge incontinence in patients with neurogenic, as well as nonneurogenic, forms of detrusor overactivity. In addition, vanilloids have been shown also to reduce bladder pain in patients with hypersensitive disorders. Vanilloids are exogenous ligands of vanilloid receptor type 1 (VR1), an ion channel present in the membrane of type C primary afferent nerve fibers. This receptor, which plays a key role in pain perception and control of the micturition reflex, may be upregulated by nerve growth factor (NGF), a neurotrophic molecule detected in high concentrations in overactive detrusor tissue. Vanilloids, by reducing uptake of NGF through sensory neurons, may counteract VR1 upregulation. Intravesical injections of botulinum-A toxin, a neurotoxin produced by Clostridium botulinum, were shown to increase bladder capacity and to decrease urge incontinence episodes in patients with neurogenic detrusor overactivity. Botulinum-A toxin impedes the release of acetylcholine from cholinergic nerve endings at the neuromuscular junction, leading to paralysis of the detrusor smooth muscle.

Resiniferatoxin for detrusor instability refractory to anticholinergics

PURPOSE

We have evaluated the clinical and urodynamic effects of intravesical instillation of resiniferatoxin in patients with idiopathic detrusor instability refractory to anticholinergics.

MATERIALS AND METHODS

There were 30 women, median age 56 years old with detrusor instability for over 6 months and a history of anticholinergic use with no response or intolerable collateral effects. A 50 nM solution of resiniferatoxin was prepared for intravesical instillation. All patients were evaluated for urinary symptoms, as well as for urodynamic assessments before and 30 days after instillation. Tolerability was analyzed during the instillation.

RESULTS

A clinical improvement was observed in 30% of the patients with urinary urgency and in 33% of the patients with urge-incontinence. The mean maximum cystometric capacity before application was 303.9 +/- 78.9 and after application 341 +/- 84.6. No significant difference was observed (p = 0.585). The mean maximum amplitude of the contractions diminished from 47.86 +/- 29.64 to 38.72 +/- 30.77 (p = 0.002).

CONCLUSIONS

Resiniferatoxin, in this concentration, proved to be useful in a small percentage of patients regarding clinical detrusor instability. Maximum amplitude of the involuntary contractions was significantly reduced and in 33% patients the involuntary contractions disappeared. Further studies with different concentrations are recommended.

Effectiveness of intravesical resiniferatoxin for anticholinergic treatment refractory detrusor overactivity due to nonspinal cord lesions

PURPOSE

Evidence suggests that unmyelinated C fibers become predominant in the mediation of the detrusor reflex in patients with chronic spinal cord lesions and possibly in idiopathic detrusor hyperactivity. Intravesical vanilloid therapy might be effective in treating refractory detrusor overactivity due to nonspinal cord lesion. This study investigated the clinical effect of intravesical resiniferatoxin in treating detrusor overactivity of nonspinal cord lesions refractory to anticholinergics.

MATERIALS AND METHODS

A total of 41 patients received intravesical resiniferatoxin therapy with 10 ml of 100 nM resiniferatoxin in 10% ethanol solution for 40 minutes. The clinical effects on a decrease in incontinence episodes and urodynamic study were evaluated at baseline and after treatment. Clinical improvement was considered if patients became dry or had a decrease in incontinence episodes of 50%. Therapeutic results were analyzed by disease category and type of initial detrusor response.

RESULTS

Of the 41 patients 10 had neurogenic lesions, 18 had previous transurethral prostatectomy and 13 had idiopathic detrusor overactivity. There were 20 women and 21 men with a mean age of 73.6 years (range 43 to 82) and a symptom duration of 3.6 +/- 4.5 years. After resiniferatoxin treatment 21 patients had clinical improvement (51.2%) including 5 with neurogenic (50%), 11 with previous transurethral prostatectomy (61.1%) and 5 with idiopathic detrusor overactivity (38.5%). An improvement was found in 11 patients with type I initial response (84.6%), 3 patients with type II response (23%) and 7 patients with type III response (46.7%). The 21 patients with improvement had a significant increase in cystometric capacity (208 +/- 80.7 vs 287.2 +/- 118.6 ml, p = 0.001) and a significant decrease in detrusor pressure (33.6 +/- 11.1 vs 27.4 +/- 11.8 cmH(2)O, p = 0.047), but no significant difference in maximal flow rate and residual urine volume.

CONCLUSIONS

Intravesical resiniferatoxin was effective in treating refractory detrusor overactivity in 51.2% of patients with nonspinal cord lesions. Patients with detrusor overactivity due to previous bladder outlet obstruction benefited the most. Detrusor contractility decreased after resiniferatoxin treatment in the group with improvement but did not influence voiding efficiency. The initial detrusor response to resiniferatoxin treatment might predict the clinical outcome.

The effect of intravesical resiniferatoxin in patients with idiopathic detrusor instability suggests that involuntary detrusor contractions are triggered by C-fiber input

PURPOSE

We evaluated the role of bladder C-fiber input in involuntary detrusor activity in patients with idiopathic detrusor instability.

MATERIALS AND METHODS

Filling cystometry and a voiding chart were done in 13 patients with idiopathic detrusor instability. The first detrusor contraction, maximal cystometric capacity, daily frequency and the number of episodes of urinary incontinence were determined. A 50 nM. solution of resiniferatoxin, a specific C-fiber neurotoxin, was then instilled in the bladder for 30 minutes. Patients were reevaluated 30 and 90 days later.

RESULTS

Resiniferatoxin instillation delayed or suppressed involuntary detrusor contractions during filling cystometry. The mean first detrusor contraction plus or minus standard deviation increased from 170 +/- 109 ml. at baseline to 440 +/- 130 ml. (p = 0.0001) at 30 days and to 391 +/- 165 ml. (p = 0.008) at 90 days. Mean maximal cystometric capacity increased from 291 +/- 160 to 472 +/- 139 ml. (p = 0.01) at 30 days and to 413 +/- 153 ml. (p = 0.1) at 90 days. The mean number of episodes of urinary incontinence daily decreased from 4.3 +/- 2.7 to 0.9 +/- 2.7 (p = 0.001) at 30 days and to 0.7 +/- 0.9 (p = 0.009) at 90 days. Mean frequency daily also decreased from 12 +/- 3.2 to 9.7 +/- 3.2 (p = 0.003) and to 9.9 +/- 3.5 (p = 0.001) times at the same time points, respectively.

CONCLUSIONS

C-fiber input seems to have an important role in the generation of involuntary detrusor contractions and lower urinary tract symptoms in patients with idiopathic detrusor instability. Substances that block C-fiber input may represent a new strategy for treating this bladder dysfunction.

Effects of tiagabine, a gamma-aminobutyric acid re-uptake inhibitor, on normal rat bladder function

PURPOSE

Previous reports have demonstrated the inhibitory effect of exogenous gamma-aminobutyric acid (GABA) on micturition. In the current study we tested whether tiagabine (Sanofi Synthelab., Newcastle-upon Tyne, United Kingdom), a GABA re-uptake inhibitor increasing endogenous GABA concentrations, would affect micturition in awake rats or influence rat detrusor contraction in vitro.

MATERIALS AND METHODS

Nonanesthetized female Sprague-Dawley rats underwent cystometric investigation in a metabolic cage. Micturition was stimulated by infusing saline intravesically. Micturition parameters were recorded and compared before and after drug administration. In vitro the effects of tiagabine on electrical and carbachol induced contractions in bladder strips were investigated. Furthermore, it was studied whether tiagabine interfered with electrically induced release of acetylcholine.

RESULTS

Intravenous administration of 5 and 20 mg. kg.-1 tiagabine in 7 and 9 rats decreased micturition pressure a mean plus or minus standard error of mean of 21% +/- 11% and 42% +/- 9%, and decreased voided volume a mean of 31% +/- 9% and 33% +/- 9%, respectively. At 20 mg. kg.-1 tiagabine intravenously increased post-void residual volume a mean of 300% +/- 120% and decreased bladder capacity a mean of 14% +/- 3%. Tiagabine (100 microg.) intrathecally in 7 rats reduced micturition pressure a mean of 34% +/- 10% and increased bladder capacity a mean of 30% +/- 9% and post-void residual volume a mean of 250% +/- 75%. However, voided volume was not changed. In vitro studies demonstrated that tiagabine attenuated bladder contractions induced by electrical field stimulation to a mean of 69% +/- 6% of controls at 100 microM. but did not affect contractions induced by carbachol. Release studies revealed that tiagabine inhibited electrical induced acetylcholine release to a mean of 82% +/- 5% of controls at 100 microM.

CONCLUSIONS

The current results show that tiagabine has an inhibitory action on rat micturition. The site of action may be central and peripheral.

Effect of doxazosin on rat urinary bladder function after partial outlet obstruction

Hypoxia induced by partial outlet obstruction is believed to play a major role in both the hypertrophic and degenerative effects of partial outlet obstruction. Doxazosin (dox) is a clinically effective alpha-adrenergic antagonist used in the treatment of symptomatic benign prostatic hyperplasia (BPH). Although the major therapeutic effect of the agent is believed to occur on the smooth muscle components of the prostate by reducing prostatic urethral resistance and thus improving emptying, dox may have part of its clinical action via effects mediated by other actions, including via spinal alpha-adrenergic receptors or direct effects on the bladder, possibly via inhibition of vascular alpha receptors. The specific aim of the current study was to determine whether dox pretreatment on rats affects blood flow to the bladder and reduces the level of bladder dysfunction induced by partial outlet obstruction. In part 1, eight rats were separated into two groups of four rats each. Group 1 received oral administration of dox (30 mg/kg) for 4 weeks; group 2 received vehicle (5% dimethyl sulfoxide). After 4 weeks of treatment, blood flow studies were performed using fluorescent microspheres and the bladders excised, frozen, and submitted to Interactive Medical Technologies (IMT) for blood flow analysis. In part 2, 32 adult male rats were separated into four groups of eight rats each. Groups 1 and 2 received oral administration of dox (30 mg/kg) for 4 weeks, groups 3 and 4 received vehicle (5% dimethyl sulfoxide). At 4 weeks, the rats in groups 1 and 3 received partial outlet obstructions and treatment continued for an additional 2 weeks. After 6 weeks of treatment (total), each rat was anesthetized, the bladder excised, weighed, and isolated strips mounted and contractility studies performed. 1) Four weeks pretreatment of rats with dox increased blood flow to the bladder in both the control and obstructed groups. 2) Partial outlet obstruction induced a mild decrease in blood flow. 3) The magnitude of the increased bladder weight in the vehicle-treated obstructed group was significantly greater than in the dox-treated obstructed group. 4) Partial outlet obstruction resulted in significant decreases in the contractile response to field stimulation in both treated and non-treated rats. The magnitude of the decreased response was significantly greater in the non-treated rats. 5) The response to potassium chloride was significantly reduced by partial outlet obstruction in the vehicle-treated group but not in the dox-treated group. 6) The time to maximal tension was significantly increased in response to carbachol, adenosine triphosphate, and potassium chloride. However, the magnitude of the increase was significantly greater for the vehicle-treated obstructed groups stimulated by potassium chloride than for the dox-treated groups. Dox treatment of rats increased blood flow to the bladder and reduced the severity of the response to partial outlet obstruction. These beneficial effects would be due to pharmacological effects on alpha-adrenergic systems outside those present in the prostate. These include effects on blood flow to the bladder, effects on the micturition centers of the central nervous system, spinal reflexes, and alpha-adrenergic receptors in the urethra and bladder.

Plateau potentials in sacrocaudal motoneurons of chronic spinal rats, recorded in vitro

Intracellular recordings were made from sacrocaudal tail motoneurons of acute and chronic spinal rats to examine whether plateau potentials contribute to spasticity associated with chronic injury. The spinal cord was transected at the S2 level, causing, over time, exaggerated long-lasting reflexes (hyperreflexia) associated with a general spasticity syndrome in the tail muscles of chronic spinal rats (1-5 mo postinjury). The whole sacrocaudal spinal cord of chronic or acute spinal rats was removed and maintained in vitro in normal artificial cerebral spinal fluid (ACSF). Hyperreflexia in chronic spinal rats was verified by recording the long-lasting ventral root responses to dorsal root stimulation in vitro. The intrinsic properties of sacrocaudal motoneurons were studied using intracellular injections of slow triangular current ramps or graded current pulses. In chronic spinal rats, the current injection triggered sustained firing and an associated sustained depolarization (plateau potential; 34/35 cells; mean, 5.5 mV; duration >5 s; normal ACSF). The threshold for plateau initiation was low and usually corresponded to an acceleration in the membrane potential just before recruitment. After recruitment and plateau activation, the firing rate changed linearly with current during the slow ramps [63% of cells had a linear frequency-current (F-I) relation] despite the presence of the plateau. The persistent inward current (I(PIC)) producing the plateau and sustained firing was estimated to be on average 0.8 nA as determined by the reduction in injected current needed to stop the sustained firing [DeltaI = -0.8 +/- 0.6 (SD) nA], compared with the current needed to start firing (I = 1.7 +/- 1.5 nA; 47% reduction). In motoneurons of acute spinal rats, plateaus were rarely seen (3/22), although they could be made to occur with bath application of serotonin. In motoneurons of chronic spinal rats there were no significant changes in the mean passive input resistance, rheobase or amplitude of the spike afterhyperpolarization (AHP) as compared with acute spinal rats. However, there were significant increases in AHP duration and initial firing rate at recruitment and decreases in minimum firing rate and F-I slope. We suggest that the higher initial firing rate resulted from the plateau activation at recruitment and the lower F-I slope resulted from an increase in active conductance during firing, due to I(PIC). Brief dorsal root stimulation also triggered a plateau and sustained discharge (long-lasting reflexes; 2-5 s) in motoneurons of chronic (but not acute) spinal rats. When the plateau was eliminated by a hyperpolarizing current bias, the reflex response was significantly shortened (to 1 s). Thus plateaus contributed substantially to the long-lasting reflexes in vitro and therefore should contribute significantly to the corresponding exaggerated reflexes and spasticity in awake chronic spinal rats.

Separate urinary bladder and external urethral sphincter neurons in the central nervous system of the rat: simultaneous labeling with two immunohistochemically distinguishable pseudorabies viruses

This work examines the distribution, in the central nervous system, of virus-labeled neurons from the rat urinary bladder and the external urethral sphincter simultaneously within the same tissue sections. Two immunohistochemically distinct pseudorabies virus strains were injected into male Sprague--Dawley rats (approximately 280 g). One virus was injected into the bladder and the other into the external urethral sphincter. After incubation intervals of 2, 2.5 and 3 days, sections from the spinal cord and brain were treated immunohistochemically to detect cells which were labeled separately by each virus or were labeled by both viruses. The major result of these experiments is that each strain of virus labeled a separate population of neurons and that some neurons were labeled by both strains. In the lumbosacral cord, 3 days post-infection, neurons labeled by virus from the external urethral sphincter were found in Onuf's nucleus, the dorsal gray commissure, and the superficial dorsal horn. Neurons labeled by virus from the urinary bladder were found in the L6--S1 and L1--L2 spinal cord segments within the dorsal gray commissure, the intermediolateral area and the superficial dorsal horn. Double-labeled interneurons were mainly located in the dorsal gray commissure although some were also found in the intermediolateral area and the superficial dorsal horn. In the medulla, external urethral sphincter neurons and bladder neurons and double-labeled neurons were found in the reticular region and the raphe. More rostrally, bladder neurons were located in the pontine micturition center and external urethral sphincter neurons were found in the locus coeruleus and subcoeruleus. A very small number of double-labeled neurons were found in the pontine micturition center and the locus coeruleus or subcoeruleus.

Comparative physiology and biochemistry of rat and rabbit urinary bladder

OBJECTIVE

To compare directly the biochemistry and contractile responses of rat and rabbit bladder to different stimuli. Materials and methods Sexually mature male New Zealand White rabbits and Sprague Dawley rats were compared. Each bladder was excised while the animal was anaesthetized; longitudinal bladder strips were cut and then mounted in an organ bath. Tension (2 g) was placed on all strips and each underwent field stimulation (FS) for a total of 20 s at 1-32 Hz, 1 ms and 80 V and was exposed to carbachol (100 micromol/L), ATP (2 mmol/L) and KCl (120 mmol/L). The tension was monitored continually using a polygraph and data stored digitally in a computer. The responses to each stimulus were determined as the maximum tension generated, maximum rate of tension generation and duration to a maximum response. The Ca2+- ATPase activity of the rat and rabbit bladder was determined. Bladder pressures were then predicted from the strip data using Laplace's law and compared with published values.

RESULTS

Contractile responses (per unit tissue mass) of rat bladder strips were significantly greater than those of rabbit bladder strips at all frequencies of FS and to carbachol, KCl and ATP. The rate of contractile force generated by rat bladder strips in response to all stimuli were significantly greater than that generated by rabbit strips. Rabbit bladder strips took significantly longer to generate maximum tension than did rat bladder strips in response to pharmacological stimuli. In response to FS, rat strips took significantly longer than rabbit strips to generate maximum tension. Although the predicted rat bladder pressures were significantly greater than those for rabbit, the predicted pressures for both the rat and rabbit were significantly lower than the pressure responses of the isolated whole bladder model. The contractile data correlated well with the Ca2+-ATPase activity data; rat bladder had seven times the enzyme activity of rabbit bladder.

CONCLUSION

Per unit mass, rat bladder is capable of generating more than five times the tension of rabbit bladder. Similarly, the rate of tension generation by rat bladder is three to five times greater than that by rabbit bladder. The duration to maximum tension generated in response to FS compared with pharmacological stimuli was affected by the inherent difference in the rate of contractile response to electrical activation compared with agents which diffuse through tissue, and by the difference in size between rat and rabbit bladder smooth muscle cells.

Pudendal nerve stimulation induces urethral contraction and relaxation

In this study we measured urethral pressure changes in response to efferent pudendal nerve stimulation in rats. All other neural pathways to the urethra were transected, and the urethra was continuously perfused. We found fast twitch-like contractions, superimposed on a slow relaxation. The amplitude of the twitches was independent of the stimulation frequency below 26 Hz, whereas the relaxation depended highly on this frequency. The twitches were caused by striated urethral muscles, and the relaxation was caused by smooth muscles. Both were mediated by acetylcholine. We calculated the effective urethral relaxation as the absolute relaxation multiplied by the time fraction between the twitches. Maximum effective relaxation occurred at 8-10 Hz, exactly the frequency of spontaneous oscillations during bladder voiding in rats. Although the oscillatory sphincter contractions in rats during voiding may be needed in other mechanisms for efficient voiding, our data suggest that they may be a side effect of the actual purpose: urethral relaxation.

Experimental bladder instability following bladder outlet obstruction in the female rat

PURPOSE

In rats, urethral obstruction was previously shown to lead to detrusor instability, but bladder instability in conscious animals has not been well characterized. The present study was designed to describe the consequences of bladder outlet obstruction on urodynamic parameters in the conscious rat. A categorization of different types of bladder instability in conscious rats is described.

MATERIALS AND METHODS

Cystometry was performed on conscious animals with chronically implanted lines. Recordings of the micturition pattern and the bladder pressure during the micturition cycle were made from normal female rats and those with instability caused by infravesical outflow obstruction.

RESULTS

In control rats, the peak micturition pressure was low (45.6+/-2.5 cm. H2O) and only small pressure fluctuations occurred before or after micturition. Rats with outlet obstruction exhibited bladder hypertrophy, high micturition pressure (95.5+/-6.8 cm. H2O) as well as marked spontaneous activity throughout the micturition cycle. According to the spontaneous activity profile we identified four main patterns of abnormal micturition cycles.

CONCLUSION

Urethral obstruction in rats leads to a significant increase in bladder weight and to altered micturition patterns which reveal clear similarities with features of the cystometric profiles performed in men with infravesical outflow obstruction. These modifications are not consistently correlated with an increase in bladder weight.

An animal model for the neuromodulation of neurogenic bladder dysfunction

OBJECTIVE

To develop an animal model to examine the pathophysiology by which S3 sacral root electrostimulation alters the micturition reflex in patients with bladder hyper-reflexia.

MATERIALS AND METHODS

Chronic sacral nerve root electrostimulation was applied to spinally transected rats; 21 animals were divided into four groups. The spinal cord was completely transected at the T10-11 level and stainless-steel electrodes implanted into the sacral foramen in 17 animals; these animals were subsequently divided into two groups (1 and 2). Six rats in group 1 underwent sacral root elctrostimulation for 2 h/day and five in group 2 for 6 h/day, for 21 days. The sham group (group 3, six rats) received no stimulation and four rats were used as healthy controls (group 4). Voiding frequency was recorded and each animal was evaluated cystometrically at the end of the stimulation period. The results were compared with the sham and control groups.

RESULTS

Spinal cord transection resulted in bladder areflexia and complete urinary retention; 7-9 days after the injury, the bladder recovered its activity. Twenty-one days after transection all animals had evidence of uninhibited bladder contractions. The mean (SD) hourly frequency of urination was 0.66 (0.18) in healthy controls, 0.83 (0.21) in group 1, 0.87 (0.34) in group 2 and 1.1 (0.31) in group 3. There was a significant decrease in eh cystometric signs of bladder hyper-reflexia in groups 1 and 2 when compared with group 3.

CONCLUSIONS

This work reports and initial study showing that chronic electrostimulation of sacral nerve roots can reduce the signs of bladder hyper-reflexia in the spinally injured rat. To our knowledge, this is the first report describing the rat as an animal model to determine the effects of chronic electrostimulation on the micturition reflex.

Neurophysiological modeling of voiding in rats: urethral nerve response to urethral pressure and flow

In male urethan-anesthetized rats, activity was measured in nerves that run over the proximal urethra. The urethral nerve response to stepwise urethral perfusion could be described by a four-parameter model (fit error < 6%). At the onset of perfusion, the urethra was closed and the pressure increased with the infused volume. The nerve activity (NA) increased linearly with this inserted volume to a maximum (NAmax), which was proportional to the instantaneous pressure. The duration of this first episode (delta t) was inversely proportional to the perfusion rate. After infusion of a fixed volume, the urethra opened and the NA decreased with a time constant phi -1 (approximately 1.8 s) to an elevated level (NAlevel). NAlevel was linearly related to the steady-state pressure. Accordingly, sensors in the urethra are sensitive to pressure rather than to the perfusion rate. The parameters NAmax, NAlevel, and delta t showed very good reproducibility (SD approximately 19% of mean). The measured activity was most likely afferent and conducted to the major pelvic ganglion.

Neural input regulates tissue NGF and growth of the adult rat urinary bladder

To gain insight into the effect of innervation on neurotrophin production, NGF levels in the urinary bladder were measured following unilateral ganglionectomy (bladder denervation) or separation of the post-ganglionic bladder neurons from the central nervous system of the adult rat (bladder and ganglion decentralization). These interruptions of the neural input to half of the bladder caused histological evidence of smooth muscle growth, increased bladder weight (denervation-3 weeks: 98.6 +/- 6 mg; decentralization-3 weeks: 94.0 +/- 7 mg vs. control: 79.6 +/- 4 mg, P < 0.05), transient increases in tissue NGF up to 10-fold (1.99 +/- 0.65 pg NGF/bladder control vs. 20.24 +/- 0.53 (P < 0.05) denervated, ipsilateral, 1 week) and hypertrophy of the neurons in the pelvic ganglia supplying the bladder (control: 340 +/- 4.4 microns2; denervated-3 weeks: 530 +/- 6.8 microns2, P < 0.05; decentralized-3 weeks: 463 +/- 6.8 microns2, P < 0.05). These data suggest that neural input has a significant role in regulating growth of the bladder. Furthermore, the findings show that innervation influences tissue levels of NGF in the bladder.