Changes in vascular resistance in the feline urinary bladder in response to bladder filling

New Kid on the Block: The Efficacy of Phytomedicine Extracts Urox® in Reducing Overactive Bladder Symptoms in Rats

The aim of the current study was to determine if phytomedicine (Urox^®) would reverse retinyl acetate (RA)–induced changes characteristic of bladder overactivity. There were 60 rats divided into the following 4 groups: I—control, II—received RA to induce detrusor overactivity (DO), III—received Urox (840 mg daily for 14 days), and IV—received combination of RA and Urox^®. The cystometry was performed 2 days after the last dose of Urox^®. Next, urothelium thickness and biochemical parameter measurements were performed. In group IV, a decrease in basal pressure and detrusor overactivity index was noted when compared to group II. Furthermore, in group IV the following parameters were increased: threshold pressure, voided volume, intercontraction interval, and bladder compliance in comparison with group II. There were significant elevations in c-Fos expression in the neuronal voiding centers in group II, while the expression of c-Fos in group IV was normalized. No significant changes in the values of the analyzed biomarkers in group III were found, while in group II, an elevation in BDNF, NGF, CGRP, ATP, Rho kinase, malondialdehyde, 3-nitrotyrosine, TRPV1, OCT-3, and VAChT and then a decrease in E-cadherin and Z01 were found. A successful restoration of all the abovementioned biomarkers’ levels was observed in group IV. Phytomedicine extracts (Urox^®) were found to be potent in reversing RA-induced changes in several cystometric and biochemical parameters that are determinants of overactive bladder (OAB). The actions of Urox^® were proved to be dependent on several factors, such as growth factors and several OAB biomarkers but not pro-inflammatory cytokines.

Effects of vesical and perfusion pressure on perfusate flow, and flow on vesical pressure, in the isolated perfused working pig bladder reveal a potential mechanism for the regulation of detrusor compliance

AIMS

Although there is evidence that deficits in bladder blood flow negatively impact bladder function, the effects of vesical, and perfusion pressures on bladder perfusion (perfusate flow), and of perfusate flow on vesical pressure, remain poorly understood. The present study used the isolated perfused working pig bladder model to examine the relationships between blood flow, and vesical and perfusion pressures.

METHODS

Vesical arteries of pig bladders obtained from a local slaughterhouse were cannulated and perfused with Krebs-Henseleit solution at different pressures, and with carbachol to cause bladder contraction. The urethra of each bladder was cannulated to permit filling (10 mL/min), isovolumetric contraction and emptying. A ureter was cannulated with a pressure sensor to monitor vesical pressure.

RESULTS

When at rest (50 mL vesical volume), bladder vesical pressure was 8.06 ± 1.5 mmHg and perfusate flow driven by a pressure gradient of 105 mmHg was 22.5 ± 2 mL/min (58.9 ± 7.8 mL/min-100 g). During filling, vesical pressure increased and flow decreased, but not necessarily in-parallel. Perfusate flow decreased transiently during isovolumetric contraction, and flow increased during emptying. A reduction in perfusion pressure from ∼105 to ∼40 mmHg reduced flow from ∼70 to ∼20 mL/min-100g, and reduced flow correlated with reduced vesical pressure.

CONCLUSION

Perfusate flow is dependent on bladder perfusion pressure, and not necessarily reciprocally dependent on vesical pressure. Vesical pressure is highly sensitive to the level of perfusate flow, which supports the hypothesis that vesical pressure is dependent on the level of detrusor smooth muscle contractile activity (tone), and that compliance is dependent on bladder perfusion.

The link between vascular dysfunction, bladder ischemia, and aging bladder dysfunction

The vascular supply to the human bladder is derived mainly from the superior and inferior vesical arteries, the latter being directly connected to the internal iliac artery. Aging is associated with an impairment of blood vessel function and changes may occur in the vasculature at the molecular, cellular and functional level. Pelvic arterial insufficiency may play an important role in the development of bladder dysfunctions such as detrusor overactivity (DO) and the overactive bladder syndrome. Chronic ischemia-related bladder dysfunction may progress to bladder underactivity and it would be desirable to treat not only lower urinary tract symptoms (LUTS) induced by chronic ischemia, but also the progression of the morphological bladder changes. Studies in experimental models in rabbits and rats have shown that pelvic arterial insufficiency may result in significant bladder ischemia with reduced bladder wall oxygen tension. In turn, this will lead to oxidative stress associated with upregulation of oxidative stress-sensitive genes, increased muscarinic receptor activity, ultrastructural damage, and neurodegeneration. The phosphodiesterase type 5 (PDE5) inhibitor tadalafil, the α₁-adrenoceptor (AR) blocker silodosin, the β₃-AR agonist mirabegron, and the free radical scavenger melatonin, exerted a protecting effect on urodynamic parameters, and on functional and morphological changes of the bladder demonstrable in vitro. Since the agents tested are used clinically for relieving LUTS, the results from the animal models seem to have translational value, and may be of relevance for designing clinical studies to demonstrate if the drugs may prevent progression of ischemia-related functional and morphological bladder changes.

Microvascular architecture of mouse urinary bladder described with vascular corrosion casting, light microscopy, SEM, and TEM

The urinary bladder is a unique organ in that its normal function is storage and release of urine, and vasculature in its wall exhibits specialized features designed to accommodate changes in pressure with emptying and filling. Although we have previously described the fine details of the microvasculature of the urinary bladder of the rabbit and dog, information on the fine details of the microvasculature of the mouse bladder were deemed to be of value because of the increasing use of this species in developing genetic models for studying human disorders. The present study shows that many of the special features of the microvasculature of the mouse urinary bladder are similar to those described in the rabbit and dog, including vessel coiling, abundant collateral circulation, arterial sphincters, and a dense mucosal capillary plexus.

Functional consequences of chronic bladder ischemia

The pathophysiology of lower urinary tract symptoms (LUTS), particularly in the elderly, seems to be multifactorial. One of the factors involved may be chronic ischemia of the bladder caused by bladder outflow obstruction (male) or atherosclerosis (male/female). The mechanisms by which chronic ischemia initiates and causes LUTS and progressive bladder dysfunction, and the time course of the effects, are incompletely known. Bladder ischemia and repeated ischemia/reperfusion during a micturition cycle may produce oxidative stress, leading to denervation of the bladder and the expression of tissue damaging molecules in the bladder wall. This may be responsible for the development of detrusor overactivity progressing to detrusor underactivity and inability to empty the bladder. The extent of bladder dysfunction in chronic bladder ischemia may depend on the degree and duration of ischemia. To prevent chronic bladder ischemia caused by atherosclerosis and to treat its consequences, more pathophysiological knowledge is needed. Several animal models of atherosclerosis-induced chronic bladder ischemia are available and should be useful tools for further research.

Microvasculature of the urinary bladder of the dog: a study using vascular corrosion casting

The urinary bladder is an unusual organ in that its normal function includes filling and emptying with alternating changes in internal pressure. Although fluctuations in blood flow to the bladder wall are known to accompany these changes, detailed descriptions of the bladder microvasculature are sparse. The present study uses vascular corrosion casting and scanning electron microscopy to describe the three-dimensional anatomy of the microvasculature of the urinary bladder of the dog. Specialized features of that microvasculature, including collateral circulation, vessel folding, vessel orientation, the presence of valves and sphincters, and mucosal capillary density, that may enhance and control blood flow during normal bladder function, are described and discussed.

Inhibitory actions of calcitonin gene-related peptide and capsaicin: evidence for local axonal reflexes in the bladder wall

OBJECTIVES

To explore the actions of capsaicin and the neurotransmitters released by capsaicin (substance P and calcitonin gene-related peptide, CGRP) on the phasic contractile activity generated in the whole isolated guinea pig bladder by muscarinic stimulation, and to examine the hypothesis that collateral fibres of sensory axons contribute to a local reflex in the bladder wall.

MATERIALS AND METHODS

All experiments used whole isolated bladders from female guinea pigs (270-300 g). Bladders were cannulated via the urethra to measure intravesical pressure and suspended in a heated chamber containing oxygenated Tyrode's solution at 33-35 degrees C. All drugs were added to the solution bathing the abluminal surface.

RESULTS

Application of capsaicin (10 micromol/L) to the whole isolated bladder resulted in complex changes in the frequency and amplitude of phasic activity generated by muscarinic stimulation; an initial burst of activity involving a rise in frequency, a second phase of reduced amplitude and frequency and a third phase where the amplitude of the transients recovered and the frequency increased. Capsaicin had no effect on the phasic activity generated by the nicotinic ligand lobeline (30 micromol/L). As capsaicin releases the neurotransmitter content of the sensory nerves, experiments explored the actions of CGRP and substance P on the muscarinic-induced activity. CGRP (3-30 nmol/L) reduced the amplitude and slowed the frequency of the phasic activity. On washing off CGRP the amplitude and frequency of the transient activity recovered and there was a transient increase in frequency above the levels before stimulation. There was also evidence of a desensitization to CGRP on repeated application. In contrast, substance P (100-300 nmol/L) increased the frequency of the transients, while on removing it there was an inhibition of both amplitude and frequency.

CONCLUSIONS

These results suggest that neurotransmitters released from sensory nerve endings in the guinea pig bladder wall affect phasic activity. The direct application of CGRP inhibited phasic activity while substance P was excitatory, indicating the specific contributions of these neurotransmitters. The excitation after stimulation with CGRP and inhibition with substance P may indicate that these neurotransmitters feed back on the sensory nerves to induce transmitter release. Taken together, these observations suggest the presence of a local reflex in the bladder wall, where axon collaterals of afferent sensory fibres innervate the pacemaker mechanism in the bladder wall responsible for generating phasic activity. The possible importance of this reflex in the physiology and pathophysiology of the bladder is discussed.

Evidence for the autoregulation of vesical circulation by intravesical potassium chloride and distension in the normal human bladder

OBJECTIVES

To determine the influence of distension and intravesical KCl on vesical blood flow in the normal human bladder. Subjects and methods Nine normal volunteers underwent comparative cystometry (NaCl vs 0.2 mol/L KCl; filling rate 50 mL/min). Peak systolic blood flow velocity (PSBFV) and end-diastolic blood flow velocity (EDBFV) were measured in several intramural arteries at a filling volume of 50 mL and at maximum cystometric capacity (Cmax). For these measurements a colour Doppler unit fitted with an endorectal probe was used. The resistance index (RI) was defined as (PSBFV-EDBFV)/PSBFV.

RESULTS

In the presence of NaCl, the mean PSBFV increased significantly from 9 cm/s at 50 mL to 17 cm/s at Cmax (512 mL). Compared with NaCl, KCl induced a significantly higher mean PSBFV at 50 mL (15 cm/s). With increasing distension the rise in PSBFV with KCl filling (Cmax 478 mL) was nearly parallel to that obtained on NaCl filling (mean 22 cm/s); the RI did not change.

CONCLUSIONS

Bladder distension and intravesical KCl significantly increased the PSBFV. The unchanged RI indicated a concomitant increase in perfusion rates. Hence, the composition of urine (high potassium concentrations and hyperosmolarity) and its storage govern the autoregulation (independent of cardiac output) of vesical circulation, probably by reflexive pathways. These findings provide further evidence for prevesical arteriovenous shunts.

Sex differences and role of nitric oxide in blood flow of canine urinary bladder

Continuous measurements were made of bladder blood flow by laser Doppler flowmetry in anesthetized dogs during bladder filling and emptying. In both mucosa and muscle, perfusion was inversely proportional to intravesical pressure. There was significantly greater perfusion in the bladder mucosa of males than females at baseline and up to 10 cm water filling pressure but not in the muscle. Intra-arterial infusion of the nitric oxide synthase inhibitor NG-nitro-L-arginine produced a significant decrease in resting bladder perfusion in the mucosa only, with no differences seen in the response to intravesical pressure. Intra-arterial infusion of L-arginine produced a significant increase in the level of perfusion in the mucosa seen immediately after the bladder was drained. No changes were observed in muscle perfusion after L-arginine. These results suggest that the perfusion of the bladder mucosa differs by gender and is regulated differently than the bladder muscle, possibly related to the different function of the two layers.

Effects of ligation of the internal iliac artery on blood flow to the bladder and detrusor function in rat

Ischaemia induced by atherosclerosis is a common cause of disorders in the elderly, including impairment of bladder function. To evaluate experimentally the effects of ischaemia on detrusor function, we performed infusion cystometry and evaluated the morphologic findings in the bladder of the rat. Blood flow to the bladder of the rat was evaluated with a Doppler flowmeter before and after the unilateral or bilateral ligation of the internal iliac arteries. Reevaluation was done at one and two weeks after surgery. Bladder function was studied by infusion cystometry performed in vivo under urethane anaesthesia. Finally, histological examination was performed. Blood flow at mid-dorsal wall of the control bladder was inversely related to intravesical volume. Unilateral or bilateral ligation of the internal iliac arteries decreased blood flow to the bladder, which showed a complete recovery two weeks postoperatively. Infusion cystometry of the ischaemic bladder with bilateral ligation of the internal iliac arteries demonstrated a decrease in voiding pressure, an increase in bladder capacity, and an increase in pressure at which micturition was initiated vs. the control. The bladder with unilateral ligation of the artery showed a decrease in voiding pressure, with no change in the other parameters. Histological examination indicated that the bilateral ischaemia and ischaemic side of unilateral ischaemia led to a degeneration of the mucosa, and severe oedema in submucosal and muscle layers one week postoperatively. Degeneration of smooth muscle was predominant at 2 weeks. Contralateral side of the unilaterally ischaemic bladder showed oedema and congestion of the submucosa and smooth muscle. Ligation of the internal iliac artery decreased blood flow to the bladder significantly, which resulted in smooth muscle degeneration. Consequently, in vivo voiding pressure was impaired in the ischaemic bladder.

Canine bladder blood flow and oxygenation: changes induced by filling, contraction and outlet obstruction

PURPOSE

To study changes in bladder blood flow and oxygenation associated filling, contraction and outlet obstruction.

MATERIALS AND METHODS

Intravesical pressure, bladder flow, bladder wall oxygen tension, iliac artery blood flow and systemic blood pressure were measured simultaneously in anesthetized dogs (N = 18).

RESULTS

In the empty bladder, blood flow and oxygen tension in the bladder were greater than at the dome with and without outlet obstruction. Bladder filling caused a significant decrease in bladder wall blood flow and oxygen tension with or without outlet obstruction. Spontaneous bladder contractions resulted in a marked decrease in bladder wall perfusion in the obstructed bladder but not in the unobstructed bladder. Pelvic nerve stimulation produced strong bladder contractions associated with significant drop in bladder wall perfusion and bladder oxygenation in both the open and closed bladder neck models. Little change was noted after stimulation of the hypogastric nerve.

CONCLUSIONS

Bladder distention and contraction, especially against a closed bladder neck, induce significant ischemia and hypoxia of the bladder wall. These findings may be important in the pathophysiology of a variety of common clinical problems.

Leaky urothelium and/or vesical ischemia enable urinary potassium to cause idiopathic urgency/frequency syndrome and urge incontinence

Urine contains up to 10 times more potassium (K+) than blood plasma. Hence, extracellular K+ concentration of the bladder wall can increase secondary to a leaky urothelium (GAG layer deficiency) and/or vesical ischemia (reduced washout) at low filling volumes. Consequent sensory afferentiated excitation/depolarization of the detrusor leads to urgency/frequency and facilitates the onset of 'uninhibited' contractions. This feature, in association with a weak rhabdosphincter, causes urge incontinence. The non-neuromuscular (non-reflexive) origin explains refractoriness to any neurotransmitted inhibition. Even successful interference with contractility (Ca2+) leaves depolarization unaffected. Accordingly, comparative cystometry (saline versus 0.2 M KCl) is recommended in order to comprise better former falsely under-diagnosed 'normals' as well as former undiscovered urge incontinence, and thus indications for bladder neck surgery as well as neuromuscular drug treatment. Future first-line therapy in idiopathic storage disorders should be directed to the GAG layer, vesical blood flow (K+ washout) and the rhabdosphincter.

Blood flow rate and total blood flow related to length density and total length of blood vessels in mini-pig urinary bladder after chronic outflow obstruction and after recovery from obstruction

Chronic partial bladder outlet obstruction was created in mini-pigs by implanting a 6-7 mm ring around the proximal urethra. After a median obstruction period of 63 days the ring was removed, and after a median recovery period of 60 days the animals were sacrificed. At each study occasion the blood flow rate (ml per 100 g per min) was measured by washout of locally injected 133Xe in the bladder wall and the washout curves analyzed by the corrected initial slope method. Stereological estimation of length density and total length of blood vessels in the bladder were performed. The results can be summarized as follows: (1) no differences in the blood flow rate at the time of ring implantation, obstruction, or recovery, (2) no decrease in the blood flow rate in normal bladders after bladder distension, (3) a significant decrease in blood flow rate in obstructed bladders after distension, (4) a 6-fold increase in total bladder blood flow after obstruction, (5) an unchanged blood flow per length of blood vessels per min during the study, (6) no changes in length densities of blood vessels during the study, and (7) a 7-fold increase in total length of blood vessels after obstruction and reversion to control level after recovery. The unchanged blood flow per length of vessels implies that capillary proliferation matched the increased bladder mass during the study.

Effects of nerve stimulation on blood flow in the urinary bladder, urethra and pelvic floor in the dog

Pelvic organs have triple innervation from the pelvic, sympathetic and pudendal nerves. Peripheral effects can be studied by neurostimulation of the nerves, whereas the topography of the spinal cord neurons can be determined by horseradish peroxidase tracing. We have evaluated the neurophysiologic effects of the nerves at their target organs by intraoperative electric stimulation and compared the effects to the anatomical innervation areas. These zonal areas were determined by blood flow alterations, measured with nine different microspheres. Pelvic nerve stimulation showed bladder contraction with no significant blood flow changes during stimulation. Sympathetic nerve stimulation caused moderate detrusor contraction and pressure increase in the bladder neck and intraprostatic area. Regional blood flow showed a four-fold increase in the bladder neck area during neurostimulation. Pudendal nerve stimulation revealed an intraurethral pressure increase with a 3.5-fold increase of blood flow in the sphincteric area and in the pelvic floor musculature.

Intravesical instillation of terodiline--an in vivo study of drug absorption in rabbit and man

The absorption of intravesically administered terodiline was investigated in 8 healthy volunteers (10(-4)) and in 33 rabbits (10(-4)) M., 4 X 10(-4) M. and 1.6 X 10(-3) M.). In the humans, the amount of drug retained and the serum concentration were registered. In the rabbits, the influence of drug concentration, pH (5 and 9.2) and volume (5 and 20 ml.) were evaluated. Liquid scintigraphy of the bladder wall and of serum and tissue samples from striated muscle, kidney and liver was performed. Further, autoradiography of the bladder wall and calculation of drug retention were done. In the humans, 20 +/- 5% of the administered terodiline dose was retained in the body. Clinically significant serum concentrations were not detected. In the rabbits, 21 +/- 4% of the drug was retained with the pH = 5 terodiline solution as compared with 64 +/- 3% with the pH = 9.2 solution. With increasing terodiline concentrations, drug retention increased, as did the tissue and serum activities. At a given concentration, the total amount of drug retained increased with a larger volume. The drug gradient between the bladder muscle layer and serum was of a magnitude of about 100, independent of the drug concentration within the muscle layer. It is concluded that the pH and concentration of the solution are factors of major importance for the amount of terodiline absorbed from the bladder. Compared with the one obtainable by systemic drug administration, the large gradient between the bladder muscle and the serum is conspicuous, and may be of clinical interest.

Parathyroid hormone-related protein in the rat urinary bladder: a smooth muscle relaxant produced locally in response to mechanical stretch

Parathyroid hormone-related protein (PTHrP) gene expression in the pregnant rat uterus has been shown to be dependent on occupancy of the uterus by the fetus. To further test the hypothesis that the synthesis of PTHrP in smooth muscle tissue is regulated by mechanical stretch, we conducted experiments using the rat urinary bladder as a model of an expansible hollow organ. The results indicate that PTHrP mRNA levels do change in response to the stretch of the bladder wall. Under normal conditions PTHrP mRNA levels in the bladder correlated with the urine volume-namely, the extent of bladder distension. When bladders were maintained empty in vivo, PTHrP mRNA levels decreased gradually. Conversely, when bladders were distended by the accumulation of urine, levels of PTHrP mRNA increased dramatically with time. When distension was limited to one-half of the bladder, the increase in PTHrP mRNA was observed only in the distended portion. Histochemical studies performed on distended bladder tissue indicated the presence of PTHrP immunoreactivity in smooth muscle cells. Isolated organ bath studies were used to examine the possible physiological role of PTHrP in smooth muscle tonicity. In vitro responsiveness of bladder muscle strips to exogenous PTHrP was dependent on the in vivo condition of the bladder. In muscle strips obtained from bladders kept empty in vivo, PTHrP-(1-34)-NH2 relaxed carbachol-induced contraction in a dose-dependent manner but failed to relax the contraction in muscle strips from distended bladders that had high endogenous PTHrP expression. These results and the previous findings in the rat uterus suggest a physiological role of PTHrP in bladder smooth muscle function.

Rate of urinary bladder blood flow evaluated by 133Xe washout and radioactive microspheres in pigs

Urinary bladder blood flow as measured by the washout of locally injected 133Xe and by the simultaneously performed radioactive microsphere reference-sample method was studied in pigs. The washout curves were analyzed according to the initial slope, the corrected initial slope and the total curve. The corrected-initial-slope flow rates were not statistically significantly different from the microsphere whole-wall flow rates. The variability between the methods shown by the test-retest difference revealed only a minor lack of agreement. The bladder blood flow tended to decrease after the intravesical pressure had been increased to 20 cmH2O, but the difference was not statistically significant. Washout of locally injected 133Xe can be used for the evaluation of urinary bladder blood flow in humans and in longitudinal animal studies. The corrected-initial-slope method is recommended for the analysis of washout curves.

Difference in the actions of calcitonin gene-related peptide on pig detrusor and vesical arterial smooth muscle

Calcitonin gene-related peptide has been demonstrated in urinary bladder nerves, and suggested to play a role in local control of bladder motility. In isolated strips of pig detrusor muscle, calcitonin gene-related peptide did not affect spontaneous contractile activity, or contractions induced by high K+, carbachol, substance P, and electrical field stimulation. In contrast, calcitonin gene-related peptide elicited a concentration-dependent and pronounced (78-99%) relaxation of vesical arteries precontracted with endothelin-1, noradrenaline or prostaglandin F2 alpha. As a vasodilator, CGRP was approximately 50 times more potent than acetylcholine. Removal of the endothelium abolished acetylcholine-induced relaxation, but did not affect the relaxation produced by calcitonin gene-related peptide. Pretreatment with methylene blue, glibenclamide or indomethacin had no influence on CGRP's ability to relax the vessels. The inhibitor of NO-synthesis, NG-nitro-L-arginine, had no effect on the maximum vascular relaxation induced by calcitonin gene-relate peptide. It is concluded that in the pig, calcitonin gene-related peptide has no functionally important mechanical effects on isolated detrusor muscle strips, but is a potent dilator of vesical arteries. The vascular effects of the peptide are endothelium-independent, and seem to be exerted directly on the vascular smooth muscle.

A vascular network closely linked to the epithelium of the urinary bladder of the rat

Scanning electron microscopy was used on the mucosa of the rat urinary bladder after digestion with strong alkali and microdissection. The underside of the epithelium (and the plane of the epithelium-tunica propria interface) is not smooth but is scored by grooves--10 microns wide and 3-4 microns deep--connected into a fine mesh. A net of blood capillaries located in the uppermost part of the tunica propria occupies these grooves. They measure 3-9 microns in diameter, are separated from the epithelium by a gap of 0.3 micron, often show fenestrations, and are accompanied by numerous and extensive pericytes and by some fibroblasts. We discuss these observations in the light of current knowledge of blood flow in the bladder, contraction and distension of the bladder wall and formation of mucosal folds, transport of solutes through the epithelium, and plasma extravasation from mucosal blood vessels in neurogenic inflammation.

Urinary bladder blood flow. I. Comparison of clearance of locally injected 99mtechnetium pertechnate and radioactive microsphere technique in dogs

The blood flow of the dog urinary bladder measured by radioactive microsphere technique was compared to the clearance of locally injected 99mTechnetium pertechnate (99mTc) in the bladder wall. In semilogarithmic plots the 99mTc washout curves showed a multiexponential course. From the initial slopes (median 5.7 min) the bladder blood flow was calculated to be only 30-62% of the results obtained from the radioactive microsphere technique (blood flow in the muscular layer 21.7-44.8 ml/100 g/min). These lower values imply that the rate of removal of the hydrophilic tracer 99mTc at these flow rates is limited by the capillary diffusion capacity. The multiexponential curves reflect recirculation and excretion of 99mTc by the kidneys with accumulation of 99mTc in the bladder. It is concluded, that clearance studies of locally injected 99mTc in the bladder wall are unable to evaluate bladder blood flow.

Urinary bladder and urethral responses to pelvic and hypogastric nerve stimulation and their relation to vasoactive intestinal polypeptide in the anaesthetized dog

The effects on the urinary bladder and urethra of pelvic and hypogastric nerve stimulation and their relation to vasoactive intestinal polypeptides (VIP) were investigated in the anaesthetized dog. Both pelvic and hypogastric nerve stimulation elicited a twofold increase in urinary bladder blood flow and a clear-cut increase in bladder venous effluent VIP concentration. Hypogastric nerve stimulation induced an initial, partly alpha-adrenergic and partly non-adrenergic, non-cholinergic, contraction of the urinary bladder followed by a relaxation. The urethra response was a maintained alpha-adrenergic contraction. Pelvic nerve stimulation elicited a bladder contraction with an initial non-cholinergic peak, whereafter the bladder pressure was maintained at a lower level, an effect which was mainly cholinergic in origin. The urethral response was an initial non-adrenergic, non-cholinergic contraction followed by a maintained cholinergic contractile response. Afferent pelvic nerve stimulation led to an efferent activity that seemed to be a combination of activity in pelvic and hypogastric pathways to the urinary bladder and the urethra. VIP (10 nmol) injected i.v. induced a relaxation of the urinary bladder and the urethra, together with a fall in systemic blood pressure. However, despite high plasma concentrations, no vasodilation was elicited in the urinary bladder. Thus, the main target for the VIP release during pelvic and hypogastric nerve stimulation is probably not the bladder vasculature, but instead perhaps the bladder smooth muscle proper.

The rat urinary bladder: vasoactivity and macromolecular leakage in a new model

An in vivo model of the rat urinary bladder microcirculation has been developed and microcirculatory responses to agents which produce vasoconstriction, vasodilation, and macromolecular leakage have been characterized. The urinary bladder of anesthetized female Sprague-Dawley rats is exteriorized and positioned in a tissue bath with a single stay suture which does not penetrate the lumen of the bladder. All blood vessels and nerves from the animal remain intact. The tissue bath is filled with Krebs solution which is monitored and maintained at a temperature of 36 +/- 0.5 degrees and a pH of 7.4 +/- 0.5. In vivo television microscopy is used to monitor vascular diameter and flow changes and isothiocyanate-tagged bovine serum albumin fluorescence is used as an index of macromolecular leakage. Norepinephrine (10(-6) M) caused a statistically significant decrease in vascular diameters of both arterioles and venules while sodium nitroprusside (10(-7) M) significantly increased arteriolar and venular diameters, histamine (10(-4) M) caused no change in venular diameters but did induce a significant macromolecular leak from those vessels. Compound 48/80 (1 and 10 micrograms/ml) induced a significant dose-dependent macromolecular leakage from venules. However, only with the 10 micrograms/ml dose was there visually detectable mast cell degranulation. It is concluded that this rat urinary bladder model provides a stable, reproducible model of a smooth muscle microcirculatory bed in a controlled environment, which responds similarly to other microcirculations.

Bladder vasodilatation and release of vasoactive intestinal polypeptide from the urinary bladder of the cat in response to pelvic nerve stimulation

In the feline urinary bladder blood flow was determined by means of a direct blood flow measurement technique before and during pelvic nerve stimulation. Simultaneous sampling of venous blood from the bladder was performed, and the output of vasoactive intestinal polypeptide (VIP) was determined by means of radioimmunoassay. Maximal stimulation of the pelvic nerves led to a clearcut increase in intravesical pressure and a small but sustained increase of blood flow in the bladder wall. These changes were associated with a drastic increase in VIP output from the bladder, increasing from a control level of 0.2 fmol./min. to 15 fmol./min. during stimulation. The results suggest that VIP might be the neurotransmitter responsible for the vasodilatation in the feline urinary bladder in response to pelvic nerve stimulation. The discrepancy between the moderate blood flow increase and the pronounced increase in VIP-release might, however, indicate that VIP exerts its main effects elsewhere in the bladder than in the vascular bed, for instance the detrusor smooth muscle.