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Huang J, Li H, Zhang Y, Liu J, Cao H, Long Y. Excitatory purinergic and cholinergic expression changed in a partial bladder outlet obstruction-induced overactive bladder rat model. Sci Rep 2023; 13:18395. [PMID: 37884550 PMCID: PMC10603080 DOI: 10.1038/s41598-023-45014-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 10/14/2023] [Indexed: 10/28/2023] Open
Abstract
Overactive bladder (OAB) is a common, long-term symptom complex with a high prevalence in women worldwide. OAB has caused a social burden, and effective treatments are urgently needed. However, the pathogenesis of OAB has yet to be elucidated. Model rats underwent bladder outlet obstruction surgery. In the 2nd, 3rd, and 4th weeks after surgery, metabolic cages were used to detect the 12 h urine volume of rats in the sham and model groups. The urodynamic parameters bladder leak point pressure (BPLL), maximum voiding pressure (MVP), residual volume (RV), maximum bladder capacity (MBC), bladder compliance (BC), voided efficiency (VE), and non-voiding contractions (NVCs) were also detected. Moreover, the contractile responses of isolated detrusor muscles to electrical and carbachol stimulation were examined at the abovementioned time points. At the 4th week after surgery, the bladders of both groups were obtained for hematoxylin-eosin (H&E) and Masson's trichrome staining. Real-time qPCR and Western blot were performed to quantify the expression of choline acetyltransferase (ChAT) and solute carrier family 17 member 9 (SLC17A9). At week 4, compared with the sham group, the 12 h urine volume of PBOO group increased significantly. The BLPP, MVP, VE, MBC, and NVCs increased significantly, and the VE was significantly reduced in 4-week PBOO group. The contractile responses of isolated detrusor muscles to electrical and carbachol stimulation significantly increased in 4-week PBOO group. In the 4-week PBOO group, the bladder wall and the ratio of bladder muscle to collagen within the bladder smooth muscle layer wall were significantly higher than those in the sham group. ChAT and SLC17A9 mRNA and protein expression in the OAB model rats significantly increased. At 4 weeks after PBOO, the OAB model was successfully established. The gene and protein expression levels of ChAT and SLC17A9 increased in the bladder of the OAB model, suggesting that OAB may be related to increased excitatory purinergic and cholinergic expression.
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Affiliation(s)
- Jingyi Huang
- Guangzhou University of Chinese Medicine, No.232 Outer Ring East Road, Higher Education Mega Center, Guangzhou, Guangdong, China
| | - Hongliang Li
- Guangzhou University of Chinese Medicine, No.232 Outer Ring East Road, Higher Education Mega Center, Guangzhou, Guangdong, China
| | - Yao Zhang
- Guangzhou University of Chinese Medicine, No.232 Outer Ring East Road, Higher Education Mega Center, Guangzhou, Guangdong, China
| | - Jiaye Liu
- Guangzhou University of Chinese Medicine, No.232 Outer Ring East Road, Higher Education Mega Center, Guangzhou, Guangdong, China
| | - Hongying Cao
- Guangzhou University of Chinese Medicine, No.232 Outer Ring East Road, Higher Education Mega Center, Guangzhou, Guangdong, China.
| | - Yongling Long
- Guangzhou University of Chinese Medicine, No.232 Outer Ring East Road, Higher Education Mega Center, Guangzhou, Guangdong, China.
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Astragaloside IV Protects Detrusor from Partial Bladder Outlet Obstruction-Induced Oxidative Stress by Activating Mitophagy through AMPK-ULK1 Pathway. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:5757367. [PMID: 35873803 PMCID: PMC9300277 DOI: 10.1155/2022/5757367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/21/2022] [Accepted: 06/27/2022] [Indexed: 11/23/2022]
Abstract
Aims Bladder outlet obstruction (BOO) and the consequent low contractility of detrusor are the leading causes of voiding dysfunction. In this study, we aimed to evaluate the pharmacological activity of astragaloside IV (AS-IV), an antioxidant biomolecule that possess beneficial effect in many organs, on detrusor contractility and bladder wall remodeling process. Methods Partial BOO (pBOO) was created by urethral occlusion in female rats, followed by oral gavage of different dose of AS-IV or vehicle. Cystometric evaluation and contractility test were performed. Bladder wall sections were used in morphology staining, and bladder tissue lysate was used for ELISA assay. Primary smooth muscle cells (SMCs) derived from detrusor were used for mechanism studies. Results Seven weeks after pBOO, the bladder compensatory enlarged, and the contractility in response to electrical or chemical stimuli was reduced, while AS-IV treatment reversed this effect dose-dependently. AS-IV also showed beneficial effect on reversing the bladder wall remodeling process, as well as reducing ROS level. In mechanism study, AS-IV activated mitophagy and alleviated oxidative stress via an AMPK-dependent pathway. Conclusion Out data suggested that AS-IV enhanced the contractility of detrusor and protected the bladder from obstruction induced damage, via enhancing the mitophagy and restoring mitochondria function trough an AMPK-dependent way.
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Gomaa E, Ayoub MM. Vardenafil oral jellies as a potential approach for management of pediatric irritable bowel syndrome. Saudi Pharm J 2021; 29:955-962. [PMID: 34588841 PMCID: PMC8463432 DOI: 10.1016/j.jsps.2021.07.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 07/17/2021] [Indexed: 02/08/2023] Open
Abstract
Irritable bowel syndrome (IBS); a widespread disorder in gastrointestinal tract especially in children, burdens their healthcare systems and upsets families. Great attention was paid to understand the pathophysiological cause of disorder. However, developing a convenient treatment especially for children remains a challenge. Phosphodiesterase inhibitors were recently introduced for IBS management. Vardenafil (VDF), a phosphodiesterase-5 inhibitor, exhibiting limited bioavailability when taken orally due to extensive first-pass effect, was the choice for study. This study aimed to formulate VDF jellies as a buccal dosage form to improve pediatric compliance and achieve maximum drug efficacy. VDF oral jellies were prepared by heat and congeal method, and were evaluated for their pH, content uniformity, physical stability, general appearance, and in-vitro drug release. VDF jellies (F1), with satisfactory organoleptic properties and highest percent of drug released compared to other formulations was selected as a master formula for further study to ensure in-vivo efficacy. cyclic Guanosine Mono Phosphate (cGMP), used as indicator of VDF concentration in blood, was highly increased after administration of VDF jellies (F1), compared to oral VDF suspension. Increased defecation with improved fecal consistency strongly favored oral jellies as a potential alternative route for VDF for IBS management with high pediatric acceptance.
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Affiliation(s)
- Eman Gomaa
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Zagazig University, Zagazig 44519, Egypt
| | - Margrit M Ayoub
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Zagazig University, Zagazig 44519, Egypt
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Blanco-Rivero J, Xavier FE. Therapeutic Potential of Phosphodiesterase Inhibitors for Endothelial Dysfunction- Related Diseases. Curr Pharm Des 2021; 26:3633-3651. [PMID: 32242780 DOI: 10.2174/1381612826666200403172736] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 02/08/2020] [Indexed: 02/08/2023]
Abstract
Cardiovascular diseases (CVD) are considered a major health problem worldwide, being the main cause of mortality in developing and developed countries. Endothelial dysfunction, characterized by a decline in nitric oxide production and/or bioavailability, increased oxidative stress, decreased prostacyclin levels, and a reduction of endothelium-derived hyperpolarizing factor is considered an important prognostic indicator of various CVD. Changes in cyclic nucleotides production and/ or signalling, such as guanosine 3', 5'-monophosphate (cGMP) and adenosine 3', 5'-monophosphate (cAMP), also accompany many vascular disorders that course with altered endothelial function. Phosphodiesterases (PDE) are metallophosphohydrolases that catalyse cAMP and cGMP hydrolysis, thereby terminating the cyclic nucleotide-dependent signalling. The development of drugs that selectively block the activity of specific PDE families remains of great interest to the research, clinical and pharmaceutical industries. In the present review, we will discuss the effects of PDE inhibitors on CVD related to altered endothelial function, such as atherosclerosis, diabetes mellitus, arterial hypertension, stroke, aging and cirrhosis. Multiple evidences suggest that PDEs inhibition represents an attractive medical approach for the treatment of endothelial dysfunction-related diseases. Selective PDE inhibitors, especially PDE3 and PDE5 inhibitors are proposed to increase vascular NO levels by increasing antioxidant status or endothelial nitric oxide synthase expression and activation and to improve the morphological architecture of the endothelial surface. Thereby, selective PDE inhibitors can improve the endothelial function in various CVD, increasing the evidence that these drugs are potential treatment strategies for vascular dysfunction and reinforcing their potential role as an adjuvant in the pharmacotherapy of CVD.
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Affiliation(s)
- Javier Blanco-Rivero
- Departamento de Fisiologia, Facultad de Medicina, Universidad Autonoma de Madrid, Madrid, Spain
| | - Fabiano E Xavier
- Departamento de Fisiologia e Farmacologia, Centro de Biociencias, Universidade Federal de Pernambuco, Recife, Brazil
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Shinkai N, Ichihara K, Kobayashi K, Tabata H, Hashimoto K, Fukuta F, Tanaka T, Masumori N. Long-term tadalafil administration can prevent functional and structural changes of the urinary bladder in male rats with partial bladder outlet obstruction. Neurourol Urodyn 2020; 39:1330-1337. [PMID: 32401423 DOI: 10.1002/nau.24383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/30/2020] [Accepted: 04/30/2020] [Indexed: 02/03/2023]
Abstract
AIMS There have been few reports on whether long-term oral phosphodiesterase 5 inhibitor administration can ameliorate bladder changes due to bladder outlet obstruction (BOO). Therefore, we clarified the chronological changes of the bladder using male BOO rats and evaluated the effects of tadalafil on these changes. METHODS Eight-week-old male Sprague-Dawley rats were used. BOO was created by placing a polyethylene catheter around the urethra. Then, the rats were orally treated with a vehicle, or tadalafil 2 or 10 mg/kg until each evaluation period. Cystometric measurements were performed and the degree of fibrosis in the smooth muscle layer was evaluated at 2, 4, and 16 weeks. RESULTS In BOO rats, a significant increase in the number of non-voiding contractions (NVCs) and a shortened intercontraction interval (ICI) were observed in the earlier phase (2 and 4 weeks) compared to Sham rats. In the chronic phase (16 weeks), markedly increased residual urine volume and an extended ICI were observed accompanied by enhanced smooth muscle fibrosis. These results indicated that the bladder in BOO rats represented the overactive phenotype in the earlier phase and changed into the underactive phenotype in the chronic phase. Even in Sham rats, an increased number of NVCs and enhanced fibrosis were observed with time. Tadalafil administration significantly prevented these bladder changes in both BOO and Sham rats. CONCLUSIONS Long-term oral administration of tadalafil can prevent functional and histological changes in the BOO rat bladder. This agent is also effective for the bladder functional change even in non-obstructed rats.
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Affiliation(s)
- Nobuo Shinkai
- Department of Urology, School of Medicine, Sapporo Medical University, Hokkaido, Japan
| | - Koji Ichihara
- Department of Urology, Sapporo Central Hospital, Hokkaido, Japan
| | - Ko Kobayashi
- Department of Urology, School of Medicine, Sapporo Medical University, Hokkaido, Japan
| | - Hidetoshi Tabata
- Department of Urology, School of Medicine, Sapporo Medical University, Hokkaido, Japan
| | - Kohei Hashimoto
- Department of Urology, School of Medicine, Sapporo Medical University, Hokkaido, Japan
| | - Fumimasa Fukuta
- Department of Urology, School of Medicine, Sapporo Medical University, Hokkaido, Japan
| | - Toshiaki Tanaka
- Department of Urology, School of Medicine, Sapporo Medical University, Hokkaido, Japan
| | - Naoya Masumori
- Department of Urology, School of Medicine, Sapporo Medical University, Hokkaido, Japan
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Kadekawa K, Sugaya K, Yoshimura N. [Effects of alpha-1A/D adrenoceptor antagonist and phosphodiesterase type 5 inhibitor on bladder remodeling in rats with spinal cord injury]. Nihon Yakurigaku Zasshi 2020; 155:10-15. [PMID: 31902838 DOI: 10.1254/fpj.19108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Spinal cord injury (SCI) can lead to detrusor overactivity and detrusor-sphincter dyssynergia, which result in inefficient voiding and bladder wall tissue remodeling such as hypertrophy and fibrosis. However, no effective modality for controlling the bladder remodeling is available. In order to clarify whether an alpha1A/D-adrenoceptor (α1A/D-AR) antagonist, naftopidil, or a phosphodiesterase type 5 (PDE-5) inhibitor, tadalafil, prevents bladder wall remodeling after SCI, we examined the bladder and urethral activity as well as ischemic and fibrotic changes in the bladder using SCI rats with or without naftopidil or tadalafil treatment. Adult female Sprague-Dawley rats were divided into 4 groups; (1) normal (spinal cord intact), (2) vehicle SCI, (3) naftopidil SCI, and (4) tadalafil SCI groups. In SCI groups, rats underwent Th9-10 spinal cord transection followed by oral application of vehicle, naftopidil or tadalafil for 12 weeks. Bladder and urethral pressures, mRNA levels of fibrosis-related molecules and ischemia markers and the composition of bladder collagen and elastin were evaluated. Naftopidil treatment reduced the upregulation of mRNA levels of ischemia and fibrosis markers at the early phase of SCI, and ameliorated the decrease of bladder compliance and voiding efficiency, and the increase of collagen concentration in the bladder wall at the late phase of SCI. Tadalafil treatment reduced the upregulation of mRNA levels of fibrosis markers, the decrease of bladder compliance and the increase of collagen concentration at the late phase of SCI. These results suggest that PDE-5 inhibitors and α1A/D-AR antagonists treatments improved the bladder remodeling after SCI.
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Combination phosphodiesterase type 4 inhibitor and phosphodiesterase type 5 inhibitor treatment reduces non-voiding contraction in a rat model of overactive bladder. PLoS One 2019; 14:e0220788. [PMID: 31461445 PMCID: PMC6713339 DOI: 10.1371/journal.pone.0220788] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 07/23/2019] [Indexed: 01/24/2023] Open
Abstract
Introduction Current treatments for overactive bladder (OAB) are often discontinued due to side effects or lack of efficacy. The goal of this study was to determine if combining a phosphodiesterase type 4 inhibitor (PDE4i); with a type 5 inhibitor (PDE5i); would have a beneficial effect on OAB symptoms and if a reduced dose of PDE4i in combination with PDE5i could also provide a beneficial effect in OAB. We hypothesized that PDE5i and PDE4i combination treatment could be utilized to reduce non-voiding contractions and smooth muscle disruption in a rat model of OAB. Methods Fifty-eight age-matched Sprague-Dawley rats underwent PBOO and daily gavage with PDE4i alone (roflumilast; 1mg/kg), PDE5i alone (tadalafil;10mg/kg), high dose combination (PDE4i 1mg/kg, PDE5i 10mg/kg), low dose combination (PDE4i 0.2mg/kg, PDE5i 10mg/kg), or vehicle for 28 days. Fourteen animals underwent sham PBOO with vehicle. Rats underwent conscious and anesthetized cystometry 28 days after PBOO and were euthanized for qualitative bladder histology. One-way ANOVA on ranks with a Dunn’s post hoc test was used to indicate statistically significant differences between groups (p<0.05). Results Bladder & urethral weight was significantly increased after PBOO with vehicle, PDE4i alone, and PDE5i alone, but not with either combination treatment. Frequency of non-voiding contractions during both conscious and anesthetized cystometry increased significantly after PBOO with vehicle, but not after PDE4i or high dose combination treatments compared to sham PBOO. Threshold pressure for voiding was significantly decreased with high dose combination compared to vehicle. PBOO treated with PDE4i alone or high dose combination showed less bladder smooth muscle fibrosis than vehicle, PDE5i alone, or low dose combination treatments. Conclusion A PDE4i and PDE5i combination treatment has potential benefit in reducing OAB symptoms, but future research is needed.
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Preparation and characterization of intravaginal vardenafil suppositories targeting a complementary treatment to boost in vitro fertilization process. Eur J Pharm Sci 2018; 111:113-120. [DOI: 10.1016/j.ejps.2017.09.044] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 09/14/2017] [Accepted: 09/26/2017] [Indexed: 11/21/2022]
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Aizawa N, Igawa Y. Pathophysiology of the underactive bladder. Investig Clin Urol 2017; 58:S82-S89. [PMID: 29279880 PMCID: PMC5740034 DOI: 10.4111/icu.2017.58.s2.s82] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 08/22/2017] [Indexed: 01/05/2023] Open
Abstract
Underactive bladder (UAB), which has been described as a symptom complex suggestive of detrusor underactivity, is usually characterized by prolonged urination time with or without a sensation of incomplete bladder emptying, usually with hesitancy, reduced sensation on filling, and slow stream often with storage symptoms. Several causes such as aging, bladder outlet obstruction, diabetes mellitus, neurologic disorders, and nervous injury to the spinal cord, cauda equine, and peripheral pelvic nerve have been assumed to be responsible for the development of UAB. Several contributing factors have been suggested in the pathophysiology of UAB, including myogenic failure, efferent and/or afferent dysfunctions, and central nervous system dysfunction. In this review article, we have described relationships between individual contributing factors and the pathophysiology of UAB based on previous reports. However, many pathophysiological uncertainties still remain, which require more investigations using appropriate animal models.
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Affiliation(s)
- Naoki Aizawa
- Department of Continence Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Yasuhiko Igawa
- Department of Continence Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
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Kadekawa K, Majima T, Kawamorita N, Okada H, Yoshizawa T, Mori K, Tyagi P, Sugaya K, Yoshimura N. Effects of an alpha1A/D-adrenoceptor antagonist, naftopidil, and a phosphodiesterase type 5 inhibitor, tadalafil, on urinary bladder remodeling in rats with spinal cord injury. Neurourol Urodyn 2016; 36:1488-1495. [DOI: 10.1002/nau.23158] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Accepted: 09/18/2016] [Indexed: 11/08/2022]
Affiliation(s)
- Katsumi Kadekawa
- Department of Urology; University of Pittsburgh School of Medicine; Pittsburgh Pennsylvania
- Southern Knights’ Laboratory; LLP; Okinawa Japan
- Okinawa Kyodo Hospital; Okinawa Japan
| | - Tsuyoshi Majima
- Department of Urology; University of Pittsburgh School of Medicine; Pittsburgh Pennsylvania
| | - Naoki Kawamorita
- Department of Urology; University of Pittsburgh School of Medicine; Pittsburgh Pennsylvania
| | - Hiroki Okada
- Department of Urology; University of Pittsburgh School of Medicine; Pittsburgh Pennsylvania
| | - Tsuyoshi Yoshizawa
- Department of Urology; University of Pittsburgh School of Medicine; Pittsburgh Pennsylvania
| | - Kenichi Mori
- Department of Urology; University of Pittsburgh School of Medicine; Pittsburgh Pennsylvania
| | - Pradeep Tyagi
- Department of Urology; University of Pittsburgh School of Medicine; Pittsburgh Pennsylvania
| | - Kimio Sugaya
- Southern Knights’ Laboratory; LLP; Okinawa Japan
| | - Naoki Yoshimura
- Department of Urology; University of Pittsburgh School of Medicine; Pittsburgh Pennsylvania
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Influence of sildenafil on blood oxygen saturation of the obstructed bladder. BMC Urol 2014; 14:44. [PMID: 24886184 PMCID: PMC4060762 DOI: 10.1186/1471-2490-14-44] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 05/21/2014] [Indexed: 12/21/2022] Open
Abstract
Background Blood oxygen saturation (BOS) is decreased in a low-compliant, overactive obstructed bladder. The objective of this study is to determine the effect of Sildenafil (SC) on bladder function and BOS) in an in vivo animal model of bladder outlet obstruction. Methods Thirty-two guinea pigs; sham operated (n = 8), sham operated + SC (n = 8), urethrally obstructed (n = 8) and urethrally obstructed + SC (n = 8) were studied during an 8 week period. BOS of the bladder wall was measured by differential path-length spectroscopy (DPS) before obstruction, at day 0, and at week 8. The bladder function was evaluated by urodynamic studies every week. Results Before surgery and after sham operation all study parameters were comparable. After sham operation, bladder function and BOS did not change. In the obstructed group the urodynamic parameters were deteriorated and BOS was decreased. In the group obstruction + SC, bladder compliance remained normal and overactivity occurred only sporadic. BOS remained unchanged compared to the sham group and was significantly higher compared to the obstruction group. Conclusions In an obstructed bladder the loss of bladder function is accompanied by a significant decrease in BOS. Treatment of obstructed bladders with SC yields a situation of high saturation, high bladder compliance and almost no overactivity. Maintaining the microcirculation of the bladder wall might result in better bladder performance without significant loss of bladder function. Measurement of BOS and interventions focussing on tissue microcirculation may have a place in the evaluation / treatment of various bladder dysfunctions.
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Matsumoto S, Watanabe M, Hashizume K, Wada N, Hori JI, Kita M, Iwata T, Kakizaki H. Effects of chronic treatment with cilostazol, a phosphodiesterase 3 inhibitor, on female rat bladder in a partial bladder outlet obstruction model. Urology 2014; 83:675.e7-11. [PMID: 24581543 DOI: 10.1016/j.urology.2013.11.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 10/29/2013] [Accepted: 11/20/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To investigate whether bladder dysfunction after bladder outlet obstruction (BOO) could be altered by treatment with cilostazol, a phosphodiesterase 3 inhibitor (PDE3i). METHODS Twelve-week-old female Sprague-Dawley rats were divided into 5 groups: groups 1 and 2, sham-operated rats and groups 3-5, BOO rats. Group 1 and 3 rats were given normal diet, group 2 and 5 rats were given high-dose PDE3i diet, and group 4 rats were given low-dose PDE3i diet. PDE3i was given within diet from the day of surgery. Four weeks after BOO, the bladder was excised and dissected into 4 longitudinal strips for isometric organ-bath assay. Contractile responses of bladder strips to electrical field stimulation (EFS), carbachol, and potassium chloride (KCl) were determined for each group. RESULTS BOO induced a significant increase in bladder weight in groups 3-5 compared with groups 1 and 2. PDE3i treatment did not affect bladder weight in sham or BOO rats. Contractile forces in response to EFS, carbachol, and KCl in group 3 were about 20%-40% of those in group 1. Contractile responses to EFS or KCl in PDE3i-treated BOO rats were not significantly different from those in group 3. Only high dose of PDE3i treatment in BOO rats caused a statistically significant increase in the response to carbachol compared with group 3. CONCLUSION PDE3i has a small but significant protective effect on the contractile dysfunction induced by a 4-week BOO in rats, although the increase in bladder mass was not altered. PDE3i could be a useful protection against contractile dysfunction of the obstructed bladder.
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Affiliation(s)
- Seiji Matsumoto
- Department of Renal and Urologic Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
| | - Masaki Watanabe
- Department of Renal and Urologic Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Kazumi Hashizume
- Department of Renal and Urologic Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Naoki Wada
- Department of Renal and Urologic Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Jun-ichi Hori
- Department of Renal and Urologic Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Masafumi Kita
- Department of Renal and Urologic Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Tatsuya Iwata
- Department of Renal and Urologic Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Hidehiro Kakizaki
- Department of Renal and Urologic Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
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Maciejewski CC, Tredget EE, Metcalfe PD. Urodynamic improvements following oral medical therapy for partial bladder outlet obstruction in an animal model. Neurourol Urodyn 2013; 34:286-91. [DOI: 10.1002/nau.22528] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 10/22/2013] [Indexed: 11/10/2022]
Affiliation(s)
| | - Edward E. Tredget
- Division of Plastic Surgery, Department of Surgery; University of Alberta; Edmonton Canada
| | - Peter D. Metcalfe
- Division of Urology, Department of Surgery; University of Alberta; Edmonton Canada
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SHIGEHARA K, SUGIMOTO K, KONAKA H, MAEDA Y, KITAGAWA Y, MIZOKAMI A, KOH E, NAMIKI M. Lower Urinary Tract Symptoms are Associated with Erectile Function and Psychological Symptoms in Men with Late-Onset Hypogonadism Syndrome. Low Urin Tract Symptoms 2013; 6:151-6. [DOI: 10.1111/luts.12033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 07/12/2013] [Accepted: 08/01/2013] [Indexed: 01/17/2023]
Affiliation(s)
- Kazuyoshi SHIGEHARA
- Department of Urology; Ishikawa Prefectural Central Hospital; Kanazawa Japan
| | - Kazuhiro SUGIMOTO
- Department of Integrative Cancer Therapy and Urology; Kanazawa University Graduate School of Medical Science; Kanazawa Japan
| | - Hiroyuki KONAKA
- Department of Integrative Cancer Therapy and Urology; Kanazawa University Graduate School of Medical Science; Kanazawa Japan
| | - Yuji MAEDA
- Department of Integrative Cancer Therapy and Urology; Kanazawa University Graduate School of Medical Science; Kanazawa Japan
| | - Yasuhide KITAGAWA
- Department of Integrative Cancer Therapy and Urology; Kanazawa University Graduate School of Medical Science; Kanazawa Japan
| | - Atsushi MIZOKAMI
- Department of Integrative Cancer Therapy and Urology; Kanazawa University Graduate School of Medical Science; Kanazawa Japan
| | - Eitetsu KOH
- Department of Integrative Cancer Therapy and Urology; Kanazawa University Graduate School of Medical Science; Kanazawa Japan
| | - Mikio NAMIKI
- Department of Integrative Cancer Therapy and Urology; Kanazawa University Graduate School of Medical Science; Kanazawa Japan
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Rahnama'i MS, Ückert S, Hohnen R, van Koeveringe GA. The role of phosphodiesterases in bladder pathophysiology. Nat Rev Urol 2013; 10:414-24. [DOI: 10.1038/nrurol.2013.101] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Vignozzi L, Filippi S, Morelli A, Comeglio P, Cellai I, Sarchielli E, Maneschi E, Mancina R, Gacci M, Vannelli GB, Maggi M. Testosterone/Estradiol Ratio Regulates NO‐Induced Bladder Relaxation and Responsiveness to PDE5 Inhibitors. J Sex Med 2012; 9:3028-40. [DOI: 10.1111/j.1743-6109.2012.02946.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Kawai Y, Oka M, Kyotani J, Oyama T, Matsumoto S, Kakizaki H. Effect of the phytotherapeutic agent eviprostat on the bladder in a rat model of bladder overdistension/emptying. Neurourol Urodyn 2012; 32:1031-7. [PMID: 23143863 DOI: 10.1002/nau.22350] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Accepted: 10/12/2012] [Indexed: 11/09/2022]
Abstract
AIMS Ischemia-reperfusion injury is an important factor in the development of lower urinary tract symptoms (LUTS) that is partly mediated by the generation of free radicals. We investigate the effect of the phytotherapeutic agent Eviprostat, a treatment for benign prostatic hyperplasia (BPH) that has antioxidant and anti-inflammatory activity, on urinary bladder blood flow (BBF), and function in a rat model of bladder overdistension and emptying (OE). METHODS For 8 days before surgery, OE rats received daily oral Eviprostat (36 mg/kg/day) or vehicle, while sham-operated animals received vehicle. The bladder was distended by infusion of saline over a period of 2 hr (overdistension) and then emptied. After 24 hr, BBF was measured with a laser speckle blood flow imager. The oxidative-stress marker malondialdehyde (MDA), proinflammatory cytokines, and myeloperoxidase were determined in the isolated bladder, and histological analysis was performed. Functional contractile responses of bladder strips to electrical field stimulation, carbachol, and KCl were measured. RESULTS Twenty-four hours after bladder OE, a significant decrease in BBF and significant increases in bladder weight, malondialdehyde, proinflammatory cytokines, and myeloperoxidase were observed. Eviprostat almost completely prevented these changes. Histological analysis of the bladder of OE rats showed hemorrhage, accumulation of leukocytes, desquamation of epithelium, and edema, and Eviprostat suppressed these changes. The reduction in functional contractile forces in the bladder of OE rats was also prevented by Eviprostat. CONCLUSION Eviprostat-mediated suppression of increased bladder oxidative stress and inflammation caused by bladder OE may contribute to the improvement of BBF and bladder function by Eviprostat.
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Affiliation(s)
- Yuko Kawai
- Discovery Research Laboratories, Nippon Shinyaku Co., Ltd., Nishinosho-monguchi-cho, Kisshoin, Minami-ku, Kyoto, Japan
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Minagawa T, Aizawa N, Igawa Y, Wyndaele JJ. Inhibitory effects of phosphodiesterase 5 inhibitor, tadalafil, on mechanosensitive bladder afferent nerve activities of the rat, and on acrolein-induced hyperactivity of these nerves. BJU Int 2012; 110:E259-66. [PMID: 22591258 DOI: 10.1111/j.1464-410x.2012.11255.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
UNLABELLED What's known on the subject? and What does the study add? Tadalafil, a phosphodiesterase type 5 inhibitor, might be effective for not only erectile dysfunction but also lower urinary tract symptoms (LUTS). One of the mechanisms of tadalafil on LUTS is added in the study. OBJECTIVE To determine if tadalafil, a phosphodiesterase type 5 inhibitor, decreases afferent nerve activity from the bladder with and without chemical stimulation by intravesical acrolein instillation. MATERIALS AND METHODS Female Sprague-Dawley rats were used. Under urethane anaesthesia, single afferent fibres of the nerve primarily originating from the bladder were identified by electrical stimulation of the pelvic nerve and by bladder distension, and classified by conduction velocity as Aδ- or C-fibres. After measuring the baseline single afferent activities (SAA) during constant filling, two experiments were performed. First, tadalafil was administrated intravenously (i.v.) at three doses, 0.01, 0.03 and 0.1 mg/kg cumulatively and SAA were repeatedly studied after each administration. Second, in the presence of vehicle or tadalafil (0.1 mg/kg) i.v., the effect of intravesical instillation of acrolein (0.003%) was studied. RESULTS In all, 39 single units were isolated (Aδ-fibres 21; C-fibres, 18) in 25 rats. Tadalafil dose-dependently decreased SAA of both Aδ- and C-fibres during saline instillation. Intravesical acrolein facilitated SAA of both fibres after vehicle administration. Pretreatment with tadalafil significantly inhibited the acrolein-induced hyperactivity of both fibres. CONCLUSION Our study shows, using selective unifibre potential measurement, that systemic administration of tadalafil reduces mechanosensitive afferent activities of both Aδ- and C-fibres elicited by bladder distension in the rat, and also that tadalafil has an inhibitory effect on the increased activities of both fibres induced by intravesical acrolein instillation.
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Affiliation(s)
- Tomonori Minagawa
- Department of Urology, Antwerp University Hospital and Antwerp University, Faculty of Medicine, Antwerp, Belgium
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Matsumoto S, Kakizaki H. Causative significance of bladder blood flow in lower urinary tract symptoms. Int J Urol 2011; 19:20-5. [PMID: 22146061 DOI: 10.1111/j.1442-2042.2011.02903.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The association between metabolic syndrome and lower urinary tract symptoms has been attracting enormous interest and attention. This enthusiasm is based on the presence of many common risk factors being involved in both metabolic syndrome and lower urinary tract symptoms, as shown by various epidemiological studies. Metabolic syndrome and lower urinary tract symptoms have many pathophysiological features in common, particularly overactive bladder. Herein, we analyze the pathophysiological relationship between metabolic syndrome and lower urinary tract symptoms with a special emphasis on bladder blood flow. We also propose a new treatment strategy for treating lower urinary tract symptoms from the viewpoint of bladder blood flow.
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Affiliation(s)
- Seiji Matsumoto
- Department of Renal and Urologic Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
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Shigehara K, Namiki M. Late-onset hypogonadism syndrome and lower urinary tract symptoms. Korean J Urol 2011; 52:657-63. [PMID: 22087358 PMCID: PMC3212658 DOI: 10.4111/kju.2011.52.10.657] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Accepted: 06/27/2011] [Indexed: 01/31/2023] Open
Abstract
Androgen replacement therapy (ART) is a widely accepted form of treatment worldwide for aging men with late-onset hypogonadism (LOH) syndrome. Concurrent with the progressive decline in testosterone from middle age, there is a gradual increase in prostate volume, reflecting the development of benign prostatic hyperplasia (BPH). Prostate growth is dependent on the presence of androgens, and conversely, antiandrogen agents or orchidectomy can decrease prostate volume in patients with BPH. Thus, it is important to investigate whether ART could have any negative effects on prostatic disease or lower urinary tract symptoms (LUTS). Although only limited amounts of information on the correlations between androgen levels in aging men and clinical manifestations of LUTS are available, a few recent studies have suggested that testosterone levels may have some beneficial effects on various urinary functions in men. Androgen receptors are found in the urothelium, urinary bladder, prostate, and urethra, and testosterone could have an impact on the autonomic nervous system, bladder smooth muscle differentiation, nitric oxide synthase, phosphodiesterase-5 and Rho/Rho-kinase activities, and pelvic blood flow. In addition, some previous studies demonstrated that ART had little effect on LUTS or urinary function in aging men with LOH syndrome. Furthermore, some recent randomized controlled trials indicated that short-term ART may be effective in the improvement of LUTS in hypogonadal men with mild BPH. However, only limited information is available regarding the effects of longer-term ART or the safety of ART in men with severe BPH and LUTS, and further studies are required to reach more definitive conclusions.
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Affiliation(s)
- Kazuyoshi Shigehara
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan
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Liu L, Zheng S, Han P, Wei Q. Phosphodiesterase-5 inhibitors for lower urinary tract symptoms secondary to benign prostatic hyperplasia: a systematic review and meta-analysis. Urology 2011; 77:123-9. [PMID: 21195830 DOI: 10.1016/j.urology.2010.07.508] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2010] [Revised: 06/14/2010] [Accepted: 07/02/2010] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To evaluate the efficacy and safety of phosphodiesterase-5 (PDE-5) inhibitors for treating lower urinary tract symptoms secondary to benign prostatic hyperplasia. METHODS Randomized controlled trials were identified and extracted from MEDLINE, Embase, Cochrane Central, and relevant reference lists. The database search, quality assessment, and data extraction were independently performed by 2 reviewers. Heterogeneity was analyzed using the chi-square test and I(2) test. If lacking of heterogeneity, fixed-effects models were used for the meta-analysis, otherwise random-effects models were used. RESULTS A total of 5 studies (11 randomized controlled trials) were identified from the search strategy. Compared with placebo, short-term trials (≤12 weeks) indicated that PDE-5 inhibitors significantly improved the International Prostate Symptom Score (mean difference -2.60, 95% confidence interval [CI] -3.12 to -2.07; P < .00001), and statistical significance was observed in the International Prostate Symptom Score irritative and obstructive subscore, International Prostate Symptom Score quality of life and erectile function. However, no statistically significant difference was detected in maximal urinary flow rate (mean difference 0.21, 95% CI -0.21-0.64; P = .32) and postvoid residual urine volume (mean difference 0.09, 95% CI -4.71-4.89; P = .80). No statistically significant difference was found between the 2 groups in the incidence of serious adverse events (relative risk 0.52, 95% CI 0.25-1.07; P = .07), despite that adverse event with a greater incidence was detected in the PDE-5 group (relative risk 1.87, 95% CI 1.31-2.68; P = .0005). CONCLUSIONS As the first-line treatment of erectile dysfunction, the PDE-5 inhibitor is also effective and safe for lower urinary tract symptoms secondary to benign prostatic hyperplasia. It could be considered as the first-line treatment in the future for the treatment of patients with comorbid benign prostatic hyperplasia and erectile dysfunction.
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Affiliation(s)
- Liangren Liu
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
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Amano T, Imao T, Takemae K, Iwamoto T, Nakanome M. Testosterone replacement therapy by testosterone ointment relieves lower urinary tract symptoms in late onset hypogonadism patients. Aging Male 2010; 13:242-6. [PMID: 20795793 DOI: 10.3109/13685538.2010.487552] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Patients with late onset hypogonadism (LOH) also suffered from lower urinary tract symptoms (LUTS) and LOH symptoms. The objects of this study are to evaluate the efficacy of testosterone replace therapy (TRT) by testosterone ointment (Glowmin: GL) for LUTS in LOH patients. METHODS The Aging Male Symptom (AMS) scale, Medical Outcomes Study (MOS) 36-Item Short-Form Health Survey (SF-36), International Index of Erectile Function (IIEF-5) and the International Prostate Symptom Score (IPSS) were obtained from patients with LOH. A total of 41 patients with LOH have been treated with TRT using 6 mg/day of GL for 3 months. Serum free testosterone levels (FT) and these four scores were compared before and after TRT. RESULTS Serum FT levels and the scores for the four parameters of AMS, six of eight domains in SF-36, IIEF-5 and total IPSS improved significantly after 3 months TRT. In addition, all IPSS domains also improved significantly, and voiding disturbance seems to have improved more than storage disturbance (P = 0.0280 vs. 0.0483). CONCLUSION TRT by administration of GL is considered to be effective in the improvement of not only ED and LOH symptoms, but also LUTS (especially voiding disturbance) of patients with LOH.
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Affiliation(s)
- Toshiyasu Amano
- Department of Urology, Nagano Red Cross Hospital, Nagano, Japan.
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Dorsey P, Keel C, Klavens M, Hellstrom WJG. Phosphodiesterase type 5 (PDE5) inhibitors for the treatment of erectile dysfunction. Expert Opin Pharmacother 2010; 11:1109-22. [DOI: 10.1517/14656561003698131] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Matsumoto S, Hanai T, Uemura H. Chronic treatment with a PDE5 inhibitor increases contractile force of normal bladder in rats. Int Urol Nephrol 2009; 42:53-6. [PMID: 19449122 DOI: 10.1007/s11255-009-9564-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2008] [Accepted: 03/24/2009] [Indexed: 11/28/2022]
Abstract
OBJECTIVES We have previously shown that a phosphodiesterase 5 (PDE5) inhibitor, vardenafil, possesses bladder protective effects in bladder outlet obstruction (BOO) rats by preserving contractile force. In this study, we examined the effects of vardenafil to obtain clues for further research elucidating the mechanism of action of vardenafil on rat normal bladder. MATERIALS AND METHODS In all, twenty 12-week-old female Sprague-Dawley rats were divided into two equal groups: group 1, water-treated rats; and group 2, vardenafil-treated rats. Vardenafil (8 mg/kg/day) was given by drinking water. Four weeks after, vardenafil was washed out by giving water for 24-48 h, and then bladder was excised and dissected into four longitudinal strips for isometric organ bath assay. Contractile profile of bladder strips to electrical field stimulation (EFS), carbachol, and potassium chloride (KCl) was investigated. RESULTS Vardenafil had no effect on body and bladder weight. Contractile forces to EFS, carbachol, and KCl were all increased significantly in group 2 by chronic vardenafil treatment. CONCLUSION These effects were consistent with those observed in BOO rats for carbachol response, suggesting that effects of vardenafil are not limited to diseased condition, but also apply in normal condition. Chronic treatment with vardenafil increased contractile force of rat normal bladder strips.
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Affiliation(s)
- Seiji Matsumoto
- Urological and Urodynamic Center, Koushinkai Hospital, Toyoda, Sakai, Osaka, 590-0106, Japan.
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