Urological Research

, Volume 32, Issue 3, pp 200–203 | Cite as

The effect of intravesical sodium nitroprusside on idiopathic detrusor overactivity

  • Fatih Tarhan
  • Erkan Erbay
  • Bilal Eryıldırım
  • Gökhan Faydacı
  • Uður Kuyumcuoğlu
Original Paper
First Online:
Received:
Accepted:

Abstract

Although nitric oxide (NO) plays an important role in the urethra and outlet region of the bladder, the role of this inhibitory neurotransmitter in the human detrusor remains unclear. We conducted a prospective, randomised, open study on 31 patients with urodynamically proven idiopathic detrusor overactivity in order to examine the effects of intravesical administration of the NO donor sodium nitroprusside (SNP) on detrusor overactivity. Thirty-one consecutive patients (14 male, 17 female; mean age 53.0±2.7 years) with idiopathic detrusor overactivity diagnosed by pressure-flow analysis were included in this study. The patients were randomised into two groups. Cystometries were performed with normal saline in the control group (n=10) and with 7.2 mM SNP solution (2.16 mg/ml) in the study group (n=21). We urodynamically investigated sensation, maximal cystometric capacity, compliance, instability index, amplitude and frequency of involuntary contractions. No statistically significant differences was found between the first (pressure-flow) and second (saline or SNP cystometry) urodynamic values in the control and study groups (P>0.05). We have demonstrated that SNP does not have any effect on uninhibited bladder contractions. These results suggest that the intravesical administration of SNP is not an effective treatment for detrusor overactivity.

Keywords

Urine bladder Detrusor overactivity Nitric oxide Sodium nitroprusside 
This is a preview of subscription content, log in to check access.

Notes

Acknowledgement

The authors thank Dr. Petek Arıoğlu for help with the English language manuscript.

References

  1. 1.
    Garnett S, Abrams P (2002) Clinical aspects of the overactive bladder and detrusor overactivity. Scand J Urol Nephrol [Suppl] 210: 65Google Scholar
  2. 2.
    Mumtaz FH, Khan MA, Thompson CS, Morgan RJ, Mikhailidis DP (2000) Nitric oxide in the lower urinary tract: physiological and pathological implications. BJU Int 85: 567CrossRefPubMedGoogle Scholar
  3. 3.
    Mamas MA, Reynard RM, Brading AF (2003) Nitric oxide and the lower urinary tract: current concepts, future prospects. Urology 61: 1079CrossRefPubMedGoogle Scholar
  4. 4.
    Haab F (2000) Discussion: nitric oxide and bladder overactivity. Urology 55 [Suppl]: 58Google Scholar
  5. 5.
    Persson K, Pandita RK, Aszodi A, Ahmad M, Pfeifer A, Fassler R, Andersson K-E (2000) Functional characteristics of urinary tract smooth muscles in mice lacking cGMP protein kinase type I. Am J Physiol Regulatory Integrative Comp Physiol 279: R1112Google Scholar
  6. 6.
    Jung SY, Fraser MO, Ozawa H, Yokoyama O, Yoshiyama M, De Groat WC, Chancellor MB (1999) Urethral afferent nerve activity affects the micturition reflex; implication for the relationship between stress incontinence and detrusor instability. J Urol 162: 204CrossRefPubMedGoogle Scholar
  7. 7.
    Bennett BC, Kruse MN, Roppolo JR, Flood HD, Fraser M, De Groat WC (1995) Neural control of urethral outlet activity in vivo: role of nitric oxide. J Urol 153: 2004CrossRefPubMedGoogle Scholar
  8. 8.
    Nishizawa S, Igawa Y, Okada N, Ohhashi T (1997) Capsaicin-induced nitric-oxide-dependent relaxation in isolated dog urethra. Eur J Pharmacol 335: 211CrossRefPubMedGoogle Scholar
  9. 9.
    Birder LA, Apodaca G, De Groat WC, Kanai AJ (1998) Adrenergic- and capsaicin-evoked nitric oxide release from urothelium and afferent nerves in urinary bladder. Am J Physiol 275: F226PubMedGoogle Scholar
  10. 10.
    Pandita RK, Mizusawa H, Andersson KE (2000) Intravesical oxyhemoglobin initiates bladder overactivity in conscious, normal rats. J Urol 164: 545PubMedGoogle Scholar
  11. 11.
    Chung B, Choi SK, Chang K (1996) Effects of nitric oxide on detrusor relaxation. J Urol 155: 2090PubMedGoogle Scholar
  12. 12.
    Ozawa H, Chancellor BM, Jung SY, Yokoyama T, Fraser OM, Yongbei YU, De Groat CW, Yoshimura N (1999) Effect of intravesical nitric oxide therapy on cyclophoshamide-induced cystitis. J Urol 162: 2211PubMedGoogle Scholar
  13. 13.
    Theobald RJJr (2003) Differing effects of NG-monomethyl-L-arginine and 7-nitroindazole on detrusor activity. Neurourol Urodyn 22: 62CrossRefPubMedGoogle Scholar
  14. 14.
    Smet PJ, Jonavicius J, Marshall VR, De Vente J (1996) Distribution of nitric oxide synthase-immunoreactive nerves and identification of the cellular targets of nitric oxide in guinea-pig and human urinary bladder by cGMP immunohistochemistry. Neuroscience 71: 337CrossRefPubMedGoogle Scholar
  15. 15.
    Fathian-Sabet B, Bloch W, Klotz T, Niggemann S, Jacobs G, Addicks K, Engelmann U (2001) Localization of constitutive nitric oxide synthase isoforms and the nitric oxide target enzyme soluble guanylyl cyclase in the human bladder. J Urol 165: 1724PubMedGoogle Scholar
  16. 16.
    Klotz T, Mathers MJ, Bloch W, Nayal W, Engelmann U (1999) Nitric oxide based influence of nitrates on micturition in patients with benign prostatic hyperplasia. Int Urol Nephrol 31: 335PubMedGoogle Scholar
  17. 17.
    James MJ, Birmingham AT, Bates CP (1993) Partial mediation by nitric oxide of the relaxation of human isolated detrusor strips in response to electrical field stimulation. Br J Clin Pharmacol 35: 366PubMedGoogle Scholar
  18. 18.
    Moon A (2002) Influence of nitric oxide signalling pathways on pre-contracted human detrusor smooth muscle in vitro. BJU Int 89: 942CrossRefPubMedGoogle Scholar
  19. 19.
    Gerber JG, Nies AS (1990) Antihypertensive agents and the drug therapy of hypertension. In: Gilman AG, Rall TW, Nies AS, Taylor P (eds) The pharmacological basis of therapeutics. Pergamon, New York, p 803Google Scholar
  20. 20.
    Moncada S, Palmer RMJ, Higgs EA (1991) Nitric oxide: physiology, pathophysiology and pharmacology. Pharmacol Rev 43: 109PubMedGoogle Scholar
  21. 21.
    Abrams P, Cardozo L, Fall M, Griffiths D, Roiser P, Ulmsten U, Van Kerrebroeck, Victor A, Wein A (2002) The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 21: 167CrossRefPubMedGoogle Scholar
  22. 22.
    Tapp A, Fall M, Norgaard J, Massey A, Choa R, Carr T, Korhonen M, Abrams P (1989) Terodiline: a dose titrated, multicenter study of the treatment of idiopathic detrusor instability in women. J Urol 142: 1027PubMedGoogle Scholar
  23. 23.
    Dixon JS, Pen Py, Gosling JA (1997) A double-label immunohistochemical study of intramural ganglia from the human male urinary bladder neck. J Anat 190: 125CrossRefPubMedGoogle Scholar
  24. 24.
    Ehrén I, Iversen H, Jansson O, Adolfsson J, Wiklund NP (1994) Localization of nitric oxide synthase activity in the human lower urinary tract and its correlation with neuroeffector responses. Urology 44: 683PubMedGoogle Scholar
  25. 25.
    Williams P, Datta S, German K, Stephenson TP, Bedwani JR (1995) Comparison of relaxation responses of detrusor strips from neuropathic and control patients. Br J Urol 76: 726PubMedGoogle Scholar
  26. 26.
    Persson K, Andersson KE (1994) Non-adrenergic, non-cholinergic relaxation and levels of cyclic nucleotides in rabbit lower urinary tract. Eur J Pharmacol 268: 159CrossRefPubMedGoogle Scholar
  27. 27.
    Morita T, Tsujii T, Dokita S (1992) Regional difference in functional roles of cAMP and cGMP in lower urinary tract smooth muscle contractility. Urol Int 49: 191PubMedGoogle Scholar
  28. 28.
    Fujiwara M, Andersson K, Persson K (2000) Nitric oxide-induced cGMP accumulation in the mouse bladder is not related to smooth muscle relaxation. Eur J Pharmacol 401: 241PubMedGoogle Scholar
  29. 29.
    Gryglewski RJ, Marcinkiewicz E, Robak J, Michalska Z, Madej J (2002) Mesoionic oxatriazoles (MOTA): NO-donating characteristics and pharmacology. Curr Pharm Des 8: 167PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Fatih Tarhan
    • 1
    • 2
  • Erkan Erbay
    • 1
  • Bilal Eryıldırım
    • 1
  • Gökhan Faydacı
    • 1
  • Uður Kuyumcuoğlu
    • 1
  1. 1.Urology ClinicKartal Training and Research Hospital
  2. 2.Genç Sokak 10/781010 Acıbadem-Kadıköy

Personalised recommendations