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Ischemia as an Etiological Factor in Bladder Instability: Implications for Therapy

  • Chapter
Bladder Disease, Part A

Abstract

Bladder instability, characterized by spontaneous insuppressible increases in intravesical pressure during bladder filling, and leading to the symptoms of urgency, frequency, nocturia and urge incontinence, may occur idiopathically or be associated with outflow obstructions or various forms of neuropathy. The fact that the signs and symptoms of this lower urinary tract dysfunction are so similar, regardless of the etiology, strongly suggests that there are common causative changes underlying bladder instability.

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References

  1. Brading AF, Greenland JE, Mills IW, McMurray G, Symes, S: Blood supply to the bladder during filling. Scand J Urol Nephrol, 201(Suppl):25, 1999.

    Article  CAS  Google Scholar 

  2. Brading AF, Turner WH: The unstable bladder: towards a common mechanism. Br J Urol, 73:3, 1994.

    Article  PubMed  CAS  Google Scholar 

  3. Bratslavsky G, Whitbeck C, Horan P, Levin RM: Effects of in vivo ischemia on contractile responses of rabbit badder to field stimulation, carbachol, ATP and KG. Pharmacology, 59:221, 1999.

    Article  PubMed  CAS  Google Scholar 

  4. Charlton RG, Morley AR, Chambers P, Gillespie, JI: Focal changes in nerve, muscle and connective tissue in normal and unstable human bladder. Br J Urol, 84:953, 1999.

    CAS  Google Scholar 

  5. Elbadawi A, Yalla SV, Resnick NM: Structural basis of geriatric voiding dysfunction. III. Detrusor overactivity. J Urol, 150:1668, 1993.

    PubMed  CAS  Google Scholar 

  6. Flint Beal M, Howell N, Bodis-Wollner IE: Mitochondria and free radicals in neurodegenerative diseases. New York: Wiley-Liss Inc, 1997.

    Google Scholar 

  7. German K, Bedwani J, Davies J, Brading AF, Stephenson TP: Physiological and morphometric studies into the pathophysiology of detrusor hyperreflexia in neuropathic patients. J Urol, 153:1678, 1995.

    Article  PubMed  CAS  Google Scholar 

  8. Gosling JA, Gilpin SA, Dixon JS, Gilpin CJ: Decrease in the autonomic innervation of human detrusor muscle in outflow obstruction. J Urol, 136:501, 1986.

    PubMed  CAS  Google Scholar 

  9. Greenland JE, Brading AF: Urinary bladder blood flow changes during the micturition cycle in a conscious pig model. J Urol, 156:1858, 1996.

    Article  PubMed  CAS  Google Scholar 

  10. Greenland JE, Brading AF: The in vivo and in vitro effects of hypoxia on pig urethral smooth muscle. Br J Urol, 79:525, 1997.

    Article  PubMed  CAS  Google Scholar 

  11. Greenland JE, Hvistendahl JJ, Andersen H, Jorgensen TM, McMurray G, Brading AF, et al: Vesical blood flow and oxygen tension in the pig. The effects of early bladder outlet obstruction. Neurourol Urodyn, 16:450, 1997.

    Article  Google Scholar 

  12. Harrison SC, Ferguson DR, Doyle PT: Effect of bladder outflow obstruction on the innervation of the rabbit urinary bladder. Br J Urol, 66:372, 1990.

    Article  PubMed  CAS  Google Scholar 

  13. Harrison SC, Hunnam GR, Farman P, Ferguson DR, Doyle PT: Bladder instability and denervation in patients with bladder outflow obstruction. Br J Urol, 60:519, 1987.

    Article  PubMed  CAS  Google Scholar 

  14. Hyman BT, Marlzoff K, Wenniger JJ, Dawson TM, Bredt DS, Snyder SH: Relative sparing of nitric oxide synthase-containing neurons in the hippocampal formation in Alzheimer’s disease. Ann eurol, 32:818, 1992.

    Article  CAS  Google Scholar 

  15. Jorgensen TM, Djurhuus JC, Jørgensen HS, Sorensen SS: Experimental bladder hyperreflexia in pigs. Urol Res, 11:239, 1983.

    Article  PubMed  CAS  Google Scholar 

  16. Levin RM, Haugaard N, Hypolite JA, Wein AJ, Buttyan R: Metabolic factors influencing lower urinary tract function. Exp Physiol, 84:171, 1999.

    PubMed  CAS  Google Scholar 

  17. Levin RM, Leggett R, Whitbeck C, Horan P: Correlation of EGTA and calcium-blocking agents on the response of the bladder to in vitro ischemia. Pharmacology, 58:113, 1999.

    Article  PubMed  CAS  Google Scholar 

  18. Levin RM, Leggett RE, Whitbeck C, Horan P: Effect of diltiazem and pinacidil on the response of the rabbit urinary bladder to repetitive stimulation and in vitro ischemia. Neurourol Urodyn, 18:129, 1999.

    Article  PubMed  CAS  Google Scholar 

  19. Levin RM, Wein, AJ: Response of the in vitro whole bladder (rabbit) preparation to autonomic agonists. J Urol, 128:1087, 1982.

    PubMed  CAS  Google Scholar 

  20. LoPachin RM, Lehning EJ: Mechanism of calcium entry during axon injury and degeneration. Toxicol Appl Pharmacol, 143:233, 1997.

    Article  PubMed  CAS  Google Scholar 

  21. Mills IW: The Pathophysiology of Detrusor Instability and the Role of Bladder Ischaemia in its Aetiology. D.M. thesis, Oxford, 1999.

    Google Scholar 

  22. Mills IW, Greenland JE, McMurray G, McCoy R, Ho KMT, Noble JG, Brading AF: Studies of the pathophysiology of idiopathic detrusor instability: the physiological properties of the detrusor smooth muscle and its pattern of innervation. J Urol, 163:646, 2000.

    Article  PubMed  CAS  Google Scholar 

  23. Mills IW, Noble JG, Brading AF: Effect of prolonged bladder distension on detrusor smooth muscle responses. Neurourol Urodyn, 17:311, 1998.

    Google Scholar 

  24. Morley P, Hogan MJ, Hakim AM: Calcium-mediated mechanismsof ischemic injury and protection. Brain Pathol, 4:37, 1994.

    Article  PubMed  CAS  Google Scholar 

  25. Pessina F, McMurray G, Wiggin A, Brading AF: The effect of anoxia and glucose-free solutions on the contractile response of guinea-pig detrusor strips to intrinsic nerve stimulation and the application of excitatory agonists. J Urol, 157:2375, 1997.

    Article  PubMed  CAS  Google Scholar 

  26. Reid MS: Reactive oxygen and nitric oxide in skeletal muscle. News Physiol. Sci, 11:114, 1996

    CAS  Google Scholar 

  27. Sethia KK, Brading AF, Smith JC: An animal model of non-obstructive bladder instability. J Urol, 143:1243, 1990.

    PubMed  CAS  Google Scholar 

  28. Sibley GNA: The response of the bladder to lower urinary tract obstruction, D.M. thesis, Oxford, 1984.

    Google Scholar 

  29. Sibley GNA: An experimental model of detrusor instability in the obstructed pig. Br J Urol, 57:292, 1985.

    Article  PubMed  CAS  Google Scholar 

  30. Sibley GNA: The physiological response of the detrusor muscle to experimental bladder outflow obstruction in the pig. Br J Urol, 60:332, 1987.

    Article  PubMed  CAS  Google Scholar 

  31. Smet PJ, Edyvane KA, Jonavicius J, Marshall VR: Neuropeptides and neurotransmitter-synthesizing enzymes in intrinsic neurons of the human urinary bladder. J Neurocytol, 25:112, 1996.

    Article  PubMed  CAS  Google Scholar 

  32. Speakman MJ, Brading AF, Gilpin CJ, Dixon JS, Gilpin SA, Gosling, JA: Bladder outflow obstruction-a cause of denervation supersensitivity. J Urol, 138:1461, 1987.

    PubMed  CAS  Google Scholar 

  33. Whitbeck C, Barreto M, Horan P, Levin SS, Levin RM: Rabbit versus rat urinary bladder: effects of in vitro hypoxia. Pharmacology, 59:156, 1999.

    Article  PubMed  CAS  Google Scholar 

  34. Williams JH, Turner WH, Sainsbury GM, Brading AF: Experimental model of bladder outflow tract obstruction in the guinea-pig. Br J Urol, 71:543, 1993.

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. University Department of Pharmacology, Oxford Continence Group, Oxford, UK

    Alison F. Brading & Stephanie Symes

Authors
  1. Alison F. Brading
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  2. Stephanie Symes
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Editor information

Editors and Affiliations

  1. Children’s Hospital and Harvard Medical School, Boston, Massachusetts, USA

    Anthony Atala

  2. Ridgefield, Connecticut, USA

    Debra Slade

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© 2003 Springer Science+Business Media New York

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Brading, A.F., Symes, S. (2003). Ischemia as an Etiological Factor in Bladder Instability: Implications for Therapy. In: Atala, A., Slade, D. (eds) Bladder Disease, Part A. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-8889-8_18

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  • DOI: https://doi.org/10.1007/978-1-4419-8889-8_18

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-4707-1

  • Online ISBN: 978-1-4419-8889-8

  • eBook Packages: Springer Book Archive

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