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Muscarinic Cholinergic Receptors in Bladder Exstrophy

Pharmacological Observations Supporting Functional Closure and Subsequent Bladder Neck Reconstruction
  • Ellen Shapiro
  • Robert D. Jeffs
  • John P. Gearhart
  • Herbert Lepor
Chapter

Abstract

The surgical management of classical bladder exstrophy should be influenced by the inherent detrusor function of the exstrophied bladder. Up until the last decade, the biochemical and neurophysiological properties of the exstrophied bladder had never been studied. Our study using radioligand receptor binding techniques was the first investigation to compare the density and equilibrium dissociation constant of muscarinic cholinergic receptors in control and exstrophy bladders. The density of muscarinic cholinergic receptors in the control and exstrophy groups was 1.97 ± 0.29 and 1.44 ± 0.21 fmol. per.μg. DNA (mean ± S.E.M.), respectively. The dissociation constant of the control and exstrophy groups was 0.15 ± 0.02 and 0.14 ± 0.02 nM. (mean ± S.E.M.), respectively. The data show that the muscarinic receptor density and binding affinity in control and exstrophy bladders are similar. Therefore, the neurophysiological composition of the exstrophied bladder is not significantly altered during the anomalous development. Quantitative morphometric studies suggest that the closed bladder sxstrophy has a cellular composition that is similar to control bladders. Our findings together with these morphometric studies suggest that patients with bladder exstrophy should have normal detrusor contractility if successful bladder closure and subsequent bladder neck reconstruction are ultimately achieved.

Keywords

Bladder Neck Urinary Continence Equilibrium Dissociation Constant Muscarinic Cholinergic Receptor Exstrophied Bladder 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Harvard, B. M. and Thompson, G. J.: Congenital exstrophy of the urinary bladder: late results of treatment by the Coffey-Mayo method of uretero-intestinal anastomosis. J.Urol., 65: 223, 1951.PubMedGoogle Scholar
  2. 2.
    Marshall, V. F. and Muecke, E. C.: Functional closure of typical exstrophy of the bladder. J. Urol., 104: 205, 1970.PubMedGoogle Scholar
  3. 3.
    Nisonson, I. and Lattimer, J. K.: How well can the exstrophied bladder work ? J. Urol., 107: 664, 1972.PubMedGoogle Scholar
  4. 4.
    Lepor, H. and Jeffs, R. D.: Primary bladder closure and bladder neck reconstruction in classical bladder exstrophy. J. Urol., 130: 1142, 1983.PubMedGoogle Scholar
  5. 5.
    Jeffs, R. D., Lakshmanan, Y., and Gearhart, J. P.: A 21-year experience with functional reconstruction in 87 consecutive patients followed from birth. Am Assoc Genito Surg Annual Meeting, 1997, Abstract.Google Scholar
  6. 6.
    Toguri, A. G., Churchill, B. M., Schillinger, J. F. and Jeffs, R. D.: Gas cystometry in cases of continent bladder exstrophy. J. Urol., 119: 536, 1978.PubMedGoogle Scholar
  7. 7.
    Lapides, J., Friend, C. R., Ajemian, E. P. and Sonda, L. P.: Comparison of action of oral and parenteral bethanechol chloride upon the urinary bladder. Invest. Urol., 1: 94, 1963.PubMedGoogle Scholar
  8. 8.
    Shapiro, E., Jeffs, R. D., Gearhart, J. P. and Lepor, H.: Muscarinic cholinergic receptors in bladder exstrophy: insights into surgical management. J. Urol., 134: 308, 1985.PubMedGoogle Scholar
  9. 9.
    Burton, K.: A study of the conditions and mechanism of the diphenylamine reaction for the colorimetric examination of the oxyribonucleic acid. Biochem. J., 62: 315, 1956.PubMedGoogle Scholar
  10. 10.
    Scatchard, G.: The attractions of proteins for small molecules and ions. Ann. N.Y. Acad. Sci., 51: 660, 1949.CrossRefGoogle Scholar
  11. 11.
    Steel, R. G. D. and Torrie, J. H.: Principles and Procedures of Statistics: A Biochemical Approach. New York: McGraw-Hill Book Co., p. 60, 1980.Google Scholar
  12. 12.
    Levin, R. M., Staskin, D. R. and Wein, A. J.: The muscarinic cholinergic binding kinetics of the human urinary bladder. Neurourol. Urodynam., L: 221, 1982.Google Scholar
  13. 13.
    Lepor, H. and Kuhar, M. J.: Characterization of muscarinic cholinergic receptor binding in the vas defer-ens, bladder prostate and penis of the rabbit. J. Urol., 132: 392, 1984.PubMedGoogle Scholar
  14. 14.
    Bradley, W. E. and Scott, F. B.: Physiology of the urinary bladder. In: Campbell’s Urology, 4th ed. Edited by J. H. Harrison, R. F. Gittes, A. D. Perlmutter, T. A. Stamey and P. C. Walsh. Philadelphia: W. B. Saunders Co., vol. 1, chapt. 4, p. 87, 1978.Google Scholar
  15. 15.
    Gup, D. I., Baumann, M., Lepor, H. and Shapiro, E.: Muscarinic cholinergic receptors in normal pediatric and myelodysplastic bladders. J. Urol., 142: 595, 1989.PubMedGoogle Scholar
  16. 16.
    Muecke, E. C.: The role of the cloacal membrane in exstrophy: The first successful experimental study. J. Urol., 92: 659, 1964.PubMedGoogle Scholar
  17. 17.
    Culp, D. A.: The histology of the exstrophied bladder. J. Urol., 91: 538, 1964.PubMedGoogle Scholar
  18. 18.
    Shapiro, E., Becich, E. R. Pearlman, E. and Lepor, H.: Bladder wall abnormalities in myelodysplastic bladders: a computer assisted morphometric analysis. J. Urol., 145: 1024, 1991.Google Scholar
  19. 19.
    Lais, A., Paolocci, N., Ferro, F., Bosman, C., Boldrini, R., and Caione, R: Morphometric analysis of smooth muscle in the exstrophy-epispadias complex. J. Urol., 156: 819, 1996.PubMedCrossRefGoogle Scholar
  20. 20.
    Lee, B. R., Perlman, E. J., Partin, A. W., Jeffs, R. D., and Gearhart, J. P.: Evaluation of smooth muscle and collagen subtypes in normal newborns and those with bladder exstrophy. J. Urol., 156: 2034, 1996.PubMedCrossRefGoogle Scholar
  21. 21.
    Peppas, D. S., Tchetgen, M. B., Jeffs, R. D., and Gearhart, J. P.: A quantitative histological analysis of the bladder in classical bladder exstrophy in various stages of reconstruction utilizing color morphometry. Urology, submitted for publication.Google Scholar

Copyright information

© Springer Science+Business Media New York 1999

Authors and Affiliations

  • Ellen Shapiro
    • 1
  • Robert D. Jeffs
    • 2
  • John P. Gearhart
    • 2
  • Herbert Lepor
    • 1
  1. 1.New York University School of MedicineNew YorkUSA
  2. 2.The Department of UrologyThe Johns Hopkins University School of MedicineBaltimoreUSA

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