The urothelium plays an important role in the maintenance of normal bladder function. It provides a nonpermeable barrier to the contents of urine. The urothelium is directly involved in the transduction of both intravesical pressure and intravesical volume information to the afferent nerve fibers located within the lamina propria area. A third function may be to modulate bladder contractile function through local secretion of bioactive substances into the muscularis layers adjacent to the urothelium. To test this last hypothesis, the following experiments were performed: Strips of female cat bladders were isolated from the bladder body, base and urethra. The mucosa of alternate adjacent strips was removed, and the contractile response to field stimulation (FS), bethanechol (body), phenylephrine (base, urethra) and KCI was determined. For the bladder body, the strips without mucosa responded to FS, bethanechol, adenosine triphosphate (ATP) and KCI significantly greater than the strips with mucosa intact. For the bladder base and urethra, the contractile responses to FS, KCI and phenylephrine were significantly greater for the strips with mucosa removed as compared with the strips with mucosa intact. For the urethra and bladder base, FS in the presence of phenylephrine produced a relaxation. For the bladder base, the degree of FS relaxation of the isolated strips with mucosa removed was significantly greater than the strips with mucosa intact. For the urethra, FS relaxation was similar for the two groups. In conclusion, removal of the urothelium significantly and substantially increased the contractile response to FS, KCI, bethanechol and phenylephrine. Field stimulation relaxation in the bladder base was also enhanced. Thus in the cat, the mucosa has a significant inhibitory effect on the contractile response of the bladder to stimulation. The mechanism of this activity is not clear at the present time but will be the subject of further study.

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The fact that NF-kappaB is capable of transactivating pro-inflammatory mediators, which in turn can amplify NF-kappaB activation by a positive regulatory loop, suggests that inflammatory and/or immune responses in interstitial cystitis can be exacerbated possibly by persistent activation of this nuclear factor. We believe that our study provides a novel basis for investigating the role of NF-kappaB activation in the pathophysiology of interstitial cystitis and further opens a frontier for the development of an innovative therapeutic approach to interstitial cystitis.

For comprehensive telemetric monitoring of bladder function in monkeys, transducers were implanted in the bladder wall and abdominal cavity. The EMG lead was buried in the external sphincter. All wires terminated in a subcutaneous transmitter. Conventional urodynamics were performed for comparison. Excellent reproducibility with conventional urodynamics was found. Implantation caused detrusor instability, which subsided in 6 to 8 weeks. Real-time computer-based multichannel telemetric studies of voiding are feasible and reliable. Telemetric studies monitor for long periods without stress or anesthesia and provide an excellent model for lower urinary tract studies.