Following a review of the literature for non-cholinergic, non-adrenergic mechanisms that are assumed to play a part in regulating the function of the lower urinary tract, some methods of neuropeptide research are described to determine the actual distribution and concentration of these substances. Prominence in the group of nonopioid peptides is given to VIP for the experimentally founded part it plays as relaxation mediator and the probable effect it produces in reducing the spontaneous detrusor activity. Opioid peptides, on the other hand, exercise influence over bladder capacity regulation. There is sporadic clinical evidence for the part certain neuropeptides may play in giving rise to bladder instability. Further studies are invited to add a new aspect to the aetiology and therapy of the relevant pathologic conditions.

Prostatitis, the most common urological disease in men, af¯icts between 25 and 50% of all adult men. Four clinical categories are recognized: acute and chronic bacterial prostatitis, non-bacterial prostatitis and prostatodynia. The role of Gram-positive aerobic bacteria and the different anaerobes in chronic bacterial prostatitis is still a matter of debate. During this study, the urethral discharge and the prostatic¯uid obtained after prostatic massage of 50 patients with chronic prostatitis, con®rmed by clinical examination and resistant to empirical quinolone therapy, were cultured under aerobic and anaerobic conditions. The parallel specimens from 24 patients exhibited high colony counts of Gram-positive and Gram-negative anaerobic bacteria, either alone (18 cases) or in combination with aerobic bacteria (6 cases). The specimens obtained after prostatic massage of the remaining 26 patients were completely negative for both aerobic and anaerobic bacteria. No Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum or Trichomonas vaginalis were isolated from these patients. Patients with chronic prostatitis who gave positive culture results for anaerobes were treated with amoxicillin/clavulanic acid or clindamycin for 3±6 weeks. After treatment, samples were again taken and cultured for all pathogens known to cause prostatitis. These post-therapeutic samples revealed a decrease or total elimination of the symptoms, and no anaerobic bacteria could be detected.

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A simple and rapid method of measuring 5 alpha-reductase (5 alpha-R) activity and of determining the kinetic parameters (KM and Vmax) of the enzyme is described. The 5 alpha-R activity in the homogenate of the prostate of Wistar rats aged 8-12 weeks was established, and the effects of natural and synthetic steroids and of non-steroidal antiandrogens (IC50) upon the 5 alpha-R activity were studied. Of the natural steroids, 17-OH-progesterone was found to have the highest inhibitory effect (IC50 = 1.35 microM), followed in decreasing order by progesterone (IC50 = 5.0 microM) and 4-androstene-3,17-dione (IC50 = 21.6 microM). Oestradiol-17 beta had practically no inhibitory effect. Of the synthetic steroids, 4-MA had the highest inhibitory effect (IC50 = 0.068 microM), followed by nortestosterone (IC50 = 7.4 microM) and RU-486 (Mifepristone) (IC50 = 115 microM). Even at 1000 microM, cyproterone acetate exerted no inhibitory effect. Of the nonsteroidal compounds, ketoconazole proved a weak inhibitor (IC50 = 115 microM), while flutamide was practically ineffective.

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