Absorption of Intravesically Applied Drugs: Comparison of Normal and Ileal Augmented Rabbit Bladder

Krege, Susanne; Kinzig‐Schippers, Martina; Sörgel, Fritz; Baschek, R.; Michel, M.; Rübben, H.

doi:10.1097/01.ju.0000137938.47097.63

Cited by 10 publications

(4 citation statements)

References 13 publications

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“…Researchers have long considered the urothelium to be only a passive barrier. However, this barrier can become leaky under pathophysiological conditions, and even the intact urothelium exhibits permeability to some xenobiotics; accordingly, intravesically applied drugs may reach systemically active concentrations (15). Perhaps even more importantly, the urothelium plays a key role in the regulation of bladder function, as it can receive input from various stimuli acting on a large number of receptors and integrate these signals to release mediators acting on other urothelial cells, afferent nerves, and smooth muscle cells (Figure 1).…”

Section: Role Of the Urotheliummentioning

confidence: 99%

Therapeutic Modulation of Urinary Bladder Function: Multiple Targets at Multiple Levels

Michel

2015

Annu. Rev. Pharmacol. Toxicol.

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Storage dysfunction of the urinary bladder, specifically overactive bladder syndrome, is a condition that occurs frequently in the general population. Historically, pathophysiological and treatment concepts related to overactive bladder have focused on smooth muscle cells. Although these are the central effector, numerous anatomic structures are involved in their regulation, including the urothelium, afferent and efferent nerves, and the central nervous system. Each of these structures involves receptors for—and the urothelium itself also releases—many mediators. Moreover, hypoperfusion, hypertrophy, and fibrosis can affect bladder function. Established treatments such as muscarinic antagonists, β-adrenoceptor agonists, and onabotulinumtoxinA each work in part through their effects on the urothelium and afferent nerves, as do α1-adrenoceptor antagonists in the treatment of voiding dysfunction associated with benign prostatic hyperplasia; however, none of these treatments are specifically targeted to the urothelium and afferent nerves. It remains to be explored whether future treatments that specifically act at one of these structures will provide a therapeutic advantage.

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Section: Role Of the Urotheliummentioning

confidence: 99%

Therapeutic Modulation of Urinary Bladder Function: Multiple Targets at Multiple Levels

Michel

2015

Annu. Rev. Pharmacol. Toxicol.

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“…However, the airways and the bladder serve very different purposes within the mammalian body. While the airways are filled with air and primarily serve the purpose of air flow to ultimately yield gas exchange, the bladder is filled with urine and allows for only limited absorption and secretion (Krege et al 2004 ). While the airways undergo several filling/emptying cycles every minute, only one such cycle occurs in a healthy human bladder every couple of hours.…”

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confidence: 99%

Similarities and differences in the autonomic control of airway and urinary bladder smooth muscle

Michel

Parra

2008

Naunyn-Schmied Arch Pharmacol

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The airways and the urinary bladder are both hollow organs serving very different functions, i.e. air flow and urine storage, respectively. While the autonomic nervous system seems to play only a minor if any role in the physiological regulation of airway tone during normal breathing, it is important in the physiological regulation of bladder smooth muscle contraction and relaxation. While both tissues share a greater expression of M 2 than of M 3 muscarinic receptors, smooth muscle contraction in both is largely mediated by the smaller M 3 population apparently involving phospholipase C activation to only a minor if any extent. While smooth muscle in both tissues can be relaxed by β-adrenoceptor stimulation, this primarily involves β 2 -adrenoceptors in human airways and β 3 -adrenoceptors in human bladder. Despite activation of adenylyl cyclase by either subtype, cyclic adenosine monophosphate plays only a minor role in bladder relaxation by β-agonists; an important but not exclusive function is known in airway relaxation. While airway β 2 -adrenoceptors are sensitive to agonist-induced desensitization, β 3 -adrenoceptors are generally considered to exhibit much less if any sensitivity to desensitization. Gene polymorphisms exist in the genes of both β 2 -and β 3 -adrenoceptors. Despite being not fully conclusive, the available data suggest some role of β 2 -adrenoceptor polymorphisms in airway function and its treatment by receptor agonists, whereas the available data on β 3 -adrenoceptor polymorphisms and bladder function are too limited to allow robust interpretation. We conclude that the distinct functions of airways and urinary bladder are reflected in a differential regulation by the autonomic nervous system. Studying these differences may be informative for a better understanding of each tissue.

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“…All the analyzed work covered only native bladders, therefore they did not include experiences with intravesical use on neobladders or augmented bladders [ 34 ], whose anatomical characteristics and absorption properties have shown completely different behavior, both in humans and experimental animals [ 34 , 39 , 40 , 41 ]. Therefore, the use of these agents in augmented bladders should be avoided.…”

Section: Discussionmentioning

confidence: 99%

Intravesical Agents in the Treatment of Bladder Clots in Children

et al. 2023

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Bladder blood clots represent an infrequent urinary condition in children. They usually result from hematuria with many underlying causes, such as urinary tract infections and urethral/bladder traumas. Treatment options for clot removal include trans-urethral or suprapubic bladder irrigation and, if unsuccessful, endoscopic management under general anesthesia with a resectoscope. In younger male children, however, the repeated passage of a trans-urethral resectoscope may be challenging and traumatic, due to the small lumen diameter. Eventually, an open surgical approach can be required in many patients. Few anecdotal non-surgical approaches have been proposed for the management of bladder blood clots in children. This review aims to summarize the conservative techniques described in the literature with the instillation of intravesical agents, analyzing the different strategies and their advantages.

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Absorption of Intravesically Applied Drugs: Comparison of Normal and Ileal Augmented Rabbit Bladder

Cited by 10 publications

References 13 publications

Therapeutic Modulation of Urinary Bladder Function: Multiple Targets at Multiple Levels

Therapeutic Modulation of Urinary Bladder Function: Multiple Targets at Multiple Levels

Similarities and differences in the autonomic control of airway and urinary bladder smooth muscle

Intravesical Agents in the Treatment of Bladder Clots in Children

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