Clinical Experience with Intravesical Prostaglandin E₂| A Prospective Study of 36 Patients

Abstract

In a prospective study, intravesical prostaglandins were given to 36 patients who had urinary symptoms associated with a poorly functioning detrusor; 67% of these patients were found to be in chronic retention. Using standard urodynamic techniques, 72% showed objective evidence of an immediate improvement in detrusor function and there was prolonged therapeutic benefit in 39%. A prolonged response occurred only in patients who had an intact sacral reflex arc and urodynamic evidence of a pathologically enlarged bladder, and who did not have radiologically demonstrable outflow obstruction. The use of intravesical prostaglandin to stimulate the detrusor was also found to be of value as a urodynamic technique for the investigation of the lower urinary tract.

Prostaglandin E2 and bethanechol in combination for treating detrusor underactivity

“…A notable reduction in both the first desire to void and the maximum cystometric capacity for the active treatment arm provides some evidence of the pharmacological activity of this drug combination, and re-affirms the objective evidence observed by others [9,11].…”

“…The use of intravesical PGs and oral BC has been assessed in isolation in an attempt to improve voiding in patients with chronic retention, but unsuccessfully [4,6]. The hypothesis that the two drugs together may improve detrusor function was drawn from previous clinical experience with intravesical PGE 2 [9]. In that study the authors remarked that the effects of PGE 2 appeared to be additive or synergistic in some of the patients who were already receiving cholinergic stimulation.…”

“…No prospective clinical study to date has assessed these two drugs in combination and their effects on bladder emptying. One paper reporting 36 patients treated with intravesical PGE 2 noted that the results were encouraging for those already receiving oral cholinergic stimulation, with a prolonged reduction in the postvoid residual urine volume (PVR) [9]. No prospective study to date has specifically assessed the combined therapy.…”

Alteration in Contractile Responses in Human Detrusor Smooth Muscle from Obstructed Bladders with Overactivity

“…Urinary levels of these factors may be used as markers to evaluate DO symptoms. While it was found in the previous in vitro studies that both PGF2 ␣ and PGE2 increased detrusor contractions in significant ratios, it has been shown in in vivo studies that bladder contractions improved and detrusor contraction increased after gynecological operations with direct instillation of PGs into the bladder [21,22] . While Bergman et al [23] found insignificant changes in PGF2 ␣ and TXB2 levels in detrusor overactivity, they also found that 6-keto-PGF1 ␣ levels increased.…”

Age-Related Changes in Contractile Force of Rabbit Detrusor Muscle to Prostaglandin E₁, E₂ and F_2α

“…There have been numerous studies on the effects of prostaglandins (PGs) on the smooth muscle of the uri nary bladder both in vivo and in vitro [1][2][3][4][5][6][7][8][9][10] and attempts have been made to evoke bladder contractions in man by the intravesical infusion of PGE2 [4,11], The effects of PGs are known to differ with age in human lymphocyte [12], rat testicular capsule [13] and in the colon, stomach and ileum of the guinea pig and rat [14], The effect of age on the response of urinary bladder smooth muscle to PGs has not been studied previously. The present study was designed to assess the age-dependent effects of PGs on rabbit detrusor smooth muscle.…”