Effects of local anesthetics on human bladder contractility

Oh, Seung‐June; Paick, Sung Hyun; Lim, Do Young; Lee, Eunsik; Lee, Sang Eun

doi:10.1002/nau.20113

Cited by 10 publications

(3 citation statements)

References 27 publications

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“…That the electrical field stimulation-evoked bladder contraction must have been generated by the stimulation of bladder innervation and the release of neurotransmitters can be concluded by the following facts: the remaining part of the electrical field stimulation-evoked bladder contraction in the presence of muscarinic and adrenergic blockade and after P 2X purinoceptor desensitization was small and the same in inflamed bladder preparations and controls. Second, when a high concentration of the sodium channel antagonist lidocaine, with minute direct effects on bladder smooth muscle [45], was administered to the detrusor preparations, the electrical field stimulation-evoked contraction was totally abolished, both in inflamed bladder preparations and in controls. Third, the applied electrical field stimulation was conducted at a short duration of time.…”

Section: Discussionmentioning

confidence: 99%

In vitro Characterization of Parasympathetic and Sympathetic Responses in Cyclophosphamide‐Induced Cystitis in the Rat

Giglio

Aronsson

Eriksson

et al. 2007

Basic Clin Pharma Tox

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In cyclophosphamide-induced cystitis in the rat, detrusor function is impaired and the expression and effects of muscarinic receptors altered. Whether or not the neuronal transmission may be affected by cystitis was presently investigated. Responses of urinary strip preparations from control and cyclophosphamide-pretreated rats to electrical field stimulation and to agonists were assessed in the absence and presence of muscarinic, adrenergic and purinergic receptor antagonists. Generally, atropine reduced contractions, but in contrast to controls, it also reduced responses to low electrical field stimulation intensity (1-5 Hz) in inflamed preparations. In both types, purinoceptor desensitization with α , β -methylene adenosine-5'-triphosphate ( α , β -meATP) caused further reductions at low frequencies ( < 10 Hz). The muscarinic receptor antagonists atropine, 4-diphenylacetoxy-N -methylpiperidine (4-DAMP) ('M 1 /M 3 /M 5 -selective'), methoctramine ('M 2 -selective') and pirenzepine ('M 1 -selective') antagonized the tonic component of the electrical field stimulation-evoked contractile response more potently than the phasic component. 4-DAMP inhibited the tonic contractions in controls more potently than methoctramine and pirenzepine. In inflamed preparations, the muscarinic receptor antagonism on the phasic component of the electrical field stimulation-evoked contraction was decreased and the pirenzepine and 4-DAMP antagonism on the tonic component was much less efficient than in controls. In contrast to controls, methoctramine increased -instead of decreased -the tonic responses at high frequencies. While contractions to carbachol and ATP were the same in inflamed and in control strips when related to a reference potassium response, isoprenaline-induced relaxations were smaller in inflamed strips. Thus, in cystitis substantial changes of the efferent functional responses occur. While postjunctional β -adrenoceptor-mediated relaxations are reduced, effects by prejunctional inhibitory muscarinic receptors may be increased.The contraction of the urinary bladder is principally mediated by the parasympathetic stimulation of the muscarinic receptors populating the detrusor [1]. However, a well-known phenomenon in the rat as well as in many other species is that a large part of the parasympathetic contraction of the bladder is resistant to atropine [2,3]. One non-adrenergic, non-cholinergic transmitter candidate in the atropine-resistant contractile response in the rat bladder is adenosine-5'-triphosphate (ATP, [4 -7]), and in this species the purine generates a transient contraction of the bladder by the activation of P 2X purinoceptors, causing depolarization through non-selective cation channels [8][9][10]. Studies show that in the human urinary bladder, the atropine-resistant contractile response is minute or absent [11][12][13][14], but it may appear in the unstable bladder, during interstitial cystitis or due to spinal cord injuries [15][16][17]. Under such pathological conditions of the bladder, cha...

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Section: Discussionmentioning

confidence: 99%

In vitro Characterization of Parasympathetic and Sympathetic Responses in Cyclophosphamide‐Induced Cystitis in the Rat

Giglio

Aronsson

Eriksson

et al. 2007

Basic Clin Pharma Tox

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“…In vitro, l'immersion de lambeaux de détrusor humain dans des solutions anesthésiantes (lidocaïne, bupivacaïne, tétra-caïne, ropivacaïne) inhibe les contractions du détrusor induites tant par la stimulation électrique fonctionnelle que par l'exposition à des solutions procontractiles telles le carbachol ou le chlorure de potassium [30]. La transposition clinique de ces effets dans l'hyperactivité neurogène du détrusor n'est pas clairement démontrée.…”

Section: Les Anesthésiques Locauxunclassified

Intérêt des thérapies intravésicales en neuro-urologie

Sèze

Delleci

Ruffion³

2009

Acta Endosc

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Intravesical instillation therapy is an easy way to provide high concentrations of pharmacological agents to bladder tissue without causing significant systemic side effects. Urethral catheterization is frequently used for bladder management and follow-up in neurological patients, making such treatment easy to administer in this population. Several agents have been suggested, acting on either the afferent or efferent arm of the micturition reflex, for the treatment of hyperactive or underactive detrusor in patients who do not respond to first-line oral therapies. Despite the established interest of some agents, their use is limited by the lack of commercially available solutions and/or the short duration of the therapeutic effect, resulting in under-use of this promising approach.

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“…In vitro, l'immersion de lambeaux de détrusor humain dans des solutions anesthésiantes (lidocaïne, bupivacaïne, tétracaïne, ropivacaïne) inhibe les contractions du détrusor, induites tant par la stimulation électrique fonctionnelle que par l'exposition à des solutions procontractiles telles le carbachol ou le chlorure de potassium [30]. La transposition clinique de ces effets dans l'hyperactivité neurogène du détrusor n'est pas clairement démontrée.…”

Section: Anesthé Siques Locauxunclassified

Les thérapies intravésicales en neuro-urologie

Sèze

Wiart

et al. 2007

Pelv Perineol

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L'administration intravésicale d'agent théra-peutique permet de délivrer in situ des principes actifs à forte dose en limitant l'occurrence d'effets secondaires systémiques. Le fréquent recours aux cathétérismes urétraux pour la gestion et le suivi de l'appareil urinaire chez les patients neurologiques favorise la faisabilité de cette voie d'administration dans cette population. De nombreuses molécules, affectant le versant afférent ou efférent du réflexe mictionnel, ont été proposées pour réduire l'hyperactivité du détrusor ou favoriser sa contraction chez des patients réfractaires aux thérapies orales de première ligne. Cependant, en dépit du profil d'efficacité et de tolérance satisfaisant de certains agents, l'accès à ces thérapeutiques est limité par leur absence de conditionnement commercialisé pour administration intravésicale et/ou leur courte durée d'efficacité, ne laissant aux thérapies intravésicales qu'une place marginale et sous-exploitée dans l'arsenal thérapeutique des troubles vésicosphinctériens neurogènes.Abstract: Intravesical instillation therapy is an effective method of introducing high concentrations of pharmacological agents into bladder tissue without causing significant systemic side effects. Urethral catheterization is standard treatment in bladder management in neurogenic patients, making intravesical treatment more feasible in this population. Several therapeutic agents, which act on the afferent and efferent pathways of the micturition reflex, have been proposed as second-line treatments for hyperactive or underactive detrusor muscles. Despite the wide interest in a number of these agents, their use is limited because of the lack of commercially available solutions and the short duration of their therapeutic effects, which have led to underestimating their promise.

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Effects of local anesthetics on human bladder contractility

Cited by 10 publications

References 27 publications

In vitro Characterization of Parasympathetic and Sympathetic Responses in Cyclophosphamide‐Induced Cystitis in the Rat

In vitro Characterization of Parasympathetic and Sympathetic Responses in Cyclophosphamide‐Induced Cystitis in the Rat

Intérêt des thérapies intravésicales en neuro-urologie

Les thérapies intravésicales en neuro-urologie

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