The Urethral Resistance to Rapid Dilatation: An Analysis of the Effect of Autonomic Receptor Stimulation and Blockade and of Pudendal Nerve Blockade in Healthy Females

Thind, Peter; Lose, Gunnar; Colstrup, Hans; Andersson, Karl‐Erik

doi:10.3109/00365599509180544

Cited by 4 publications

(2 citation statements)

References 33 publications

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“…Another reason for choosing this method is that our velocity rates are low. The highest rate tested during this trial was approximately 10 mm 2 /s (20 cmH 2 O/s) compared with earlier trials where the lowest rate was 50 mm 2 /s [ 6,23,24 ] . When we take into account that our highest rate was abandoned, the lowest rate in the earlier trials was a minimum of 10 times higher than the highest rate in our trial.…”

Section: Discussionmentioning

confidence: 49%

Urethral pressure reflectometry; a novel technique for simultaneous recording of pressure and cross‐sectional area: a study of feasibility in the prostatic urethra

et al. 2012

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Study Type – Diagnostic (case series) Level of Evidence 4 What's known on the subject? and What does the study add? In the 1980s and 1990s, a method for direct measurement of pressure and cross‐sectional area in women and men was developed. It was successful in terms of obtaining meaningful results in several studies. But the technique, which was based on the field gradient principle, was never implemented in the clinical setting because of technical limitations. In 2005, urethral pressure reflectometry was introduced as a new technique in female urodynamics. The technique has been shown to be more reproducible than conventional urethral pressure profilometry, when measuring incontinence in women. In 2010 it was also introduced as a new measuring technique in the anal canal. This study, adds a new and interesting technique to the field of male urodynamics. For the first time, sound waves have been used to measure pressure and cross‐sectional area simultaneously, directly in the prostatic urethra. The results from this first trial with urethral pressure reflectometry are promising, in terms of obtaining meaningful physiological parameters. Our hope is that, future trials will help us to be able to identify specific areas of obstruction or rigidity in the prostatic urethra, making treatment more direct and side effects from surgery less severe. However, further studies are needed to evaluate the technique with regards to clinical usefulness in men with benign prostatic obstruction. OBJECTIVE Urethral Pressure Reflectometry (UPR) was introduced in 2005, and it has since been used in the female urethra for simultaneous measurement of pressure (P) and cross‐sectional area (CA). It has shown to be more reproducible than conventional pressure measurement and reintroduced direct measurement of pressure and elastance in the urethra as important parameters when assessing incontinent women. To test the feasibility of UPR in the prostatic urethra. PATIENTS AND METHODS We tested the technique in ten male patients, median age 73 and range 51–91. Measurements were performed in the supine position, with less than 50 ml of urine in the bladder. The UPR valuables measured were opening and closing pressure, opening and closing elastance and hysteresis. RESULTS The PVC tube was easy to insert to the same degree as a normal KAD. Opening pressure and opening elastance were measured on all patients. The sphincter area was easily identified during measurements. UPR provides results compatible with previous techniques. A standardized method for measurements was developed. CONCLUSION UPR has been shown feasible in the prostatic urethra. Further studies on healthy volunteers and patients with lower urinary tract symptoms and benign prostatic obstruction (BPO) are needed, to determine if UPR has a future role in urodynamic diagnostics of male patients with BPO.

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Section: Discussionmentioning

confidence: 49%

Urethral pressure reflectometry; a novel technique for simultaneous recording of pressure and cross‐sectional area: a study of feasibility in the prostatic urethra

et al. 2012

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“…Therefore, the HFO appear to be an integral part of the micturition re¯ex in these species (at least under anesthesia) and may contribute to the effectiveness of the bladder to empty. Although humans do not show oscillatory sphincter behavior during their expulsion phase, there is some evidence that pudendal nerve block may affect the bladder's effectiveness to empty by reducing the expulsion¯ow rate [Brindley et al, 1974] and also reducing urethral pressure in women possibly contributing to stress incontinence [Thind and Lose, 1994;Thind et al, 1995]. Therefore, it appears that coordinated activity in the pudendal nerve innervating the external urethral sphincter, be it in the form of HFO or not, plays an important role in the micturition cycle.…”

Section: Discussionmentioning

confidence: 99%

Effects of the atypical neuroleptic clozapine on micturition parameters in anesthetized rats

Vera

Nadelhaft

2001

Neurourology and Urodynamics

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Clozapine, an atypical antipsychotic, has resulted in a number of reports of urinary disturbances in the clinical literature. We examined the effects of clozapine on urodynamic parameters in the anesthetized rat and compared the effects to those of the typical antipsychotic haloperidol and the selective D2 and D4 antagonists, raclopride and L-745,870, respectively. Clozapine abolished high-frequency oscillations (HFO) during the expulsion phase, and profoundly altered a number of other parameters (e.g., intercontraction interval and resting pressure). Clozapine did not affect the peak contraction pressure during cystometrograms but displayed peripheral inhibition of bladder contractions elicited by electrical stimulation of the pelvic nerve (possibly mediated via clozapine's anti-muscarinic effects). Haloperidol had less potent effects than clozapine since it reduced the amplitude of HFO to 25% of control and also affected several other parameters but without peripheral bladder inhibition. Raclopride only resulted in a modest decrease (approximately 70% of control) in the HFO and no alteration in other parameters. L-745,870 was effective only at highest dose tested suggesting that it might not be acting selectively at D4 receptors. Therefore, we propose that clozapine primarily interferes with the function of the external urethral sphincter. These effects can only be partly explained through antagonism of D2 receptors. Since both clozapine and haloperidol have interactions with other transmitter systems beside dopamine, we suggest that central antagonism of D2 receptors, coupled to central antagonism of another receptor system and peripheral muscarinic receptor blockade, may account for clozapine's potent effects on micturition.

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Spontaneous Activity in Urethral Smooth Muscle

Sergeant

Hollywood

Thornbury

2019

Advances in Experimental Medicine and Biology

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The Urethral Resistance to Rapid Dilatation: An Analysis of the Effect of Autonomic Receptor Stimulation and Blockade and of Pudendal Nerve Blockade in Healthy Females

Cited by 4 publications

References 33 publications

Urethral pressure reflectometry; a novel technique for simultaneous recording of pressure and cross‐sectional area: a study of feasibility in the prostatic urethra

Urethral pressure reflectometry; a novel technique for simultaneous recording of pressure and cross‐sectional area: a study of feasibility in the prostatic urethra

Effects of the atypical neuroleptic clozapine on micturition parameters in anesthetized rats

Spontaneous Activity in Urethral Smooth Muscle

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