The aim of this study is to explore the relationship between measured postvoid residual urine volumes (PVR) and self-reported bother from obstructive voiding symptoms (OS) using a retrospective chart review of patients presenting to our clinic from 2004 to 2005. Demographic, primary clinical diagnoses, PVR, and responses to the short form of the Pelvic Floor Distress Inventory (PFDI-20) were recorded. We considered a PVR > 150 ml to be elevated or consistent with urinary retention. We used Spearman's for correlations and Mann-Whitney test for independent groups. Six hundred thirty-six patients were included in the study. Individual PFDI-20 items, which inquire about obstructive voiding symptoms, had poor sensitivity (13-57%) and specificity (18-38%) for elevated PVR. Using logistic regression, age (beta = 0.04, p < 0.001) and stage > or = III prolapse (beta = 0.78, p < 0.05) were predictive factors for elevated PVR. Obstructive voiding symptoms have poor sensitivity and specificity for elevated PVR in women with pelvic floor disorders.

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The novel, peripherally acting opioid peptide, BW443C81, which attenuates airway sensory nerve impulses, was examined on non-cholinergic (NC) constrictor responses in vitro and in vivo and neurogenic plasma extravasation in vivo in guinea-pig airways. Non-cholinergic contractions of guinea pig isolated bronchi, evoked by electrical field stimulation, were concentration-dependently inhibited by BW443C81 and morphine (10 nmol/1-100 mumol/l). In anaesthetised, artificially ventilated guinea pigs, frequency-related NC bronchoconstrictor responses evoked by antidromic electrical stimulation of the vagus nerves were reduced by BW443C81 (100 micrograms/kg/min i.v. infusion) and morphine (1 mg/kg i.v.). Neurogenic plasma extravasation produced by bilateral electrical vagal nerve stimulation in spontaneously breathing, anaesthetised guinea pigs was also inhibited by BW443C81 (1 mg/kg i.v.). The inhibitory effects of BW443C81 were reversed/prevented by naloxone. BW443C81 inhibits NC bronchoconstrictor responses and neurogenic plasma extravasation in guinea pig airways, consistent with its previously described mu-opioid receptor-mediated inhibitory action on airway sensory nerve function.

Neuronal control of the lower urinary tract is a highly complex, integrated process, involving sympathetic, parasympathetic, and sensory neuronal pathways for normal coordinated function. Dysfunction of this integrated mechanism is associated with disorders of the lower urinary tract, most typically urinary incontinence. This unit describes model systems for the measurement of the effects of drugs on bladder function.The first protocol provides a model for measuring the increase in bladder pressure in anesthetized dogs evoked by pelvic nerve stimulation, and for evaluating the effects of pharmacological agents on this response (see Basic Protocol). The same procedure is also described for anesthetized rats (see Alternate Protocol). This model is primarily used to investigate the effects of agents that modify the efferent parasympathetic neuronal drive to the bladder, or that directly relax the smooth muscle of the bladder wall. This preparation is suitable for simultaneous measurement of heart rate, blood pressure, cardiac output, and regional blood flow. Nerve-stimulated salivary secretion can also be measured (see Support Protocol). This is particularly relevant when investigating agents that modulate parasympathetic drive (such as muscarinic antagonists), as it allows for the measurement of relative selectivity on bladder function over the salivary gland. This unit is part of a series describing in vivo models for the assessment of pharmacological agents on lower urinary tract function. UNIT 5.10 describes both anesthetized and conscious animal models of prostate function, while this unit and UNIT 5.12 are primarily for the assessment of bladder function. The anesthetized animal models in this unit offer the potential to measure additional selectivity parameters such as blood pressure, heart rate, and salivation, and to investigate multiple compound concentrations in the same animal. UNIT 5.12 describes a conscious rat model that is arguably closer to normal physiology. However, this model does not permit measurement of additional parameters, and it is more resource intensive as compounds have to be investigated as single doses in any one day. It is important to note that while the models described here and in UNITS 5.10 & 5.12 assess potential pharmacological effects at the level of the lower urinary tract, they are not models of disease state or progression. Caveats associated with the use of rodent and canine models of incontinence include anatomical, physiological, and behavioral differences between the rodent, canine, and human genitourinary systems. For example, rodents and canines (unlike humans) use urination for territorial marking. NOTE: All protocols using live animals must first be reviewed and approved by an Institutional Animal Care and Use Committee (IACUC) or must conform to governmental regulations regarding the care and use of laboratory animals. BASIC PROTOCOL MEASUREMENT OF PELVIC NERVE-STIMULATED BLADDER CONTRACTION AND CARDIOVASCULAR FUNCTION IN THE ANESTHETIZED DOGThis protocol describes...

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