Bladder functional recovery following acute overdistension

Abstract

The effects of acute overstretching on detrusor function are unclear. Based on a new method to catheterize male rat bladder through the whole urethra, three groups (control, shamoperated, and acute bladder overdistension) of male rats were utilized in the present experiment. The contraction generated by in vitro bladders immediately post-overdistension in response to 2 Hz and 32 Hz stimulation significantly decreased at 0.75 ml and 1.5 ml intravesical volumes respectively; however, by 1 day post-overdistension the contractile responses increased toward normal. By three days the ability of the bladder to generate pressure completely returned to normal, and the average bladder weight for this group was increased. Similarly, the ability to empty was reduced at 0.75 ml and 1.5 ml immediately following overdistension and recovered fully after 3 days. The ability of the sham-operated bladders to empty at high intravesical volume was slightly reduced immediately following overdistension, and this was the only pathophysiological change observed in this group. Acute bladder overdistension did not alter intravesical capacity. It is clear that acute overdistension induced reversible changes in basic bladder function. o 1992 Wiley-Liss, Inc.

Bladder dysfunction after acute urinary retention in the rats: a novel over active bladder model

“…Interestingly, in cystometric and organ bath studies, there were not statically significant differences in maximum detrusor pressure during voiding, residual urine volume, contractions to 100 mM KCl, and E max and EC 50 values to carbachol among the control group and 2 weeks or 4 weeks AUR rat groups. Kang et al reported that by three days the ability of bladder to generate pressure returned completely to normal in a rat AUR model, and that AUR did not alter intravesical capacity as estimated by cystometory [10]. These data are in agreement with our cystometric and organ bath studies.…”

The etiology of urinary retention after surgery for genuine stress incontinence

“…It has been suggested that this pattern is also pathognomonic for an upper motoneuron lesion [Stanton et al, 1978], although our findings in this setting may be cause to reconsider this. Several authors suggested that postoperative urinary retention after non-radical gynecologic procedures is due to inhibition of detrusor contraction by the inability of patients to relax a painful perineum [Wall et al, 1993], the suppression of parasympathetic stimulation of the detrusor by perioperative opiate use [Peterson et al, 1982;Petros et al, 1993], or overdistension injury to the bladder [Tammela et al, 1986b;Kang et al, 1992;Lasanen et al, 1992]. Contrary to the latter explanations, our study suggests that at least in a subset of patients, the absence of a detrusor contraction is not responsible, but rather the lack of urethral relaxation.…”

“…Indwelling catheters can be uncomfortable or bothersome for patients, and others cannot perform intermittent self-catheterization. Episodes of urinary retention and bladder overdistension, which occur after discontinuation of catheterization, are even more distressing and costly and may damage the detrusor [Kang et al, 1992].…”

Improvement of polyuria, bladder sensation and bladder capacity following renal transplantation

“…However, to our knowledge, there have been no previous reports of such studies. In a series of animal experiments, Kang and colleagues report that acute bladder distention did not change bladder capacity 8 . According to their report, bladder function of the overdistended bladder normalized within a few days.…”