Bladder underactivity induced by prolonged pudendal afferent activity in cats

Mohapatra, Anand; Chen, Jialiang; Zhao, Jie; Zhong, Yihua; Armann, Kody; Shen, Bing; Wang, Jicheng; Beckel, Jonathan M.; Groat, William C. de; Tai, Changfeng

doi:10.1152/ajpregu.00239.2020

Cited by 7 publications

(8 citation statements)

References 29 publications

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“…Both PNS and TNS induce bladder inactivity, confirming that prolonged somatic afferent activity may be the pathophysiological cause of NOUR. The advantage of the presented animal models is the maintenance of neural control over the bladder, which makes them more compatible with the real idiopathic underactive bladder [ 22 ].…”

Section: Resultsmentioning

confidence: 99%

Fowler’s Syndrome—The Cause of Urinary Retention in Young Women, Often Forgotten, but Significant and Challenging to Treat

Szymański

Słabuszewska-Jóźwiak

Jakiel

2021

IJERPH

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Urinary retention in young women is a relatively rare clinical problem and is often underdiagnosed. In particular, functional causes of urinary retention pose a diagnostic challenge. One of them is Fowler’s syndrome, which is associated with impaired urethral relaxation. Fowler’s syndrome is characterized by a large bladder capacity, reduced sensation, increased maximal urethral closure pressure, and detrusor underactivity. Several hypotheses have arisen to explain the cause of urethral relaxation disorders: hormonal changes characteristic of Polycystic Ovary Syndrome (PCOS), causing abnormal stabilization of the muscle membrane, primary failure of relaxation of the striated muscle of the urethra sphincter, and increased urethral afferent activity, inhibiting the bladder afferent signals from reaching the brain by potentiating a spinal mechanism of urinary continence. Currently, sacral neuromodulation is the only intervention that can restore an atypical voiding pattern in women with Fowler’s syndrome. The therapeutic effectiveness exceeds 70%, although the revision rate is relatively high, exceeding 50%. Well-designed, long-term prospective studies comparing sacral neuromodulation (SNM) with other therapies such as pelvic floor muscle physiotherapy are warranted to offer the best patient-tailored treatment.

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Section: Resultsmentioning

confidence: 99%

Fowler’s Syndrome—The Cause of Urinary Retention in Young Women, Often Forgotten, but Significant and Challenging to Treat

Szymański

Słabuszewska-Jóźwiak

Jakiel

2021

IJERPH

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“…PNS was applied using uniphasic rectangular electrical pulses (5 Hz frequency, 0.2 ms pulse width) that have been previously shown to be effective in inhibiting reflex bladder activity 6 . At the beginning of each experiment, the intensity threshold (T) for PNS to induce an anal twitch was determined.…”

Section: Methodsmentioning

confidence: 99%

“…previous study, 6 which is long enough to test a single dose of a drug. There is no difference between male and female cats in the number of repeated applications of the 30-min PNS.…”

Section: Bladder Underactivity Induced By Prolonged Pnsmentioning

confidence: 99%

“…Recently a feline model of bladder underactivity was developed by administering prolonged (hours) pudendal nerve stimulation (PNS) to mimic the abnormal pudendal afferent firing in the Fowler's syndrome 6 . The prolonged pudendal afferent input to the CNS produced a sustained inhibition of bladder activity consisting of an increased bladder capacity and a reduced amplitude of bladder contractions that lasted more than 2 h after the PNS was terminated 6 . Similar to Fowler's syndrome, sacral neuromodulation is also effective in this feline model of bladder underactivity to restore the large bladder capacity to the normal control level 7 .…”

Section: Introductionmentioning

confidence: 99%

“…6 The prolonged pudendal afferent input to the CNS produced a sustained inhibition of bladder activity consisting of an increased bladder capacity and a reduced amplitude of bladder contractions that lasted more than 2 h after the PNS was terminated. 6 Similar to Fowler's syndrome, sacral neuromodulation is also effective in this feline model of bladder underactivity to restore the large bladder capacity to the normal control level. 7 In this study we investigated the possible neurotransmitter mechanisms underlying UAB/NOUR in this feline model of Fowler's syndrome.…”

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confidence: 99%

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Role of opioid and β‐adrenergic receptors in bladder underactivity induced by prolonged pudendal nerve stimulation in cats

Pintauro

Jian

Wang

et al. 2023

Neurourology and Urodynamics

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Aims To determine the role of opioid and β‐adrenergic receptors in bladder underactivity induced by prolonged pudendal nerve stimulation (PNS). Methods In α‐chloralose anesthetized cats, 30‐min PNS was applied repeatedly for 3–9 times to induce poststimulation or persistent bladder underactivity. Then, naloxone (opioid receptor antagonist, 1 mg/kg, IV) or propranolol (β‐adrenergic receptor antagonist, 3 mg/kg, IV) was given to reverse the bladder underactivity. After the drug treatment, an additional 30‐min PNS was applied to counteract the drug effect. Repeated cystometrograms were performed by slowly (1–2 mL/min) infusing the bladder with saline via a urethral catheter to determine the bladder underactivity and the treatment effects. Results Prolonged (2–4.5 h) PNS induced bladder underactivity evident as a large bladder capacity (169 ± 49% of control) and a reduced amplitude of bladder contraction (59 ± 17% of control). Naloxone fully reversed the bladder underactivity by reducing bladder capacity to 113 ± 58% and increasing the amplitude of bladder contraction to 104 ± 34%. After administration of naloxone an additional 30‐min PNS temporarily increased the bladder capacity to the underactive bladder level (193 ± 74%) without changing the amplitude of the bladder contraction. Propranolol had no effect on bladder underactivity. Conclusions A tonic enkephalinergic inhibitory mechanism in the CNS plays a critical role in the bladder underactivity induced by prolonged PNS, while the peripheral β‐adrenergic receptor mechanism in the detrusor is not involved. This study provides basic science evidence consistent with the clinical observation that comorbid opioid usage may contribute to voiding dysfunction in patients with Fowler's syndrome.

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