Effects of Duloxetine on Urethral Continence Reflex and Bladder Activity in Rats with Cerebral Infarction

Abstract

Purpose: We investigated the effect of duloxetine, a norepinephrine and serotonin reuptake inhibitor, on the sneeze induced continence reflex and on bladder function in rats with cerebral infarction. Materials and Methods: Using urethane anesthesia the effect of duloxetine (1 mg/kg intravenously) on the amplitude of urethral responses during sneezing as well as urethral baseline pressure at the mid urethra was evaluated in normal female adult rats and cerebral infarction rats. Tilt leak point pressure was also measured. In normal and cerebral infarction rats continuous cystometry was evaluated before and after duloxetine injection. Results: Incerebralinfarctionratsurethralbaselinepressurewas43%lowerthan in normal rats but the amplitude of urethral responses during sneezing did not differ in the 2 groups. Duloxetine increased the amplitude of urethral responses during sneezing and urethral baseline pressure by 31% and 21%, respectively, in normal rats but did not affect either in cerebral infarction rats. Also, in cerebral infarction rats leak point pressure was 29% lower compared with normal rats. Duloxetine increased leak point pressure in normal rats but not in cerebral infarction rats. Cerebral infarction reduced intercontraction intervals without affecting the amplitude of bladder contractions compared with normal rats. Duloxetine prolonged intercontraction intervals in cerebral infarction rats but not in normal rats. Conclusions: These results suggest that cerebral infarction induces not only bladder overactivity but also stress urinary incontinence, which may account for mixed incontinence in patients with cerebral infarction. After cerebral infarction duloxetine reduced bladder overactivity but failed to enhance active urethral closure mechanisms during sneezing, suggesting that disorganization of the brain network after cerebral infarction might influence the effect of duloxetine on lower urinary tract function.

The effect of tramadol on sneeze‐induced urethral continence reflex through μ‐opioid receptors in the spinal cord in rats

“…Eight normal and eight VD rats were used. The tilt LPP was measured with rats in an upright position, as previously reported . Briefly, the intravesical pressure was elevated gradually by raising a saline reservoir with Evans blue (100 μg/mL).…”

“…The tilt LPP was measured with rats in an upright position, as previously reported. 14,15 Briefly, the intravesical pressure was elevated gradually by raising a saline reservoir with Evans blue (100 μg/mL). LPP was defined as the lowest pressure at which blue-color saline leaked from the urethral meatus.…”

Current Opinion on the Role of Neurogenesis in the Therapeutic Strategies for Alzheimer Disease, Parkinson Disease, and Ischemic Stroke; Considering Neuronal Voiding Function

“…ISs are known as inducing not only bladder overactivity, but also stress urinary incontinence [100]. After IS occurrence duloxetine, a norepinephrine and serotonin reuptake inhibitor reduced bladder overactivity but failed to enhance active urethral closure mechanisms during sneezing, suggesting that disorganization of the brain network after IS might influence the effect of duloxetine on lower urinary tract function.…”

Neurourological Application of Neurogenesis and Inflammation and Pain Mechanisms of Rocuronium Bromide

“…Researches are currently underway in order to develop new neurogenic bladder treatments, and some researchers have reported that nerve stimulation and stem cells improve neurogenic bladder [5-7]. In order to effectively treat neurogenically dysfunctional bladder, treatments should also prevent functional deterioration of the central nervous system.…”