Estrogenic Sensitivity of α-Receptors in the Urethra Musculature

Schreiter, F.; Fuchs, P; Stockamp, K.

doi:10.1159/000280026

Cited by 100 publications

(40 citation statements)

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“…We could not confirm the finding of Caine and Raz (2) who demonstrated an increased urethral closure pressure after treatment with estrogens. Estrogens may, however, be of therapeutical value in the conservative treatment of stress incontinence especially if supplemented with a-sympathomimetic drugs as reported by Schreiter et al (10).…”

Section: Discussionmentioning

confidence: 95%

Urinary Incontinence in Postmenopausal Women Treated with Estrogens

et al. 1978

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The effect of estrogens on urinary incontinence in postmenopausal women was studied in order to investigate whether estrogens could cure urge incontinence in patients without detrusor hyperreflexia and whether estrogens could raise the maximum urethral closure pressure. The trial was double-blind. The cure rate in patients woth sensory urge incontinence was significantly better with estrogen than with placebo (p < 0.05, Fourfold Table Test). There were no statistically significant changes in the maximum urethral closure pressure and the functional profile length between the estrogen- and placebo-treated groups. Biopsies from the trigone showed a similar shift as in smears from urethra and vagina in the patients treated with estrogens. None of the patients had subjective side-effects and no significant changes were found in serum cholesterol or triglyceride.

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Section: Discussionmentioning

confidence: 95%

Urinary Incontinence in Postmenopausal Women Treated with Estrogens

et al. 1978

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“…All ofour patients were treated with long-term oral estrogen, and the effect of this therapy on the muscle bath results cannot be evaluated by the present data. Hormonal manipulation has been reported to alter the in vivo and in vitro response of other tissues to adrenergic stimulation (30)(31)(32)(33). The responses obtained in the estrogentreated humans are qualitatively identical, however, to those seen in nonhormonally treated monkeys (19).…”

Section: Discussionmentioning

confidence: 99%

Neuromorphology and Neuropharmacology of the Human Penis

Benson¹,

McConnell²,

Lipshultz³

et al. 1980

J. Clin. Invest.

132

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A B S T R A C T The neuromorphology and neuropharmacology of the human penis are only briefly described in literature. The present study was undertaken to define the adrenergic and cholinergic neuromorphology of the human corpus cavemosum (CC) and corpus spongiosum and to evaluate the in vitro response of the CC to pharmacologic stimulation. Human penile tissue was obtained from six transsexual patients undergoing penectomy. For morphologic study, the tissue was processed for (a) hematoxylin and eosin staining; (b) smooth muscle staining; (c) acetylcholinesterase localization; (d) glyoxylic acid histofluorescence; (e) electron microscopy; and (f) electron microscopy after glutaraldehyde dichromate fixation. In addition, strips of CC were placed in in vitro muscle chambers and tension changes recorded isometrically after stimulation with norepinephrine (NE) and acetylcholine. The CC contains abundant smooth muscle, numerous glyoxylic acidfluorescent (catecholaminergic) fibers and varicosities, and a scant distribution of acetylcholinesterase-positive fibers. Fewer of all these elements were present in the corpus spongiosum. No "polsters" were observed in the CC. Although glutaraldehyde-fixed controls exhibited no typical adrenergic vesicles (small, dense core, measuring 400-600 A in diameter), some small, strongly electron-dense vesicles were found in glutaraldehyde dichromate-fixed tissue and were thought to contain NE. A variety of other vesicles were also encountered.

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“…If for some reason medical treatment is indicated, the use of an alpha-receptor stimulator is currently accepted as the drug of choice. The drug effect on the urethral pressure is well documented [2][3][4][5][6] but the clinical re sponse reported so far seems to be moderate [7], The uro dynamic parameters used for the evaluation have in pre vious reports mainly been the maximal urethral closure pressure (MUCP) at rest and the functional urethral length. However, genuine stress incontinence is not char acterized by disturbances of these parameters alone, but by insufficient pressure transmission to the urethra at the moment of sudden increase in the abdominal pressure [8], Changes in the pressure transmission ratio (PTR) are therefore the most important urodynamic parameter for diagnosis as well as for the evaluation of treatment [9], In some previous reports phenylpropanolamine (PPA) has been used as an alpha receptor-stimulating drug [2,7], but serum concentration studies about the clinical and urodynamic effect of the drug have not been reported.…”

Section: Introductionmentioning

confidence: 99%

Stress Incontinence in Females: Treatment with Phenylpropanolamine

Fossberg¹,

Beisland²,

Lundgren

1983

Urol Int

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23 females, mean age 53 years, with genuine stress incontinence were treated with phenylpropanolamine (PPA), 50 mg twice daily, versus placebo. Simultaneous urethrocystometry with recording of the transmission of increased abdominal pressure to the bladder and the urethra was carried out, and serum concentration of PPA measured and related to subjective effect, effect on the maximal urethral closure pressure (MUCP) and on the pressure transmission ratio. 3 patients were excluded, 1 because of side effects, and 2 were dropouts. 12 patients reported improvement while on PPA, but none became continent. 3 patients improved on placebo. The remaining patients were unchanged. A plasma level of PPA of more than 150 ng/ml seemed necessary to obtain an effect; this level was reached after approximately 90 min after intake of 50 mg. Objectively a rise in MUCP was recorded, but there was no correlation between serum concentration and the increase in MUCP. An improvement of the pressure transmission ratio was also recorded.

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Estrogenic Sensitivity of α-Receptors in the Urethra Musculature

Cited by 100 publications

References 1 publication

Urinary Incontinence in Postmenopausal Women Treated with Estrogens

Urinary Incontinence in Postmenopausal Women Treated with Estrogens

Neuromorphology and Neuropharmacology of the Human Penis

Stress Incontinence in Females: Treatment with Phenylpropanolamine

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