Intravesical Ions, Osmolality and pH Influence the Volume Pressure
Response in the Normal Rat Bladder, and This Is More Pronounced
after DMSO Exposure

Hohlbrugger, G.; Lentsch, P

doi:10.1159/000472470

Cited by 54 publications

(31 citation statements)

References 3 publications

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“…The submucosal sensory nerves can become depolarized when a high concentration of solutes leak into this space. A direct muscle contraction independent of neurotransmission can be induced by this exctracellular hyperosmolarity or potassium enhancement [3,13,14]. A leaky urothelium can be demonstrated by the intravesical KCl test and it is thus rational to postulate that the irritation symptoms resulting from a leaky epithelium can be reduced by the restoration of a normal mucus function [3,9].…”

Section: Discussionmentioning

confidence: 99%

Urodynamic Study and Potassium Sensitivity Test for Women with Frequency-Urgency Syndrome and Interstitial Cystitis

Kuo¹

2003

Urol Int

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Purpose: The intravesical potassium chloride (KCl) sensitivity test has been used to detect urothelial leakage in patients with frequency-urgency syndrome and interstitial cystitis (IC). It is unclear whether urodynamic studies can predict a positive KCl test. This study compared the urodynamic results for women with different KCl responses who suffered from frequency-urgency syndrome and IC. Methods: A total of 196 women suffering from frequency, urgency and/or bladder pain were enrolled in this study. These patients underwent a urodynamic study with a concurrent KCl test. The urodynamic results were compared between the patients who had positive and those who had negative KCl tests and between the patients with and without characteristic IC under cystoscopic hydrodilatation. Results: Among 196 women, 138 (70.4%) had a positive and 58 (29.6%) a negative KCl test. Among the patients with a positive KCl test, 128 underwent cystoscopic hydrodilatation: 44 were proven to have characteristic IC, and 84 were not. Patients with a negative KCl test had a larger residual urine volume and a higher incidence of poor relaxation of the urethral sphincter than those with a positive test. However, patients with a positive KCl test and proven IC did not differ in urodynamic parameters from non-IC patients. The symptom of bladder pain could not predict a positive KCl test nor characteristic IC either. Conclusions: This study shows that no specific urodynamic parameter or specific symptoms can predict a positive KCl test in patients with frequency-urgency syndrome or IC. Patients with bladder pain at full bladder and a positive KCl test had only a 45.2% chance to have characteristic IC.

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Section: Discussionmentioning

confidence: 99%

Urodynamic Study and Potassium Sensitivity Test for Women with Frequency-Urgency Syndrome and Interstitial Cystitis

Kuo¹

2003

Urol Int

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“…A considerable permeability to water and electrolytes has been demonstrated for bladder mucosa from rat [2] and man [1], A more than twofold increase in permeabil ity was observed in bladders with cystitis. It seems likely that the osmolality of the fluid surrounding the smooth muscle cells of the detrusor could be influenced by the composition of the urine in the bladder lumen.…”

Section: Discussionmentioning

confidence: 99%

“…As the urine seldom is iso tonic, this introduces the possibility that the smooth muscle cells in the bladder wall under certain conditions might be subjected to an anisosmolar extracellular fluid. Hohlbrugger et al [2] have actually shown in rat bladder that the bladder capacity decreased if the content was hypertonic, and that this decrease was more pronounced in cases with experimental cystitis. This makes it impor tant to gain information regarding the cellular effects of anisosmolar solutions on excitability and contractility of the detrusor muscle.…”

Section: Introductionmentioning

confidence: 96%

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Effects of Variations in Extracellular Osmolality on Spontaneous Contractile Activity and Response to Nerve Stimulation in Rat Detrusor Muscle in vitro

Uvelius¹

1985

Urol Int

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The effects of hyperosmolar (390, 590 mosm/kg) and hypoosmolar (260 mosm/kg) solutions on myogenic spontaneous contractile activity and response to nerve stimulation were studied on strips of rat detrusor muscle in vitro. In isotonic (290 mosm/kg) solution the mean spontaneous contractile activity was 2.1 ± 0.6% and the amplitude of the largest spontaneous contractions was 9.8 ± 3.0% of maximal response to nerve stimulation. In 390 mosm/kg the frequency of spontaneous contractions decreased, but due to a fourfold increase of contraction amplitude a threefold increase of mean contractile activity was recorded. In 260 mosm/kg a similar contraction pattern as in 290 mosm/kg was seen. The spontaneous contractions were resistant to tetrodotoxin (10^––5 g/ml) in all osmolalities. In 590 mosm/kg the spontaneous activity had ceased, and a continuous contracture (resistant to tetrodotoxin) was observed with an amplitude of 41 ± 1 % of the maximal response to nerve stimulation at 290 mosm/kg. Similar maximal responses to nerve stimulation were obtained in 260, 290, and 390 mosm/kg. The frequency-response relation in 390 mosm/kg had a leftward shift at low frequencies. In 590 mosm/kg no response to nerve stimulation or acetylcholine was noted, but the preparations contracted vigorously following depolarization with high-K⁺ solution.

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“…If there is appreciable permeation of these substances through the tight junctions, then the apical membrane provides an even higher proportion of the resistance across the epithelium [12].…”

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confidence: 99%

New Frontiers in Intravesical Therapies and Drug Delivery

et al. 2006

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e u r o p e a n u r o l o g y 5 0 ( 2 0 0 6 ) 1 1 8 3 -1 1 9 3 a v a i l a b l e a t w w w . s c i e n c e d i r e c t . c o m j o u r n a l h o m e p a g e : w w w . e u r o p e a n u r o l o g y . c o m Article info AbstractObjectives: The intravesical route permits site-specific delivery of drugs with a reduced side-effect profile as compared to oral delivery systems, either by avoiding first-pass metabolism or by obtaining a local effect. We investigated mechanisms related to urothelium permeability and new physical and chemical developments in intravesical drug delivery that potentially permit successful treatment of several bladder dysfunction. Methods: A literature review. Results: Pharmacologic agents increasing urothelial permeability and useful for clinical purposes have been described, such as dimethylsulfoxide, protamine sulphate, chitosan, and nystatin. Among physical approaches, electromotive drug administration appears to be more effective than intravesical passive diffusion in delivering drugs through the urothelium into deeper layers of the bladder. Experimental and clinical reports demonstrated that electric current significantly increases the transport of local anaesthetics, mytomicin C, oxybutynin, resiniferatoxin, epinephrine, and dexamethasone. Among new chemical approaches, cell-penetrating peptides posses the ability to translocate macromolecular drugs across membranes of urothelial cells. The therapeutic benefits of sustained delivery afforded by thermosensitive hydrogel, which forms a depot for hydrophilic and hydrophobic drugs, have been demonstrated by delivering anti-inflammatory drugs. Liposomes improve the aqueous solubility of several hydrophobic drugs such as taxol, amphotericin, and capsaicin. Conclusions: Electromotive drug administration, new in situ delivery systems, and bioadhesive liposomes may make it possible to extend intravesical therapy and drug administration to many bladder diseases. Research to expand knowledge of the chemical and physical properties of the bladder and processes regulating drug transport across biologic membranes is needed to make this a reality.

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Intravesical Ions, Osmolality and pH Influence the Volume Pressure Response in the Normal Rat Bladder, and This Is More Pronounced after DMSO Exposure

Cited by 54 publications

References 3 publications

Urodynamic Study and Potassium Sensitivity Test for Women with Frequency-Urgency Syndrome and Interstitial Cystitis

Urodynamic Study and Potassium Sensitivity Test for Women with Frequency-Urgency Syndrome and Interstitial Cystitis

Effects of Variations in Extracellular Osmolality on Spontaneous Contractile Activity and Response to Nerve Stimulation in Rat Detrusor Muscle in vitro

New Frontiers in Intravesical Therapies and Drug Delivery

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