Pharmacological studies of the uninhibited neurogenic bladder

Abstract

In order to elucidate the sympathetic activity of the uninhibited neurogenic bladder, controlled cystometry before and during the influence of alpha‐ and beta‐adrenergic agonists and antagonists was performed on patients with normal and uninhibited neurogenic bladder. Alpha‐agonist increased the pathological findings in the cystometrogram of the uninhibited bladder with increase in intravesical pressure, decrease in capacity and increase in the amplitude of the uninhibited contraction, but had no effect whatsoever on the normal bladder. Alpha‐antagonists improved the uninhibited bladder with decrease in intravesical pressure, increase in capacity and decrease in amplitude of the uninhibited contraction, and decrease in intravesical pressure in normal bladder. Beta2‐agonist improved the uninhibited bladder too, but was proved to be inactive on the normal bladder. Unselective beta‐ and selective beta1 antagonists deteriorated the uninhibited bladder and had only minor effect on the normal bladder. The decreased capacity and forcible uninhibited detrusor contraction seem to be due to a reduction of inhibitory beta‐adrenergic impulses as well as an increased contractile alpha‐adrenergic action on the bladder wall in uninhibited neurogenic bladder.