SE] 7EHExtracellular acidosis reduces, and extracellular alkalosis increases, phasic contractions in detrusor strips elicited by field stimulation (Liston et al. 1991).An inward Ca2+ current, '('a' underlies the depolarizing phase of the action potential in isolated human detrusor smooth muscle cells , and the magnitude of this current is closely correlated to the strength of phasic contractions during several interventions Reduction of extracellular pH from 7.33 ± 0.02 to 6.78 ± 0.03 (6 mM NaHCO3) attenuated the magnitude of I('a by 9.8 ± 5.2 % (± S.D., n = 6, P < 0.03). An increase of extracellular pH to 7.62 ± 0.04 (48 mM NaHCO3) augmented the current by 9.5 ± 3.2% (± S.D., n = 5, P < 0.01). Steady-state activation curves were unaffected by these extracellular pH changes: half maximal activation voltages were -5.2 ± 4.6 mV (+ S.ID., n = 5), -5.3 ± 4.8 mV (n = 11) and -3.3 ± 6.6 mV (n = 6) in 48, 24 and 6 mM\1 NaHCO3, respectively. Time constants of inactivation were also unaffected by such pH changes: inactivation could be fitted by a single exponential process, r = 15.5 + 3.7 ms (± S.D., n = 5), 16.6 ± 2.4 ms (n = 11) and 18.5 ± 1.6 ms (n = 6), in 48, 24 and 6 mM NaHCO3, respectively. These interventions had corresponding effects on the action potential configuration; alkalosis increased and acidosis decreased the upstroke velocity confirming the dependence of this phase of the action potential on ICa. K+ (44 mM) produced a potential-dependent rise in the fluorescence ratio (340:380 nM) of isolated single cells loaded with Fura-2. Acidosis depressed and alkalosis increased the rate of rise of these fluorescence changes.These results demonstrate that extracellular pH influences ICa in a manner consistent with the inotropic actions of these interventions. The data further illustrate the linear relation between the magnitude of I(-and contractility.