Neurogenic Modulation of Micturition: The Relation Between Stimulation Intensity and the Maximum Shortening Velocity of the Guinea Pig Detrusor Muscle
The course of micturition depends on bladder contractility and urethral resistance. The former is determined by geometrical, muscular and neurogenic factors. The muscular aspects of bladder contractility can be characterized by the parameters Pisv, the isovolumetric detrusor pressure, and vmax, the maximum (unloaded) shortening velocity of the detrusor muscle. The neurogenic control system of the urinary tract modulates bladder contractility, which might effectively change the values of Pisv and v sub max. These parameters also depend on the instantaneous bladder volume. In previous work the dependence of Pisv on the intensity of stimulation and bladder volume was measured in guinea pig bladders in vivo and in vitro. In the present work vmax was derived in 5 guinea pig bladders in vitro, using electrical stimulation and the stop-flow technique. This technique implies that pressure values measured at a certain shortening velocity of the bladder circumference and in an isovolumetric contraction at the same volume are used to derive vmax mathematically from the Hill equation. v sub max was independent of the bladder volume in the range of 0.6 to 6.1 ml., but it was significantly different for the two intensities of stimulation used. Therefore, it is concluded that the maximum shortening velocity of the guinea pig detrusor muscle depends on the intensity of stimulation. During submaximal stimulation the detrusor not only generates lower pressures, it also contracts more slowly. A possible explanation for this phenomenon is that the bladder is not uniformly stimulated.
The isovolumetric pressure measured in the stop-flow test was compared with the isovolumetric pressure measured at the same bladder volume some minutes later. It was observed that shortening had a depressant effect of approximately 33% on the isovolumetric pressure. This implies that the clinically employed stop-flow test might underestimate detrusor contraction strength.
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From the Department of Urology, Erasmus University Rotterdam, Rotterdam, The Netherlands
