PMID: 9165626Jan 1, 1997Paper

Emptying against outflow obstruction--pharmacological aspects

Scandinavian Journal of Urology and Nephrology. Supplementum
K E Andersson

Abstract

Outflow obstruction induces changes in muscarinic and adrenergic receptor functions, and in non-adrenergic, non-cholinergic (NANC) mechanisms relevant for detrusor contraction and relaxation. The complexity of the muscarinic regulation of detrusor function makes the relative importance of the different muscarinic receptor subtypes difficult to assess, both in the normal and obstructed detrusor. This means that the optimal profile of subtype selectivity of antimuscarinic drugs meant for treatment of detrusor overactivity still remains to be established. In most animal species, detrusor contraction is mediated by both muscarinic and NANC mechanisms. The most likely transmitter responsible for the NANC-component of contraction is ATP. NANC-components are probably of minor importance in the normal human detrusor. However, if the importance of the ATP-dependent component of contraction increases in the obstructed detrusor, this may have therapeutic implications. In normal human detrusor, alpha-adrenoceptors seem to have no significant role in the contractile activation. However, the effectiveness of alpha-adrenoceptor antagonists on storage symptoms, and, occasionally, on urodynamically proven detrusor instability, in patients with ...Continue Reading

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