Hockey, Joanne Susan;
(1999)
Human detrusor smooth muscle metabolism and the pathophysiology of detrusor instability in women.
Doctoral thesis (M.D), UCL (University College London).
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Abstract
The pathophysiology of abnormal detrusor function and the development of unstable detrusor contractions is a significant clinical problem, particularly in women. The treatment available is often ineffective and is associated with many uncomfortable side effects. Often the unstable contractions occur together with damaged bladder neck support following pelvic floor damage sustained in childbirth. In women these unstable contractions are not usually associated with bladder outlet obstruction such as occurs in men with prostatic hypertrophy. Most of the human and animal research has concentrated on abnormal bladder function as a consequence of bladder outlet obstruction and this study sought to investigate possible mechanisms of the development of abnormal bladder function in the absence of such obstruction. Abnormal detrusor smooth muscle metabolism as a result of bladder ischaemia has been proposed as a pathophysiological process contributing to the development of abnormal bladder function and unstable bladder contractions. In this work the role of cellular hypoxia, specifically, in this pathophysiological process was studied in vitro using biopsies from human stable and unstable bladders, either as isolated multicellular preparations or isolated single myocytes. Cellular hypoxia was found to reduce the force of a carbachol induced contraction in isolated detrusor muscle strips, the biopsies from control bladders being more affected than those from unstable bladders. Isolated single cell experiments demonstrated that cellular hypoxia attenuated the intracellular Ca+2-transient released from the sarcoplasmic reticulum in response to muscarinic stimulation, however cellular hypoxia had no effect on the surface membrane electrophysiological properties.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | M.D |
| Title: | Human detrusor smooth muscle metabolism and the pathophysiology of detrusor instability in women |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Thesis digitised by ProQuest. |
| Keywords: | Biological sciences; Health and environmental sciences; Bladder ischaemia |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10124868 |
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