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Structural and functional denervation of human detrusor after spinal cord injury.
Oxford Continence Group, University Department of Pharmacology, Oxford, United Kingdom.
Department of Clinical Pharmacology, Lund University Hospital, Lund, Sweden.
Oxford Continence Group, University Department of Pharmacology, Oxford, United Kingdom.
Oxford Continence Group, University Department of Pharmacology, Oxford, United Kingdom.
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2000 (English)In: Laboratory Investigation, ISSN 0023-6837, E-ISSN 1530-0307, Vol. 80, no 10, 1491-9 p.Article in journal (Refereed) Published
Abstract [en]

The bladder receives an extensive nerve supply that is predominantly cholinergic, but several putative transmitters are present, some of which are colocalized. Previous studies have shown increased levels of sensory nerves, reduced inhibitory transmitters, and structural and functional changes in the excitatory input in unstable bladder conditions. The present study compared the end-organ nerve supply to the bladder in spinal cord injury (SCI) with uninjured controls. Acetylcholinesterase histochemistry and double-label immunofluorescence were used to investigate neurotransmitter content, with confocal laser scanning microscopy to assess colocalization. Organ bath studies provided functional correlates for the structural changes in the excitatory innervation. Control samples had dense innervation of the detrusor containing a diverse range of transmitters. Hyperreflexic SCI samples showed patchy denervation, and areflexic SCI samples were diffusely denervated. Vasoactive intestinal polypeptide-, neuropeptide Y-, neuronal nitric oxide synthase-, and galanin-immunoreactive nerve fibers were reduced from frequent or moderately frequent to infrequent or very infrequent in SCI. Calcitonin gene-related peptide-immunoreactive fibers were infrequent in controls and SCI samples. Patterns of colocalization were unchanged, but significantly fewer fibers expressed more than one transmitter. The subepithelial plexus was markedly reduced and several of the smaller coarse nerve trunks showed no immunoreactivity to the transmitters assessed. There was no reduction in sensitivity to electrical field stimulation of intrinsic nerves in SCI, but the maximum force generated by each milligram of bladder tissue and the peak force as a proportion of the maximum carbachol contraction were significantly reduced and the responses were protracted. There was no significant functional atropine-resistant neuromuscular transmission in controls or SCI. The reported findings have clinical implications in the management of chronic SCI and development of new treatments.

Place, publisher, year, edition, pages
Nature Publishing Group, 2000. Vol. 80, no 10, 1491-9 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-77624DOI: 10.1038/labinvest.3780158PubMedID: 11045565OAI: diva2:528143
Available from: 2012-05-24 Created: 2012-05-24 Last updated: 2012-05-29

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Hedlund, Petter
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