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1 Glickman Urological Institute and Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
* To whom correspondence should be addressed. E-mail: daneshf{at}ccf.org.
Diabetic bladder dysfunction (DBD) is among the most common and bothersome
complications of diabetes mellitus (DM). Autonomic neuropathy has been counted as the cause
of DBD. In the present study, we compared the alterations in the neurogenically-mediated
contractile responses of urinary bladder in rats with streptozocin-induced diabetes, 5% sucrose-induced
diuresis, and age-matched controls. Male Sprague-Dawley rats were divided into 3
groups: 9-week diabetics, diuretics and age-matched controls. Micturition and morphometric
characteristics were evaluated using metabolic cage and gross examination of the bladder.
Bladder detrusor muscle strips were exposed to either periodic electrical field stimulation (EFS)
or to EFS in the presence of atropine,
,
-methylene adrenasine 5'-triphosphate, or tetrodotoxin.
The proportions of cholinergic, purinergic and residual nonadrenergic-noncholinergic (NANC)
components of contractile response were compared among the three groups of animals. Diabetes
caused significant reduction of body weight compared to diuresis and controls, although the
bladders of diabetic and diuretic rats weighed more than the controls. Both diabetes and diuresis
caused significant increase in fluid intake, urine output, and bladder size. Diabetes and diuresis
caused similarly increased response to EFS, and reduced response to cholinergic component
compared to controls. However, the purinergic response was significantly smaller in diuretic
bladder strips compared with controls, but not in diabetics. A residual NANC of unknown origin
increased significantly, but differently in diabetics and diuretics compared with controls. In
conclusion, neurogenically-mediated bladder contraction is altered in diabetic rat. Diabetic-related
changes do not parallel diuretic induced changes, indicating that the pathogenesis of DBD
needs further exploration.
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