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Am J Physiol Regul Integr Comp Physiol (January 23, 2003). doi:10.1152/ajpregu.00688.2002
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Submitted on November 7, 2002
Accepted on January 16, 2003

Neurotransmission and visco-elasticity in the ovine fetal bladder after in utero bladder outflow obstruction

Nikesh Thiruchelvam1*, Changuo Wu2, Anna David3, Adrian S Woolf1, Peter M Cuckow1, and Christopher H Fry2

1 Nephro-Urology Unit, Institute of Child Health, London, United Kingdom
2 Division of Applied Physiology, Institute of Urology and Nephrology, London, United Kingdom
3 Department of Obstetrics and Gynaecology, University College London, London, United Kingdom

* To whom correspondence should be addressed. E-mail: n.thiruchelvam{at}ich.ucl.ac.uk.

Fetal bladder outflow obstruction, predominantly caused by posterior urethral valves, results in significant urinary tract pathology; these lesions are the commonest cause of end-stage renal failure in children and up to 50% continue to suffer from persistent postnatal bladder dysfunction. In order to investigate the physiological development of the fetal bladder and the response to urinary flow impairment, we performed partial urethral obstruction and complete urachal ligation in the mid-gestation fetal sheep for 30 days. By electrical and pharmacological stimulation of bladder strips, we found that muscarinic, purinergic and nitrergic mechanisms exist in the developing fetal bladder at this gestation. After bladder outflow obstruction, the fetal bladder became hypocontractile, producing less force after nerve-mediated and muscarinic stimulation with suggested denervation, and also exhibited greater atropine-resistance. Furthermore, fetal bladder urothelium exerted a negative inotropic effect, partly nitric-oxide mediated, that was not present after obstruction. Increased compliance, reduced elasticity and viscoelasticity were observed in the obstructed fetal bladder but the proportion of work performed by the elastic component (a physical parameter of extracellular matrix) remained the same. In addition to denervation, hypocontractility may result from a reduction in the elastic modulus that may prevent any extramuscular components from sustaining force produced by detrusor smooth muscle.




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