Bladder, pathophysiology

Turner WH, Brading AF 1997 Smooth muscle of the bladder in the normal and the diseased state pathophysiology, diagnosis and treatment. Pharmacol Ther 75 77—110 van Breemen C, Chen Q, Laher I 1995 Superficial buffer barrier function of smooth muscle sarcoplasmic reticulum. Trends Pharmacol Sci 16 98-105 Wray S 1993 Uterine contraction and physiological mechanisms of modulation. Am J Physiol 264 C1-C18... 

Payne CK (1998) Epidemiology, pathophysiology and evaluation of urinary incontinence and over-active bladder. Urology 51 3-10... 

Andersson K-E, Arner A. Urinary bladder contraction and relaxation physiology and pathophysiology. Physiol Rev 2004 84 935-986. 

Several studies suggest CBi receptor activation has effects on bladder, vas deferens, and uterine function, in both normal and pathophysiological states (Nicolau et al. 1978 Pertwee et al. 1992 Pertwee and Fernando 1996 Dmitrieva and Berkley 2002 Farquhar-Smith et al. 2002). While CBi receptors are expressed on tyrosine hydroxylase (noradrenaline)-positive pelvic neurons (Pan et al. 1998), detailed studies on CBi receptor distribution to these organs remains to be performed. 

The lower urinary tract consists of the bladder, urethra, urinary or urethral sphincter, and the surrounding musculofascial structures including connective tissue, nerves, and blood vessels. The urinary bladder is a hollow organ composed of smooth muscle and connective tissue located deep in the bony pelvis in men and women. The urethra is a hollow tube that acts as a conduit for urine flow out of the bladder. The interior surface of both the bladder and urethra is lined by an epithelial cell layer termed transitional epithelium, which is in constant contact with urine. Previously considered inert and inactive, transitional epithelium may actually play an active role in the pathophysiology of many lower urinary tract disorders, including interstitial cystitis and UI. The urinary or urethral sphincter is a combination of smooth and striated muscle within and surrounding the most proximal portion of the urethra adjacent to the bladder in both men and women. This is a functional but not anatomic sphincter that includes a portion of the bladder neck or outlet as well as the proximal urethra. 

It is well known that subvesical obstruction leads to bladder hypertrophy, reduced bladder compliance and capacity, high detrusor pressure during bladder filling and voiding, and unstable detrusor contractions. Based on this well-known pathophysiological mechanism, the speculative conclusion could... 

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