Reitz
Fakultäten » Medizinische Fakultät » Universitätsklinik Balgrist und Schweizerisches Paraplegikerzentrum » Paraplegikerzentrum » Prof. Dr. Volker Dietz (emeritiert) » Reitz
Completed research project
| Title / Titel | The effect of tolterodine on afferent pathways arising from the urinary bladder - a urodynamic study in healthy humans and patients with overactive bladder | ||||||
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| Abstract (PDF, 14 KB) | |||||||
| Summary / Zusammenfassung | The proposed research project focuses on physiological and pathophysiological aspects of bladder innervation, and in particular on the examination of afferent pathways arising from the lower urinary tract. This proposal concentrates on the effect of the oral anticholinergic agent tolterodine on afferent nerves arising from the urinary. The project includes both experiments in healthy volunteers and in patients suffering from overactive bladder. To assess the afferent pathways of the autonomic nervous system, intravesical electrical stimulation will be used. As shown in several studies in the past the influence of specific drugs or treatments can be investigated by electrical sensory testing in the lower urinary tract (De Wachter and Wyndaele, 2001; De Wachter and Wyndaele, 2003a) and electrical sensitivity can be a valuable tool to investigate the effect of drugs aiming to modulate sensory bladder symptoms (Wyndaele and De Wachter, 2003). During intravesical electrical stimulation recordings of the sympathetic skin response will be obtained simultaneously. As seen in former studies intravesical electrical stimulation evokes sympathetic skin responses when the perception threshold is reached. Therefore, sympathetic skin response recordings enable to objectively assess sensations arising from the urinary bladder and contribute to the evaluation of the afferent nerve pathways of the lower urinary tract (Reitz et al., 2003b; Schmid et al., 2004). The experimental set-up using both subjects’s self reported sensation and the determination of the sensory threshold towards intravesical electrical stimulation provide important information on the afferent bladder innervation. Within the first part of the experiment the sensory threshold towards intravesical stimulation will be determined. Then the subjects and patients receive 4 mg of tolterodine and the baseline protocol will be repeated two our later. In the second part we aim at determining the effect of different antimuscarinergic drugs on the threshold for electrical stimulation of the autonomic afferent nerve pathways and on the subject’s self report of sensation as well as on the sensory threshold towards intravesical electrical stimulation. Main goals of the study will be to evaluate the role of antimuscarinergic substances on the afferent nerves pathways arising from the urinary bladder and on the urgency symptoms. Furthermore, the analysis of the data obtained in patients and the comparison with those recorded in healthy volunteers should offer new insights in pathophysiological changes of the mechanisms underlying the neuronal control of the LUT and enable new understanding in the pathophysiology of overactive bladder to optimize treatment. |
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| Keywords / Suchbegriffe | bladder control; afferent pathways; overactive bladder | ||||||
| Project leadership and contacts / Projektleitung und Kontakte |
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| Funding source(s) / Unterstützt durch |
SNF (Personen- und Projektförderung), Private Sector (e.g. Industry) Pfizer |
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| Duration of Project / Projektdauer | Jul 2005 to Nov 2006 |