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• W2103792310 abstract "No AccessJournal of UrologyInvestigative Urology1 Apr 1995Inhibition of Central Sympathetic and Somatic Outflow to the Lower Urinary Tract of the Cat by the Alpha sub 1 Adrenergic Receptor Antagonist Prazosin Hansjorg Danuser and Karl B. Thor Hansjorg DanuserHansjorg Danuser More articles by this author and Karl B. ThorKarl B. Thor Requests for reprints: Division of CNS Research, Eli Lilly and Co., Indianapolis, Indiana 46285. More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)67591-8AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Selective alpha sub 1 adrenergic receptor antagonists are used to reduce the dynamic component of urethral obstruction in patients with benign prostatic hyperplasia. Their effectiveness is presumed to result from blockade of alpha1 adrenergic receptors within the prostatic smooth muscle. However, a reduction in central sympathetic tone to the prostate might also contribute to their effectiveness. The present experiments examined the effects of the selective alpha1 adrenergic receptor antagonist prazosin on sympathetic activity recorded from the hypogastric nerve in chloralose-anesthetized cats. For comparison, the effects of prazosin were also examined on somatic activity recorded from the pudendal nerve. When the urinary bladder was empty, prazosin reduced spontaneous activity recorded from the hypogastric nerve (to 65 percent of control) and reduced evoked reflex activity recorded from the hypogastric nerve (to 44 percent of control) and the pudendal nerve (to 48 percent of control). Interestingly, when the urinary bladder was filled, the inhibitory effects of prazosin on the pelvic to hypogastric reflex were overcome. These experiments indicate that central noradrenergic neurons mediate a tonic facilitation of sympathetic and somatic activity to pelvic viscera via activation of alpha sub 1 adrenergic receptors. Thus, alpha1 adrenergic receptor antagonists may reduce the dynamic component of urethral outlet obstruction in patients with benign prostatic hyperplasia through dual mechanisms: first, through a blockade of alpha1 adrenergic receptors on the prostatic smooth muscle itself and, second, by reducing the activity of the sympathetic neurons that innervate the prostate. Additional therapeutic relief may be provided through reduction of somatic neural activity to the external urethral sphincter, which might also reduce outlet resistance and improve flow. References 1 : Alpha-adrenergic blockers for the treatment of benign prostatic hyperplasia. Urol. Clin. North Am.1990; 17: 641. Google Scholar 2 : A randomized, placebo-controlled multicenter study of the efficacy and safety of terazosin in the treatment of benign prostatic hyperplasia. J. Urol.1992; 148: 1467. Link, Google Scholar 3 : Pharmacological analysis of the responses of the feline urethra to autonomic nerve stimulation. J. Auton. Nerv. Syst.1983; 8: 141. Google Scholar 4 : Comparison of peripheral and central nervous system sympatholytic actions of prazosin using the cat nictitating membrane. Eur. J. Pharmacol.1992; 211: 61. Google Scholar 5 : Studies on the mechanism of prazosin induced sympatho-inhibition. Eur. J. Pharmacol.1988; 158: 225. Google Scholar 6 : Slow EPSP and the depolarizing action of noradrenaline on sympathetic preganglionic neurons. Brain Res.1987; 414: 138. Google Scholar 7 : Multiple actions of noradrenaline on sympathetic preganglionic neurons of the cat studied in the spinal cord slice. Prog. Brain Res.1989; 81: 181. 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Google Scholar 19 : Effects of clonidine on the lumbar sympathetic pathways to the large intestine and urinary bladder of the cat. Eur. J. Pharmacol.1979; 59: 47. Google Scholar 20 : Characterization of alpha sub 1 adrenergic receptor subtypes in rat brain: a re-evaluation of [sup 3 H]WB4101 and [sup 3 H]prazosin binding. Mol. Pharmacol.1986; 29: 321. Google Scholar Department of Urology, Berne University, Berne, Switzerland, the Department of Urology, Indiana University School of Medicine and the Division of CNS Research, Eli Lilly and Company, Indianapolis, Indiana.© 1995 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byKajbafzadeh A, Baradaran N, Sadeghi Z, Tourchi A, Saeedi P, Madani A, Ataei N, Taghavinejad A and Mohsseni M (2018) Vesicoureteral Reflux and Primary Bladder Neck Dysfunction in Children: Urodynamic Evaluation and Randomized, Double-Blind, Clinical Trial on Effect of α-Blocker TherapyJournal of Urology, VOL. 184, NO. 5, (2128-2133), Online publication date: 1-Nov-2010.Kessler T, Studer U and Burkhard F (2018) The Effect of Terazosin on Functional Bladder Outlet Obstruction in Women: A Pilot StudyJournal of Urology, VOL. 176, NO. 4, (1487-1492), Online publication date: 1-Oct-2006.RUGGIERI M, BRAVERMAN A and PONTARI M (2018) COMBINED USE OF α-ADRENERGIC AND MUSCARINIC ANTAGONISTS FOR THE TREATMENT OF VOIDING DYSFUNCTIONJournal of Urology, VOL. 174, NO. 5, (1743-1748), Online publication date: 1-Nov-2005.THOR K and DONATUCCI C (2018) CENTRAL NERVOUS SYSTEM CONTROL OF THE LOWER URINARY TRACT: NEW PHARMACOLOGICAL APPROACHES TO STRESS URINARY INCONTINENCE IN WOMENJournal of Urology, VOL. 172, NO. 1, (27-33), Online publication date: 1-Jul-2004.AUSTIN P, HOMSY Y, MASEL J, CAIN M, CASALE A and RINK R (2018) alpha-ADRENERGIC BLOCKADE IN CHILDREN WITH NEUROPATHIC AND NONNEUROPATHIC VOIDING DYSFUNCTIONJournal of Urology, VOL. 162, NO. 3 Part 2, (1064-1067), Online publication date: 1-Sep-1999.Ishizuka O, Mattiasson A and Andersson K (2018) Role of Spinal and Peripheral Alpha sub 2 Adrenoceptors in Micturition in Normal Conscious RatsJournal of Urology, VOL. 156, NO. 5, (1853-1857), Online publication date: 1-Nov-1996. Volume 153Issue 4April 1995Page: 1308-1312 Advertisement Copyright & Permissions© 1995 by American Urological Association, Inc.MetricsAuthor Information Hansjorg Danuser More articles by this author Karl B. Thor Requests for reprints: Division of CNS Research, Eli Lilly and Co., Indianapolis, Indiana 46285. More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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