Intravesical Instillation of a Calcium Entry Blocker and its Effects on Detrusor Contractility: In Vitro and Vivo Experiments

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Abstract
The effects of intravesical instillation of a Ca2+ entry blocker (verapamil) on the contractility of the bladder detrusor muscle of the rabbit were investigated in vitro and in vivo. In in vitro experiments, using whole bladder preparations, spontaneous contractile activity and contraction induced by direct electric stimulation or acetylcholine were monitored. Both activities were inhibited in a time-dependent manner after the intravesical instillation of 7.5 mg. verapamil. The amplitude of spontaneous contraction 90 minutes after the instillation, was reduced to 10 percent of control (before the instillation), and the response to electric stimulation and acetylcholine were inhibited to 16 percent and 38 percent of controls respectively. The detrusor contractility was still inhibited two hours after the removal of verapamil from the bladder. This inhibition of the detrusor contractility after removal of verapamil was completely reversed by adding four mM Ca2+ intravesically. During in vivo experiments, the changes of intravesical pressure elicited by pelvic nerve stimulation and the systemic arterial pressure were monitored. Sixty minutes after the intravesical instillation of 10 mg. verapamil, the rise of the intravesical pressure following the pelvic nerve stimulation was inhibited to 18 percent of control, while the systemic arterial pressure was not affected. It is suggested that the intravesical instillation of verapamil can inhibit detrusor contractility without affecting cardiovascular status.