α1-Adrenoceptors and Bladder Function

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Abstract
Objective: To discuss the role of α-adrenoceptors (α-ARs) in the control of lower urinary tract function with special emphasis on their importance in the pathologically changed bladder. Methods: Evaluation of published information. Results: The functional role of the α-ARs in the normal detrusor muscle has not been established. Changes in the function of these α-ARs may occur in e.g., bladder outflow obstruction, bladder overactivity, and ‘neurogenic‘ bladders. The filling (irritative) symptoms in patients with benign prostatic hyperplasia and outflow obstruction, which are relieved by α-AR antagonist treatment, have been associated with bladder dysfunction produced by the obstruction. There is evidence for involvement of α-ARs in the spinal control of both the sympathetic, somatic (filling) and parasympathetic (voiding) efferent activity to the lower urinary tract. The beneficial effects of α-AR antagonists on filling symptoms, which can be obtained even in the absence of outflow obstruction, give support for the involvement of extravesical, possibly spinal, α-ARs in their pathogenesis. Conclusions: A more complete understanding of the role of α-ARs in the control of the normal or functionally changed bladder should be helpful in the development of drugs for treatment of lower urinary tract disorders.

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