Patients with cervical spinal cord injuries have altered adrenergic and cholinergic innervation in the urethra compared to those with thoracic lesions, which may relate to increased sympathetic outflow.
May inform neurogenic bladder management differences by lesion level; hypothesis-generating for targeted innervation studies in SCI.
The adrenergic and cholinergic innervation of the smooth and striated muscle components of the urethra from spinal cord injury patients with detrusor sphincter dyssynergia were investigated neurochemically and histochemically. Catecholamine fluorescence histochemistry provided no evidence for the presence of adrenergic nerves associated with the skeletal muscle. The noradrenaline content of this region probably reflects the endogenous levels in adrenergic nerves associated with the blood vessels supplying the skeletal muscle. Choline acetyltransferase activity in the skeletal muscle was significantly lower in patients with cervical lesions than in those with thoracic lesions (p less than 0.01). The noradrenaline content of the smooth muscle was significantly lower in cervical lesions than in thoracic lesions in both the mid (p less than 0.02) and the distal (p less than 0.001) regions of the urethra. The proximal region revealed similar noradrenaline levels in both groups of spinal cord injury patients. The results are discussed in relation to the role of the autonomic nervous system in the control of voiding and to the presence of increased sympathetic outflow in patients with spinal cord lesions at higher levels.
No takes yet. Share an insight, caveat, or question.
Lincoln et al. (1986) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: