Effect of vesical contraction on the non-sphincteric part of the urethra: recognition of vesicourethral inhibitory reflex.

Abstract

The effect of vesical contraction on the non-sphincteric part of the urethra has been scarcely addressed in the literature. In this study, the hypothesis that detrusor contraction effects dilatation of the non-sphincteric part of the urethra was investigated. Non-sphincteric urethral pressure response to vesical balloon distension with normal saline in increments of 50 mL was recorded in 21 healthy volunteers (mean age 40.7 +/- 10.3 years, 13 men) before and after individual anesthetization of the urethra and urinary bladder. Vesical distension was effected by a 10F balloon-ended catheter introduced into bladder per urethram. Urethral and vesical pressures were measured by means of a two-channel microtip catheter. Small-volume vesical distension effected no significant urethral or vesical pressure changes while distension with 350 and 400 mL of saline produced vesical pressure elevation (P < 0.01) and urethral pressure decrease (P < 0.01). Vesical distension after individual vesical and urethral anesthetization effected no change in the urethral pressure. These results were reproducible. Dilatation of the non-sphincteric part of the urethra upon vesical contraction is suggested to be mediated through a 'vesicourethral inhibitory reflex' and to facilitate passage of urine through the urethra. The reflex may prove to be of diagnostic significance in micturition disorders.