Effects of pregnancy on urethral and bladder neck function

Abstract

Pregnancy and menopause induce morphologic as well as functional changes in the female urethra. Symptoms of bladder irritation (frequency, urgency) and incontinence are frequent findings in these conditions and are considered to be due to alterations in the distribution of autonomic receptors induced by the changes in the hormonal milieu. In the present study, the functional responses to field stimulation (FS) and autonomic agonists of the bladder neck and urethra of pregnant, and virgin New Zealand White rabbits were compared using isolated muscle strips. Passive length-tension studies demonstrated a significantly greater compliance of strips (bladder neck and urethra) from pregnant rabbits than from virgin rabbits. FS elicited frequency dependent contractile responses in all strips. Phentolamine was significantly more effective at inhibiting the field stimulated contractile response of urethral strips from pregnant than from virgin rabbits. Atropine was significantly more effective at inhibiting the response to FS of strips isolated from bladder necks of virgin rabbits than in strips isolated from pregnant rabbits. Atropine was significantly less effective at inhibiting the response to FS of strips isolated from urethras of pregnant rabbits than of strips from virgin rabbits. Strips of bladder neck and urethra isolated from virgin rabbits responded with significantly greater contraction to phenylephrine than strips isolated from pregnant rabbits. The magnitude of field stimulated relaxation was significantly greater in urethral strips than in bladder neck strips, and also greater in urethral strips isolated from virgin rabbits than in strips isolated from pregnant rabbits. In conclusion, pregnancy induces profound hormonal changes which, in turn, result in the alteration of the compliance and functional responses of the bladder neck and urethra to various forms of autonomic stimulation and relaxation.