Intrinsic neuromuscular defects in the neurogenic bladder: X. Value and limitations of neurohistochemistry

Abstract

AbstractHistochemical changes in bladder innervation have been described in various types of clinical and experimental neurogenic voiding dysfunction. Recent studies in the cat have shown that both decentralization and postganglionic “denervation” lead to ultrastructural changes in muscular innervation of the bladder base. The present study was conducted to find out whether these changes can be detected histochemically. Decentralization of the bladder by unilateral sacral ventral rhizotomy, bilateral sacral ventral rhizotomy, or unilateral pelvic neurectomy was performed in 25, and postganglionic “denervation” by unilateral pelvic plexus neurectomy in 9, adult male cats. Specimens of the bladder body and bladder base were collected 2–4 and 8–10 weeks after decentralization, and 2–4 weeks and 10 weeks after “denervation.” The specimens were processed by histochemical methods to demonstrate cholinergic and adrenergic nerves. No recognizable differences from the norm were observed in cholinergic muscular innervation of either the body or base specimens of the decentralized bladder. While adrenergic muscular innervation of both regions was similar to normal in short‐term samples of the same specimens, there was an obvious adrenergic hyperinnervation of both in the long‐term samples. By contrast, there was an obvious, early‐developing, and persistent hypoinnervation by both cholinergic and adrenergic nerves in both the body and base regions after postganglionic “denervation.” It is concluded that histochemistry (1) has no value in detecting either short‐ or long‐term changes in cholinergic muscular innervation of the decentralized bladder and (2) is useful for revealing both short‐ and long‐term cholinergic and adrenergic hypoinnervation of the “denervated,” as well as long‐term adrenergic hyperinnervation of the decentralized vesical muscularis.