The apparent discordance between the absence of demonstrable gap junction plaques detected with light microscopy and the observation that the space constant for intercellular current flow in bladder strips is consistent with their presence has led to controversy concerning the putative presence and role of the intercellular pathway in modulating the contractility of the electrically excitable detrusor myocytes. To more directly address this issue, double whole cell patch recordings (DWCR), in conjunction with Northern and Western blot techniques were used to evaluate connexin43 (Cx43) expression and to characterize gap junction channel properties in human bladder smooth muscle cells. Northern and Western blots revealed the presence of Cx43 mRNA and protein, respectively, in cultured myocytes from human bladder, and Western blots confirmed the presence of Cx43 protein in situ as well. Consistent with the molecular observations, human bladder cell pairs were well coupled with average junctional conductances of 6.5 ± 4.6 picosiemens (pS) (ranging from 0 to 15 pS; n = 37). Macroscopic gap junction channel currents exhibited moderate voltage dependence, and the normalized Gj–Vj relation was both symmetrical on Vj polarity and, furthermore, well described by a 2-state Boltzmann relation (Gmin ≈0.33, V0 = 63.6 mV, Z = 0.117 or equal to 2.95 gating charges), indicative of a bilateral voltage-gated mechanism. The measured single channel slope conductance was 120 pS for the fully open channel and 26 pS for the substate state. Consistent with previous observations in other human smooth muscle cell types, the dwell time of the subconductance state was too small (≈10%) to be physiologically relevant to the macroscopic conductance. These data represent the first direct observation of gap junction channel activity in human bladder cell pairs. Moreover, in light of the known biophysical properties of Cx43-derived gap junction channels, these data clearly indicate that the absence of structural correlates of intercellular communication at the light microscopic level does not preclude an important role for gap junctions in the initiation, maintenance, and modulation of detrusor tone in the bladder.