| Co-Investigator(Kenkyū-buntansha) |
SUGAYA Kimio Akita Univ.,Dept. of Urology, Assistant Prof., 医学部, 助手 (20179120)
SUZUKI Takashi Akita Univ.,Dept. of Urology, Assistant Prof., 医学部, 助手 (70179224)
NOTO Hiromitsu Akita Univ.,Dept. of Urology, Assistant Prof., 医学部, 助手 (60164711)
NISHIZAWA Osamu Akita Univ., Dept. of Urology, Assistant Prof., 医学部, 講師 (60091815)
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| Research Abstract |
Decerebrate dogs were used to investigate the brainstem control of the micturition. Electrical stimulation (ES)(0.2msec, 50Hz, 10-50muA) in the Locus coeruleus alpha (LCalpha) evoked micturition, i.e. contraction of the urinary bladder and relaxation of the internal as well as the external urethral sphincter. ES in the Locus subcoeruleus (LSC) and the Nucleus pontis oralis (PoO) during micturition resulted in an inhibition of the bladder activity and an excitation of the external urethral sphincter. While ES in the LCalpha decreased bladder capacity, ES in the LSC and PoO increased bladder capacity. These results indicates that pontine micturition center (PMC) is located in the LCalpha and the pontine urine storage center (PUSC ) is located in the area of the LSC and the PoO. Microinjection of the drugs into the LCalpha,LSC and PoO modulated the micturition reflex. GABA in the LCalpha increased the bladder capacity while GABA in the LSC and the PoO decreased the bladder capacity. Enkep
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haline in the LCalpha and the LSC inhibited micturition, but Enkephaline in the PoO had no effect on the micturition reflex. Neuroanatomical studies using the HRP demonstrated that intimate connections between the PMC and the PUSC. HRP studies also showed that the PUSC sends and receives the fibers to and from the intermediolateral nucleus and Onuf's nucleus in the sacral spinal cord as well as the various sites of the brain.
Correlation between the location of the brain lesions and the vesicourethral function were examined in the patients with cerebrovascular disease. CT and MRI were used to examine the brain lesions. Simultaneous recording of the cystometry and the external urethral sphincter EMG were performed to evaluate the vesicourethral function. Following results were obtained, (1) lesions in the frontal lobe,putamen, and thalamus resulted in a hyperactive bladder (67%,67%,60%,respectively),(2)55% of the patients with lesions in the frontal lobe had a hyperactive bladder with an incompetent urethra, (3) 60% of the patients with putaminal lesion had a normal urethral function,(4) 3 of 3 patients with bilateral lesions in the dorsolateral pontine tegmentum showed an underactive bladder.
Not only basic but clinical studies indicate that the dorsolateral pontine tegmentum has an important role to regulate the micturition reflex. Less
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