OBJECTIVES: To demonstrate the existence of a prostate-bladder neural reflex that might help clarify a neurologic mechanism for voiding dysfunction associated with chronic prostatitis/chronic pelvic pain syndrome. METHODS: Experiments were performed on anesthetized adult male Wistar rats. Repeated cystometry was used to study the changes in urinary bladder behavior induced by injecting formalin into the prostate. The pathway of a prostate-bladder reflex was identified by recording the electromyographic (EMG) response of the detrusor to electrical stimulation of the prostate, after saline or lidocaine injections into the prostate, and transection of the prostate nerves. RESULTS: Intraprostatic formalin injection induced significant changes in the parameters of cystometry. Electrical stimulation of the prostate consistently evoked a bladder EMG response. Intraprostatic lidocaine injection increased the delay and reduced the amplitude of this EMG response. The bladder EMG response was not affected by transection of the cervical spinal cord nor by just cutting the sympathetic chain; however, it was suppressed by resection of the sympathetic chain and by transection of the ipsilateral L6-S3 nerve roots. CONCLUSIONS: A prostate-bladder reflex is proposed, and the lumbosacral spinal cord is assumed to be the primary center of the reflex. These findings might help determine the therapeutic approach to voiding dysfunction in patients with chronic prostatitis/chronic pelvic pain syndrome.
OBJECTIVES: To demonstrate the existence of a prostate-bladder neural reflex that might help clarify a neurologic mechanism for voiding dysfunction associated with chronic prostatitis/chronic pelvic pain syndrome. METHODS: Experiments were performed on anesthetized adult male Wistar rats. Repeated cystometry was used to study the changes in urinary bladder behavior induced by injecting formalin into the prostate. The pathway of a prostate-bladder reflex was identified by recording the electromyographic (EMG) response of the detrusor to electrical stimulation of the prostate, after saline or lidocaine injections into the prostate, and transection of the prostate nerves. RESULTS: Intraprostatic formalin injection induced significant changes in the parameters of cystometry. Electrical stimulation of the prostate consistently evoked a bladder EMG response. Intraprostatic lidocaine injection increased the delay and reduced the amplitude of this EMG response. The bladder EMG response was not affected by transection of the cervical spinal cord nor by just cutting the sympathetic chain; however, it was suppressed by resection of the sympathetic chain and by transection of the ipsilateral L6-S3 nerve roots. CONCLUSIONS: A prostate-bladder reflex is proposed, and the lumbosacral spinal cord is assumed to be the primary center of the reflex. These findings might help determine the therapeutic approach to voiding dysfunction in patients with chronic prostatitis/chronic pelvic pain syndrome.