Urethral supersensitivity and occult urethral neuropathy.

The phenomenon of postural increases in urethral tone in patients with neuropathic bladder dysfunction has been investigated and, using the technique of simulated alterations in posture, a humoral response of urethral smooth muscle has been demonstrated. Serial measurements of circulating catecholamines have shown that a close correlation exists between the contraction of urethral smooth muscle and the variations in circulating catecholamines brought about as part of cardiovascular homeostasis. Identical urethral responses have been recorded in a group of neurologically intact patients who have urethral outflow obstruction, and it is speculated that these patients may have an occult urethral neuropathy.