Increased maternal intraabdominal pressure alters the contractile properties of fetal rabbit bladder.
OBJECTIVE
Increased intraabdominal pressure (IAP) causes impairment of urine flow by compressing the urine-transporting structures and leads to development of various types of anatomical and functional abnormalities in the urinary system. An intrauterine experiment was conducted to determine the relationship between IAP and intraamniotic pressure (IAMNP) and the effects of increased IAMNP on the contractile properties of fetal bladder in the rabbit model.


METHODS
Fourteen time-mated pregnant rabbits were used. A preliminary study (n = 5, 20-day gestation) was performed to determine the relation between IAP and IAMNP. Intraabdominal pressure and IAMNP were recorded through an intraperitoneal catheter and 2 intraamniotic transducers, respectively. Basal IAP and IAMNP were recorded. Then, IAP was increased for 4 cm H(2)O in each subsequent 30-minute period until reaching 20 cm H(2)O. Control (n = 5) and experiment (n = 4) group animals underwent intraperitoneal catheter placement in the 15th day of gestation. Intraabdominal pressure was increased by intraperitoneal air insufflations from 20th day to term in the experiment group. At term, the fetal bladders were excised and the contractile activity was then recorded isometrically. Electrical field stimulation was applied, and contractile responses to carbachol and high potassium (20 mmol/L KCl) were also evaluated.


RESULTS
A strong relationship was found between IAMNP and IAP and defined as IAMNP = IAP x 0.8 + 2.0 (R(2) = 0.816, P = .000). Increased IAP did not change basal rhythmic activity but resulted in frequency-related electrical field stimulation responses being higher contractility responses for frequencies below 10 Hz (P < .05) and similar responses at and above 10 Hz. Bladders imposed to elevated IAP displayed greater sensitivity to carbachol with a shift to the left in the concentration-response curve. High potassium-induced contractions had a shorter rise time (P < .05) but similar contraction amplitudes and half decay times in bladders imposed to increased IAP.


CONCLUSIONS
Intraamniotic pressure is affected by IAP in pregnant rabbits in accordance with an equation (IAMNP = IAP x 0.8 + 2.0). Increased IAMNP changes contractile properties of the fetal rabbit bladder without affecting spontaneous activity and shortens the rise time of high potassium-induced contractions. Increased IAMNP also results in cholinergic hypersensitivity in fetal bladders. These results may explain the mechanism of dysfunctional voiding and abnormal bladder function observed in conditions in which IAP and/or IAMNP are elevated.
Karnak
Ibrahim
I
Hacettepe University Faculty of Medicine, Department of Pediatric Surgery, 06100 Sihhiye, Ankara, Turkey.
Aksöz
Erkan
E
Ekinci
Saniye
S
Onur
Rüştü
R
Tanyel
F Cahit
FC
D000005:Abdomen; D000650:Amnion; D000818:Animals; D005260:Female; D009119:Muscle Contraction / Q000502:physiology*; D011247:Pregnancy; D011312:Pressure; D011817:Rabbits; D001743:Urinary Bladder / Q000196:embryology* / Q000502:physiology*