The impact of menopause on the function of lower urinary tract-from animal and clinical studies

• Main Authors: Cheng-Yu Long, 龍震宇
• Other Authors: Eing-Mei Tsei
• Format: Others
• Language: zh-TW
• Published: 2009
• Online Access: http://ndltd.ncl.edu.tw/handle/06139363765761249100

博士 === 高雄醫學大學 === 醫學研究所 === 97 === The female genital and lower urinary tracts share a common embryologic origin, arising from the urogenital sinus. The effects of the climacteric on female reproductive organ are similar to those on urinary tract. This is supported by the fact that estrogen deficiency occurring following the menopause is known to cause atrophic changes within the urogenital tract and is associated with urinary symptoms such as frequency, urgency, nocturia, incontinence and recurrent infection. These may also co-exist with symptoms of vaginal atrophy such as dyspareunia, itching, burning and dryness. In clinical investigation, we previously evaluated the changes in urinary and sexual symptoms and introital Doppler velocimetry of lower urinary tract following 3 months of estrogen therapy (ET) in postmenopausal women with prior hysterectomy. The results of our study suggests that ET alone, by oral or vaginal route, could increase the blood flow of urogenital tract and improve some domains of sexual function and the symptoms of lower urinary tract in postmenopausal women. Thus, estrogen appears to have a direct effect on the function of lower urinary tract. Because of the difficulty in obtaining tissues from human, we designed a rodent model to evaluate the effect of hormone deficiency and/or birth trauma on muscarinic receptors of the bladder. In addition, changes in the gene and protein expression of neuronal nitric oxide synthase (nNOS) and estrogen receptor β (ER β) of the urethra were also assessed. Our data suggest that estrogen depletion without birth trauma may not contribute to a significant change in the gene and protein expression of detrusor muscarinic receptors. However, ovariectomy following birth trauma may synergistically impact the function of lower urinary tract, this being possibly through modification of the gene and protein expression of muscarinic receptors from M2 toward M3. Further studies of other receptors in this animal model may shed more light upon this issue.