α1-adrenoceptors and bladder function

Objective: To discuss the role of alpha-adrenoceptors (alpha-ARs) in the control of lower urinary tract function with special emphasis on their importance in the pathologically changed bladder. Methods: Evaluation of published information. Results: The functional role of the alpha-ARs in the normal detrusor muscle has not been established. Changes in the function of these alpha-ARs may occur in e.g., bladder outflow obstruction, bladder overactivity, and 'neurogenic' bladders. The filling (irritative) symptoms in patients with benign prostatic hyperplasia and outflow obstruction, which are relieved by alpha-AR antagonist treatment, have been associated with bladder dysfunction produced by the obstruction;There is evidence for involvement of alpha-ARs in the spinal control of both the sympathetic, somatic (filling) and parasympathetic (voiding) efferent activity to the lower urinary tract. The beneficial effects of alpha-AR antagonists on filling symptoms, which can be obtained even in the absence of outflow obstruction, give support: for the involvement of extravesical, possibly spinal, alpha-ARs in their pathogenesis. Conclusions: A more complete understanding of the role of alpha-ARs in the control of the normal or functionally changed bladder should be helpful in the development of drugs for treatment of lower urinary tract disorders.