Anita Mannikarottu

Ischemic Etiology of Incontinence in Women: A Theory and A Review

Incontinence in women is a major health problem. In a recent study, incontinence affects more than 10 million Americans, 85% of whom are women. Incontinence can result in an extremely altered life style, and is the main reason that women are admitted to nursing homes. Care for the incontinent patient represents an enormous expense nationally. The emphasis of this review is on the relevance of estrogen-dependent ischemia to urethral smooth muscle tone and tonic � -adrenergic tension in the maintenance of continence in women. Additionally, the role of ischemia in bladder dysfunc- tion will be explored. In general, the relative contribution of smooth muscle tension is greater in females than in males. It is clear from both animal and human data that during bladder filling there is a progressive increase in sympathetic stimula- tion of the urethra resulting in increased � -adrenergic tension.

1264: Estrogen Induces Angiogenesis Growth into Smooth Muscle Cells of Female Rabbit Bladder

Postmenopausal bladder dysfunction has been speculated to be partly due to the influence of estrogen. Estrogen is essential for adequate blood flow in the urinary bladder and urethra. Our previous studies have demonstrated that estrogen augmentation in female rabbits induces a “functional hypertrophy” consisting of increased contractile force, increased blood flow, and increased volume-fraction of smooth muscle of the urinary bladder. It is our hypothesis that angiogenesis is promoted by estrogen augmentation, which contributes to the enhanced blood flow to supply the enlarged bladder as well as the hypertrophied smooth muscle cells. The present study is to investigate the effects of ovariectomy and estrogen augmentation on vascularity and angiogenesis.