Comparative effects of intravesical versus extravesical administration of ZD6169 and cromakalim on the response of the in vitro rat whole bladder to field stimulation

Potassium channel openers are currently being evaluated for their inhibitory effect on hyperreflexia. Increasing potassium permeability results in a hyperpolarization of the smooth muscle membrane and a reduction in calcium entry. This stabilizes the membrane and should result in the reduction of spontaneous contractile activity. Potassium channel agonists have been shown to be effective in the reduction of hyperreflexia secondary to outlet obstruction in rats, and certainly have been shown to reduce the contractile responses of isolated tissues to a number of different agonists. In addition, intravesical administration of potassium channel openers have been shown to be effective against hyperreflexia (in rabbits) using intravesical administration, although relatively high concentrations had to be employed. Using an in vitro whole bladder model (rat), our current study compares the potency and efficacy of intravesical versus extravesical administration of two potassium channel openers for the inhibition of field-stimulated contraction. The results demonstrate that(1) the extracellular administration of ZD6169 and cromakalim were equally effective inhibitors of the contractile response to field stimulation, (2) low frequency stimulation was inhibited to a significantly greater degree than high frequency stimulation, (3) intravesical administration of ZD6169 was equally effective at inhibiting the response to low frequency field stimulation when compared to extravesical administration, (4) intravesical administration was less effective than extravesical administration at high frequency stimulation (although the inhibition was still statistically significant), and (5) intravesical administration of cromakalim did not inhibit field stimulation.